When legislation like OBBBA really starts to change the health care landscape, the practical implications matter. From tighter state budgets to the need for digital tools and provider engagement — the Q&A with Stellar Health's CEO Michael Meng and Sachs Policy Group's CEO Jeffrey Sachs unpacks it all. We’ll continue to closely monitor and track the policy as it develops, helping stakeholders understand its impact.

The Human Metric Healthcare is drowning in data but starving for meaning. We have endless dashboards, yet still miss what matters. If managed care wants to claim value, it has to measure more than cost and compliance. Real value is found in human stability, trust, and belonging — the outcomes that keep people well, not just treated. Until those metrics drive the system, we’ll keep rewarding efficiency instead of human health. #Healthcare #Medicaid #SystemChange #Leadership #HealthEquity

Looking ahead to the new year, group health plans should prepare for upcoming federal updates and compliance requirements. Employee Benefits & Executive Compensation attorneys Linda Lemel Hoseman and Aaron Weiss outline key changes employers need to anticipate, including updates to the privacy rule, telehealth provisions, DCAP and HSA adjustments, preventive care and cost-sharing limits, as well as parity requirements and compliance filings. For further information on these changes, read the full alert here: https://lnkd.in/g2CEuJzJ #GroupHealthPlans #Updates #Requirements #EBEC

The numbers don’t lie: 💰 Family premiums hit $26,993 (+6% YoY) outpacing wages ⏰ ACA subsidies expire Dec 31, millions face sticker shock ⚖️ CMS cuts hit specialties while AI labs launch in NYC & St. Louis 🌾 Rural docs fade under $100K H-1B visa fees This week’s Trendline Health dives into: ✅ Medicare’s specialty cuts & telehealth wins ✅ Anthem’s OON provider penalties ✅ 340B rebate pilot backlash ✅ UHS & Tenet’s outpatient growth bets ✅ Mount Sinai + WashU’s new AI hubs ✅ KFF’s full 2025 benefits deep dive 🔗👉 Link to the full edition in the comments below👇👇 What path will healthcare take in 2026 — cost containment or AI-powered access? #Healthcare #HealthPolicy #AIinHealthcare #Medicare #ACA #DigitalHealth

On Day 20 of the U.S. government shutdown, the impact on healthcare is becoming undeniable. It's not just about funding delays; we're seeing vital patient care pathways abruptly shut down. Since October 1st, two significant Medicare innovations have lapsed: Telehealth Flexibilities: Expired Acute Hospital Care at Home (AHCAH): Expired What this means: ➡️ Reduced Telehealth Access: For most Medicare patients (outside mental health), virtual visits from home are no longer covered. Access is now largely restricted to rural patients physically present at a medical facility, creating significant barriers for many, including the elderly and those with mobility challenges. ➡️ Increased Hospital Strain: With the AHCAH waiver gone, hospitals are transferring patients back from home care programs, adding pressure just as flu season ramps up. Providers are caught in the middle, facing uncertainty about reimbursement and needing to inform patients about potential out-of-pocket costs for previously covered virtual services. Key therapists (PTs, OTs, Audiologists) are also sidelined from providing Medicare telehealth. Why did this happen? These programs became collateral damage in the larger shutdown stalemate, which is centered on extending expiring ACA premium tax credits – a separate issue threatening coverage affordability for 24 million Americans. It's concerning to see healthcare innovation rolled back due to policy deadlines rather than clinical need. Patients and providers deserve more stability. How is your organization navigating these sudden changes? #Healthcare #HealthPolicy #Medicare #Telehealth #DigitalHealth #GovernmentShutdown #ACA #HospitalatHome #HealthTech

𝗖𝗠𝗦 𝗚𝗶𝘃𝗲𝘀 𝘁𝗵𝗲 𝗚𝗿𝗲𝗲𝗻 𝗟𝗶𝗴𝗵𝘁: 𝗖𝗹𝗮𝗶𝗺𝘀 𝗛𝗼𝗹𝗱 𝗟𝗶𝗳𝘁𝗲𝗱 𝗳𝗼𝗿 𝗦𝗲𝗹𝗲𝗰𝘁 𝗠𝗲𝗱𝗶𝗰𝗮𝗿𝗲 𝗦𝗲𝗿𝘃𝗶𝗰𝗲𝘀! CMS has directed all Medicare Administrative Contractors (MACs) to 𝗹𝗶𝗳𝘁 𝘁𝗵𝗲 𝗰𝗹𝗮𝗶𝗺𝘀 𝗵𝗼𝗹𝗱 and begin processing claims dated 𝗢𝗰𝘁𝗼𝗯𝗲𝗿 𝟭, 𝟮𝟬𝟮𝟱, 𝗮𝗻𝗱 𝗹𝗮𝘁𝗲𝗿 for certain services impacted by recent legislative changes under the 𝘍𝘶𝘭𝘭-𝘠𝘦𝘢𝘳 𝘊𝘰𝘯𝘵𝘪𝘯𝘶𝘪𝘯𝘨 𝘈𝘱𝘱𝘳𝘰𝘱𝘳𝘪𝘢𝘵𝘪𝘰𝘯𝘴 𝘢𝘯𝘥 𝘌𝘹𝘵𝘦𝘯𝘴𝘪𝘰𝘯𝘴 𝘈𝘤𝘵, 2025 (𝘗𝘶𝘣. 𝘓. 119-4).   This applies to: • Medicare Physician Fee Schedule (MPFS) claims • Ground ambulance transport claims • Federally Qualified Health Center (FQHC) claims • Telehealth claims for 𝗯𝗲𝗵𝗮𝘃𝗶𝗼𝗿𝗮𝗹 𝗮𝗻𝗱 𝗺𝗲𝗻𝘁𝗮𝗹 𝗵𝗲𝗮𝗹𝘁𝗵 𝘀𝗲𝗿𝘃𝗶𝗰𝗲𝘀   Providers should also note that several 𝘁𝗲𝗹𝗲𝗵𝗲𝗮𝗹𝘁𝗵 𝗳𝗹𝗲𝘅𝗶𝗯𝗶𝗹𝗶𝘁𝗶𝗲𝘀 that were extended during the Public Health Emergency have 𝗲𝘅𝗽𝗶𝗿𝗲𝗱 as of October 1, 2025.   At 𝗣𝗵𝘆𝘀𝗶𝗰𝗶𝗮𝗻𝘀 𝗥𝗲𝘃𝗲𝗻𝘂𝗲 𝗚𝗿𝗼𝘂𝗽, 𝗜𝗻𝗰. we’re actively monitoring 𝗖𝗠𝗦 𝘂𝗽𝗱𝗮𝘁𝗲𝘀 to ensure providers remain informed and compliant with these regulatory changes.    More details: https://lnkd.in/dWGCNTWF   #PRG #HealthcareUpdates #Medicare #Telehealth #MedicalBilling #RCM #HealthcareCompliance #PhysicianSupport

🚨 60,000+ North Carolina patients. UNC Health and Cigna couldn’t reach an agreement, and now I’ve become one of the statistics. But I’m not just a patient. I’m an RCM strategist with 23 years of experience, and what’s happening here affects every provider watching this. Here’s what practices need to know 👉 https://lnkd.in/gkU2Ytch ✔️ Timeline for patients to find new providers ✔️ Out-of-network billing + continuity risks ✔️ Revenue impact for in-network and exiting practices 📣 This week only: I’m offering complimentary strategy calls for affected providers. Drop “interested” in the comments or DM me directly. #UNCHealth #Cigna #Healthcareproviders #RevQuestLLC #HealthInsuranceCrisis #RevenueCycleManagement #Downcoding   #HealthcareLeadership #RCMStrategy #PayerContracting #PracticeManagement  #PatientAccess #HealthcareFinance

Every day a provider waits for enrollment is a day of lost revenue. Delays between credentialing and enrollment can cost health systems millions in lost revenue and denials, yet it’s rarely tracked, owned, or optimized.   In our latest blog, we cover: ✅ How slow payer approvals and manual tracking bleed $2M–$5M annually ✅ What high-performing orgs do differently to cut cycles from 120 to 30 days ✅ The 5-step playbook to fix your enrollment pipeline   Read the full blog and start recovering revenue you didn’t know you were losing.   ➡️ https://lnkd.in/gW7c8dBi   #ProviderLifecycle #HealthcareRevenue #AtlasSystems #PRIMEbyAtlasSystems

🚨 Big CMS Update: Claims Hold Lifted! 🚨 CMS has directed all Medicare Administrative Contractors (MACs) to lift the claims hold for services with dates of service October 1, 2025, and later — including the Medicare Physician Fee Schedule, ground ambulance transport, FQHC, and behavioral/mental health Telehealth claims. ⚠️ Claims for other Telehealth services and Hospital Care at Home will remain on hold for now. As of October 1, many temporary telehealth flexibilities have expired, meaning some services are no longer payable by Medicare without new Congressional action. 📄 Learn more: ABN guidance: https://lnkd.in/gS4Ry7CE Telehealth coverage: https://lnkd.in/ee75Z6mv ACO telehealth info: https://lnkd.in/g6Q5Y8KR #MedicareUpdate #Telehealth #HealthcareNews

💬 Medicare’s telehealth changes are quietly reshaping how we schedule care — sometimes in ways that delay it. Why do we keep scheduling based on what’s available instead of what’s needed? A patient with a potential cancer diagnosis was recently scheduled for a face-to-face visit two months out — not because there wasn’t capacity, but because of Medicare’s current limits on reimbursable virtual visits. Even though we had open virtual visit (VV) slots, Medicare patients can’t be scheduled into them under the new billing rules. So they end up waiting for the next “available” F2F slot — sometimes weeks or months away. This isn’t just a scheduling glitch. It’s a system-level misalignment between policy, templates, and patient needs. As Medicare continues to redefine telehealth post-pandemic, many clinics are navigating this same challenge — balancing compliance with urgency. Here’s what we can do better: ✅ Schedule based on clinical urgency, not calendar gaps. ✅ Recode and rebalance F2F/VV templates as policies evolve. ✅ Build escalation pathways for high-risk referrals (like suspected malignancies). ✅ Track “delay reasons” to advocate for smarter access models. Because no patient facing a possible cancer diagnosis should wait months for their first visit — especially when open slots exist. #HealthcareLeadership #Medicare #NurseNavigation #LungCancerScreening #PatientAccess #ProcessImprovement #ClosingTheLoop #EarlyDetection