Administrative costs are estimated to make up between 20 and 34 percent of US health care expenditures, roughly 1–4 percent of GDP. Academic and policy discussions generally characterize these costs ...

Prior authorization has been around for a long time. Initially designed in the 1960s as a mechanism to control costs and ensure the appropriate use of medical resources, the goal has (in theory) been ...

The Biden administration released a proposal to streamline Medicare Advantage (MA) and Part D plan prior authorization and add health equity requirements to star ratings. The Centers for Medicare & ...

Medicare Advantage plans say it reduces waste and inappropriate care. Critics say it often restricts coverage unnecessarily. By Paula Span Slowly but steadily, Marlene Nathanson was recovering. She ...

Forbes contributors publish independent expert analyses and insights. Diane Omdahl is a Medicare expert who keeps her readers in the know. On June 27, 2025, the Centers for Medicare and Medicaid ...

A six-state pilot program will target “wasteful care” under Medicare, Centers for Medicare & Medicaid Services says.