Policy

Medicare practice expense cuts will hurt patients

Policy

April 25, 2026

Recent federal cuts to how Medicare pays physicians are likely to deliver significant negative consequences to independent medical practices.

The Centers for Medicare and Medicaid Services’ (CMS) final rule for the 2026 Medicare Physician Fee Schedule imposes a dramatic reduction in payment rates for medical services performed in hospital settings by independent clinicians.

The payment reduction fails to account for the true resource costs incurred by independent physician practices, creating an …

Why health care fraud detection requires payment integrity alignment

Tiffiny Black, DM, MPA, MBA

Policy

April 24, 2026

In one health care organization, a provider was reviewed and cleared through routine payment integrity processes. Months later, that same provider became the subject of a fraud investigation, based on patterns that had been present all along. Both reviews were technically correct within their scope. But together, they revealed something more concerning: The system itself was not aligned. Health care organizations invest heavily in payment integrity (PI) and special investigations …

Preparing for Medicaid cuts and the imperial health boomerang

MarkAlain Dery, DO, MPH

Policy

April 24, 2026

I first met Ramon in the aftermath of Hurricane Katrina when I was moonlighting in local ERs and assisting wherever needed. New Orleans has a long-standing historical and economic connection to Honduras, primarily through the banana trade and shipping routes linking Honduran ports to New Orleans. These routes facilitated both commerce and migration between the two. Ramon, whose family has deep roots in both Honduras and New Orleans, arrived here …

Physician-owned hospitals get a narrow CMS opening

Dana Y. Lujan, MBA

Policy

April 21, 2026

You were told physician-owned hospitals were finished. That the 2010 legislation closing them out of Medicare was permanent. That if you wanted to own something, your options were a direct primary care practice, a concierge model, or a slow negotiation with the health system already employing half your colleagues. The hospital. The thing you actually trained to practice in. That was off the table.

It may not be anymore. But the …

Evaluating the credibility of major medical journals today

Laurel A. Coons, PhD

Policy

April 20, 2026

In recent months, a heated debate has emerged about the credibility of major medical journals such as the New England Journal of Medicine, the Journal of the American Medical Association, and The Lancet. Critics, including United States Health and Human Services Secretary Robert F. Kennedy Junior, have argued that these journals are compromised by pharmaceutical industry influence and therefore cannot be trusted. At first glance, the claim may sound extreme. …

How rural health care access impacts maternal mortality

Alyssa Sterner

Policy

April 20, 2026

Rural health clinics (RHCs) are Medicaid-funded community-based interventions that significantly improve maternal health in rural areas by increasing access to care. A study done in Egypt, an extremely rural country, showed that community clinics for rural health provided evidence-based interventions that have drastically lowered complication rates during pregnancy. Complications during pregnancy dropped from 38.1 percent to 15.1 percent, and postpartum complications from 81.7 percent to 7.0 percent. Although these solutions …

The hidden toll of medical debt on patient health and survival

Adam Cunningham

Policy

April 15, 2026

One hundred million Americans carry medical debt. Research published in JAMA Network Open found that medical debt is associated with higher mortality across every leading cause of death, including suicide. A national study in the Journal of Clinical Psychiatry found that people carrying debt burden are more than three times as likely to attempt suicide. Sixteen percent of suicides in this country involve a financial crisis. I do not write …

How health care lobbying distorts the U.S. opioid crisis

Richard A. Lawhern, PhD

Policy

April 12, 2026

KevinMD recently published a paper describing the horrible impacts of health care lobbying in the U.S. This article assesses how effective the lobbyists have been in misdirecting four key legislators on health care-related committees of the U.S. House of Representatives and Senate.

As we will shortly discover, these highly influential lawmakers have parts of their story right. They also have parts desperately wrong, in ways that are destroying American medicine …

How expiring ACA enhanced premium tax credits hurt business

Kelly Berry

Policy

April 10, 2026

I’ve recently been forced to make painful and difficult choices that impact my personal life as well as my small business because this Congress has been unwilling to renew tax credits that used to significantly lower the cost of my health insurance. My husband and I are both self-employed entrepreneurs. We don’t have access to corporate health plans and the substantial cost sharing that employers typically …

Bridging the gap in rural dementia care with technology

Rachel Milke and Roshni Raj

Policy

April 7, 2026

15642, five numbers that have shaped my life. We all have a zip code that we call home, yet some of us can face detrimental health outcomes based on where we live. Dementia does not discriminate by zip code, but the comprehensiveness of care and patient outcomes often do. Rural families face greater barriers to accessing dementia care resources, which deepens inequities between urban and rural health care. Barriers include …

Why physicians must lead the design of artificial intelligence in health care [PODCAST]

The Podcast by KevinMD

Policy

March 31, 2026

Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes!

Family physician, medical device inventor, and health care entrepreneur Tod Stillson discusses the article “AI governance in health care: Why physicians must lead the design.” Tod warns that the greatest threat to …

Medicine and the United Nations Sustainable Development Goals

Olumuyiwa Bamgbade, MD

Policy

March 29, 2026

Many doctors hear “the United Nations Sustainable Development Goals” and assume the subject belongs to diplomats, ministers, and development agencies. It does not. Doctors advance the Sustainable Development Goals every day, often without naming them. The United Nations’ 2030 Agenda includes 17 goals designed as an integrated framework for human well-being, equity, prosperity, sustainability, and partnership. They are meant to work together, not in silos. That matters because health does …

Preventing diabetic lower limb amputation with AI and offloading

Adwait Chafale

Policy

March 27, 2026

Globally, about $1 trillion has been spent on diabetes-related treatment, a 338 percent increase over the last 17 years, according to the International Diabetes Federation. And yet, 3.4 million deaths were related to diabetes in 2024. This shows the massive strain diabetes has placed on health systems worldwide. One of the most common and debilitating complications of diabetes is non-traumatic lower limb amputation. Diabetes …

How Medicare’s MIPS impacts skilled nursing facilities and clinicians

Steve Buslovich, MD

Policy

March 26, 2026

Most skilled nursing facility leaders understand the quality measures that affect their operations. They live with Star ratings and Quality Reporting Program requirements every day. What is less visible is how the clinicians caring for those same residents are evaluated under Medicare’s Merit-based Incentive Payment System (MIPS).

When facilities and clinicians are accountable for the same resident outcomes through different quality programs but lack shared visibility into how those programs are …

The truth about Medicare Advantage funding and costs

Timothy Bulat

Policy

March 26, 2026

For more than two decades, I have worked in health insurance, first at insurers and more recently as a consultant on Medicare policy. I have led large Medicare Advantage analytics and actuarial organizations comprising actuaries and data scientists working to improve care delivery, manage costs, and optimize revenue. Having seen firsthand the sophistication insurers bring both to improving care and to maximizing revenue within the rules, I find today’s MA …

Florida health care legislation 2026: top bills to watch

Del Carter, MD

Policy

March 20, 2026

As Florida’s 2026 state legislative session reaches the halfway point, there are several health care bills up for discussion. While every session seems to have its own theme, common issues repeat themselves year after year. Here are some of the top bills involving health care in the Florida Legislature today.

AI regulation in insurance

Artificial intelligence (AI) and the concern for its regulation continues to be a hot topic. Mandatory Human Reviews …

Violence against health care workers: the silence must end

Carleigh Beriont and June Zanes Garen, RN

Policy

March 19, 2026

I spent decades as a nurse, choosing a profession grounded in care, patience, science, and the belief that showing up for others matters, even on the hardest days.

In 2017, that belief was shattered when I was physically assaulted at work. I survived, but I carry the scars of that day, both visible and unseen.

I have worked hard to heal through therapy, reflection, and learning how to trust my body again. …

Repeating history: the ethics of the new Guinea-Bissau hepatitis B study

Meghan Johnston, MPH

Policy

March 13, 2026

In the late 1990s, a U.S.-funded study randomized HIV-positive pregnant women in Bangkok, Thailand, to either a placebo group or a group treated with a short course of AZT. At the time, AZT was the standard of care in the U.S., and researchers knew the medication protocol worked at reducing mother-to-child HIV transmission by nearly 70 percent. The study looked at whether a shortened protocol could meaningfully reduce …

The dangers of vertical integration in health care

Stephanie Waggel, MD

Policy

March 11, 2026

As a practicing physician who has worked in the health care field in five different countries, I have a pretty solid idea of why health care in the U.S. is so problematic. In the U.S., many entities related to health care are owned by the same companies. This is a concept called vertical integration, where one business controls every stage of the supply chain. To understand this, imagine the car …

The economic shift from fee-for-service to direct primary care

Dana Y. Lujan, MBA

Policy

March 9, 2026

According to the Primary Care Collaborative, primary care accounts for roughly 5 percent of health care spending, yet it influences nearly 90 percent of downstream costs. That statistic is not a compliment. It is a diagnosis. And for a profession that has spent decades accepting influence as a substitute for economic ownership, it is long past time to read it that way. For decades, physicians …

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