The Centers for Medicare & Medicaid Services (CMS) has unveiled a proposed physician payment rule aimed at significantly reducing wasteful spending while enhancing quality measures for Medicare beneficiaries. This initiative emphasizes improved chronic disease management and marks a pivotal shift towards value-based care in the healthcare landscape.
On July 1, the U.S. Senate passed a sweeping tax and spending bill with far-reaching consequences for the healthcare industry. With $930 billion in cuts targeting Medicaid and ACA programs, and 11.8 million coverage losses projected, payers and providers face potential disruptions to reimbursement, compliance, and value-based care operations.
In June 2025, the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) announced a new industry-wide initiative to streamline prior authorization processes. Led by HHS Secretary Robert F. Kennedy, Jr. and CMS Administrator Dr. Mehmet Oz, the roundtable brought together executives from major payers to formalize a set of voluntary commitments aimed at improving access to care and reducing administrative burden.
The effort is intended to advance value-based care goals by promoting interoperability, increasing process transparency, and reducing avoidable delays that contribute to inefficiencies and unnecessary costs across the healthcare continuum.
On June 9, 2025, HHS removed all members of the CDC’s vaccine advisory committee (ACIP), citing the need to restore public trust and eliminate conflicts of interest. Learn what this change could mean for healthcare payers, providers, and immunization policy in the U.S.
Federal agencies have amplified efforts to enforce healthcare price transparency, introducing stringent guidelines and escalating penalties to ensure compliance. These regulatory updates affect hospitals, insurers, and employers nationwide and demand immediate attention and action to remain compliant.
The FDA has approved the first at-home cervical cancer screening kit, the Teal Wand™, offering a self-administered alternative to Pap smears.
OpenAI has introduced HealthBench, a groundbreaking benchmark designed to assess the performance and safety of AI systems in healthcare settings.
Health Policy in 2025: Key Updates Impacting Payers and Administrators At A Glance A series of pivotal health policy shifts in early 2025 are reshaping
The FDA has approved Google’s Pixel Watch 3 for loss-of-pulse detection, marking a major step in wearable health tech.
On February 25, 2025, the Trump administration announced an Executive Order focused on enhancing price transparency in healthcare, a critical step toward empowering patients with clear and actionable pricing information. This initiative is expected to foster competition among providers and payers, ultimately aiming to reduce healthcare costs and improve patient access to care.
