TrustMed Solutions LLC

02/27/2026

IRFs get a 2.6% Medicare payment bump for FY 2026

Good news for inpatient rehab: Medicare IRF PPS rates will rise 2.6% in FY 2026 (3.3% market basket minus 0.7% productivity). CMS also finalized technical updates (wage index, case-mix weights) and adjusted the outlier threshold to maintain 3% of total payments. Centers for Medicare & Medicaid Services (CMS).

Why it matters:

-Modest relief for IRFs facing wage inflation and staffing pressure

-Small but positive step for access and sustainability

-Still short of fully offsetting cost growth—watch margins

Source: https://www.healthcarefinancenews.com/news/inpatient-rehab-facilities-get-26-payment-increase

CMS is finalizing its proposal to remove four SDOH standardized patient assessment data elements to reduce burden.

02/06/2026

MGMA warns: 2026 Medicare PFS could deepen the access crunch

The Medical Group Management Association is sounding the alarm on the proposed 2026 Medicare Physician Fee Schedule—arguing years of cuts and small fixes are pushing independent practices to the brink and risking patient access, especially in rural/underserved areas. Even with modest 2026 updates, MGMA says practices still won’t be made whole after prior reductions.

Why it matters for small practices:

- Continuing margin pressure → more consolidation

- Harder to keep doors open for Medicare patients

-Rising overhead with flat (or lower) rates

👉 What reforms would actually stabilize access—indexing updates to practice costs? Multi-year payment floor? Site-neutral parity?

Full Article here: https://healthexec.com/topics/healthcare-management/healthcare-policy/mgma-raises-alarm-over-2026-medicare-physician-fee-schedule-warns-access-crisis

Many make federal reimbursement plans into an issue about high-paid specialists complaining about pay cuts, but these fees also compensate nurses, technicians, support staff and administrators. Payment keeps the doors of brick-and-mortar medical practices open, MGMA warns.

01/30/2026

Big news for rural care: CMS launches a $50B transformation program

CMS has rolled out the Rural Health Transformation (RHT) Program—a $50 billion investment over five years (FY26–FY30) to strengthen access, workforce, tech, and value-based models in rural communities. States receive annual awards (split evenly + needs-based) and will drive local projects that modernize care delivery.

Why it matters for providers

*Funding starts in 2026 with $10B/year, supporting primary care redesign, digital tools, telehealth/remote monitoring, and operational upgrades.

*All 50 states pursued participation; initial awards were announced late 2025, with state-level implementations kicking off now.

At TrustMed Solutions, we help rural and community practices navigate funding opportunities, align workflows, and keep revenue predictable through change.

Question: If your state receives RHT dollars, what’s your first priority—workforce, tech, or care model redesign?

Full Article here: https://www.cms.gov/newsroom/press-releases/cms-launches-landmark-50-billion-rural-health-transformation-program

New Federal Program Aims to Transform Rural Health Care Nationwide

01/21/2026

Medicare 2026: Positive CF Updates—But Mind the Site-of-Service Shift

CMS finalized positive conversion factor updates for 2026: +3.77% for APM QPs and +3.26% for non-QPs. At the same time, an “efficiency” adjustment and practice expense changes shift dollars away from facility settings (~-7%) and toward non-facility/office care (~+4%). Telehealth, MIPS/MVPs, and other policy tweaks also made the cut. Practices should model the net impact—not just the headline CF bump.

At TrustMed Solutions, we help practices translate these rules into clean workflows, accurate coding, and predictable cash flow.

What’s your 2026 strategy—shift site-of-service, optimize coding mix, or lean into APMs?

Read full PDF rule here:https://www.ama-assn.org/system/files/2026-mpfs-final-rule-summary-analysis.pdf

01/09/2026

$1T is shifting to digital-first, AI-driven care by 2035 — are you ready?

PwC projects that by 2035, $1 trillion/year will move away from brick-and-mortar, admin-heavy models toward virtual, in-home, AI-enabled care. For practices, that means new winners in access, efficiency, and patient loyalty.

What providers can do now

🌟 Digitize front-door ops: online intake, triage, eligibility, scheduling → fewer no-shows & faster collections.

🌟Automate the back office: prior auth, coding edits, denial prevention, and ERA posting to curb leakage.

🌟Measure what matters: access (wait times), quality, cost-to-collect, and patient effort scores.

🌟Build at-home pathways: remote monitoring + virtual follow-ups for chronic care and post-op.

At TrustMed Solutions, we help practices translate this shift into clean claims, faster cash, and a better patient experience.

Read full article here: https://www.fiercehealthcare.com/health-tech/2035-1t-healthcare-spend-will-shift-digital-first-ai-driven-healthcare-system-pwc

Growing demand for care and a rapidly aging population could drive U.S. | The healthcare industry is on the brink of a monumental shift where artificial-intelligence-driven, consumer-centric approaches could lead to simplified care models that lower costs and increase care quality, according to PwC....

12/04/2025

H-1B Update: Possible Exemption for Physicians

Reports indicate physicians (including residents) may be exempt from the new $100,000 H-1B visa fee—a carve-out aimed at protecting the U.S. healthcare workforce amid ongoing clinician shortages. If finalized, this could help hospitals and practices maintain access to talent, especially in underserved areas.

Why it matters for practices:

-Staffing stability: Easier recruitment of hard-to-fill roles
-Continuity of care: Less disruption in access for patients
-Planning clarity: Better forecasting for hiring and onboarding

We’ll keep watching this closely and share operational guidance if the exemption is formally adopted.

Read full article here: https://economictimes.indiatimes.com/nri/work/doctors-may-be-exempt-from-100000-h-1b-visa-fee-report/articleshow/124052403.cms?from=mdr

The Trump administration's new H-1B visa policy, which introduces a $100,000 fee, might offer exemptions for certain professionals. A White House spokesperson indicated that physicians and medical residents could potentially be excluded from this fee. This development has raised concerns among medic...

11/13/2025

Medicare Advantage: Member Experience is the New Differentiator

Too many MA members enroll, then struggle to use their benefits—leading to missed care, churn, and lower Star Ratings. Plans that move from reactive service to proactive navigation (real-time provider matching, outreach for screenings, care coordination) build confidence, cut avoidable costs, and improve retention.

What we’re watching:

*Proactive engagement → higher Star Ratings & loyalty
*Coordinated scheduling & in-network guidance → fewer costly missteps
*Targeted support for at-risk groups → better equity & outcomes
*Predictive/AI tools → anticipate needs before issues escalate

If you manage MA lives, member navigation isn’t a nice-to-have—it’s a growth and quality lever. Full piece here. https://quantum-health.com/blog/member-experience-in-medicare-advantage/

Millions of Medicare Advantage members enroll in plans with valuable benefits, yet too many struggle to use them effectively.

10/20/2025

Medicare Reimbursement Update

The Senate introduced the Medicare Patient Access and Practice Stabilization Act of 2025 (S.1640), which would reverse the 2.83% physician pay cut from January and add a 2% increase through December.

It’s a welcome breather—but remember, Medicare physician payments are down ~33% since 2001 (inflation-adjusted). Long-term reform is still needed to keep practices sustainable.

At TrustMed Solutions, we help providers navigate reimbursement changes so they can focus on patient care.

👉 What do you think—is a 2% bump enough, or does Medicare need a bigger overhaul?

Read more: https://www.healthcarefinancenews.com/news/senate-bill-would-give-physicians-2-medicare-pay-increase

The American Medical Association on Wednesday said it strongly supports the Medicare Patient Access and Practice Stabilization Act of 2025 that would temporarily reverse the 2.83% payment cut to physicians.

10/01/2025

⚖️ Medicare Reimbursement: Striving for Fairness

Did you know hospitals and independent practices often get paid very differently for the same services? A new House bill aims to change that by creating more parity in Medicare payments.

👉 Why this matters:
💵 Independent providers could gain stronger financial stability
🏥 Patients may see better access to local care
⚖️ A more balanced and fair system overall

At TrustMed Solutions, we know reimbursement policy directly impacts practice sustainability — and ultimately, patient care. We’ll be watching this closely.

What do you think: Should independent providers be reimbursed at the same rates as hospitals?

🔗 Read more: https://healthexec.com/topics/healthcare-management/healthcare-policy/house-bill-aims-bring-parity-medicare-reimbursement

The Prompt and Fair Pay Act would require Medicare Advantage insurers to reimburse providers at traditional Medicare rates, effectively closing the payment gap between public and private plans.

09/10/2025

⏳ Prior Authorizations: Slowing Down Care & Adding Stress

If you’re a provider, you already know the struggle… prior authorizations (PAs) mean:

-More paperwork 📑

-Longer wait times for patients ⏱️

-Higher risk of denials if every detail isn’t perfect ❌

While PAs are supposed to ensure “medical necessity,” the reality often creates frustration for both providers and patients.

At TrustMed Solutions, we’ve seen how the right workflows make a huge difference:

✔️ Verify requirements upfront
✔️ Track authorizations closely
✔️ Stay in communication with payers

When managed proactively, prior authorizations don’t have to derail patient care — or your revenue.

👉 Want to learn more? Check out the full article here: https://www.myndshft.com/the-ultimate-guide-to-prior-authorization/ -is-prior-authorization

The Myndshft Ultimate Guide to Prior Authorization helps demystify PA and to quickly answer some of the most frequent questions.

09/03/2025

🚨 Out-of-Network Billing Doesn’t Have to Be Stressful 🚨

Submitting OON claims can feel overwhelming, but with the right steps, you can maximize reimbursement and avoid delays:

✅ Verify benefits early
✅ Use superbills or submit claims directly
✅ Check benchmark reimbursement tools (CMS, FAIR Health, etc.)
✅ Request exceptions when appropriate
✅ Watch for balance billing protections

At TrustMed Solutions, we help providers streamline OON billing so they can focus on patients—not paperwork.

💬 Want support with out-of-network claims? Let’s connect!

🔗 Read the full article: https://www.medisysdata.com/blog/how-to-get-out-of-network-claims-paid/

Learn strategies to ensure out-of-network claims are successfully processed and paid by insurance providers. Maximize reimbursements today.

08/21/2025

💡 Medicare vs. Medicaid — What’s the Difference? 🏥

Healthcare can be confusing, especially when it comes to insurance programs. Two that often get mixed up are Medicare and Medicaid:

👉 Medicare – For people 65+ or with certain disabilities, regardless of income.

👉 Medicaid – For individuals & families with limited income, offering broader coverage in many states.

Knowing the difference helps patients avoid billing surprises — and helps providers make sure claims are filed correctly.

At TrustMed Solutions, we guide healthcare providers through the maze of insurance billing so they can focus on patient care while we handle the paperwork.

📖 Read the full article here: https://www.investopedia.com/articles/pf/07/medicare-vs-medicaid.asp

Medicare provides health coverage for older adults, while Medicaid covers health costs for people with low incomes. Learn more about Medicare vs. Medicaid.