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McKinsey: Healthcare Profit Pools to Reach $819B by 2027

HIT Consultant

Let’s delve into the projected trajectory of different healthcare players in the coming years: Healthcare Profit Pools Healthcare profit pools will grow at a 7% CAGR, from $583B in 2022 to $819B in 2027. This shift fuels a 5% CAGR for payer profit pools, reaching $78 billion by 2027.

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2024 Brings Expansion to Medicaid in New York State

Healthcare Law Blog

CMS approved $500 million in infrastructure spending for NYS to establish social care networks (“ SCNs ”) to provide HRSN screening and referral services to Medicaid beneficiaries that are targeted populations for HRSN services. Medicaid Hospital Global Budget Initiative CMS authorized up to $2.2

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Long Awaited Approval of the 1115 Waiver Amendment for NYS Medicaid – Just in Time for the New York State Executive Budget State Fiscal Year (SFY) 2025

Health Care Law Brief

While still subject to legislative approval, the Executive Budget incorporates the recently approved amendment (“Waiver Amendment”) to New York’s Medicaid Section 1115 Demonstration that includes $7.5 billion in Medicaid investments over the next three years. Services will be delivered via a two-tiered system.

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CMS Issues E-Prescribing Final Rule: Quick Takeaways in a No-Slowing-Down Reg Cycle – Regulatory Talk Series

Healthcare IT Today

The Centers for Medicare & Medicaid Services (CMS) finalized new standards for electronic prescribing on June 13, concluding a complicated, 18-month regulatory process that came in fits and starts and went by without attracting much industry scrutiny. Date required : January 1, 2027 Key takeaway : Budget extra time for implementation.

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CMS Begins Option to Extend Medicaid Postpartum Coverage

Healthcare Law Blog

On April 1, 2022 , the Centers for Medicare & Medicaid Services (“CMS”) announced states may seek to extend Medicaid postpartum coverage from 60 days to one year through a new state plan option offered by the American Rescue Plan Act (“ARPA”). This option is available for five years and ends on March 31, 2027.

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CMS Imposes New Requirements on Payers to Improve Prior Authorization Process and Payer, Patient and Provider Communications

Hall Render

The improved information requirements apply to the following payers, including: Medicare Advantage plans; Medicaid and Children’s Health Insurance Program (“CHIP”) managed care plans; State Medicaid and CHIP fee-for-service payers; and Qualified Health Plans only in the Federally Facilitated Exchanges.

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Create Health Ventures Launches $21M Fund to Invest in Digital Health Startups

HIT Consultant

The firm’s investment thesis is supported by the significant growth in the payer market, with projected revenues reaching $75B by 2027. – Advocatia : Simplifies the financial assistance experience and helps more patients enroll in Medicaid and other programs such as nutrition assistance and home energy assistance.