The CMS will choose participants next year for the Ambulatory Specialty Model, which will start in 2027 and involve specialists who treat patients with heart failure or low back pain in ambulatory settings. David Pittman, founder of Pittman Policy Strategies and a former National Association of ACOs executive, says that the model introduces two-sided risk and requires participants to track performance on quality measures, report patient-reported outcomes and collaborate with primary care practices.

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Retrospective chart reviews by Medicare Advantage insurers led to additional diagnosis codes for 17% of subscribers that were not reflected in other medical records, according to a Kaiser Family Foundation analysis. Chart reviews resulted in the removal of diagnosis codes for only 1% of subscribers, researchers found. Chart review practices vary significantly among insurers and have drawn scrutiny from the Justice Department, which is pursuing legal action against some insurers for allegedly using chart reviews to inflate risk scores.

At least three large health insurance companies are not in full compliance with the Transparency in Coverage regulations, according to a study in the American Journal of Managed Care. Researchers found significant gaps in reporting in-network rates, out-of-network rates and prescription drug prices.

More than 350,000 mobile health apps are in use today, and many fall outside traditional privacy protections. Learn how to evaluate them confidently in AHIMA's latest on-demand webinar, Navigating Mobile Health Apps Safely: Your Complete Guide. Earn 1 CEU while exploring privacy risks, legal protections, and the patient-provider connection in digital health. You can also read about 5 tips to protect yourself and keep your health data safe in a new article in the Journal of AHIMA.

The Department of Veterans Affairs is implementing a "cyber dominance" strategy to enhance protection of veterans' data, moving from a compliance-based to a risk-based approach to cybersecurity, says VA acting CIO Eddie Pool. The strategy includes zero trust architecture and network microsegmentation. Pool says the VA aims to be a leader in cybersecurity within the federal government. "We do have some great things coming down the pipe in terms of how we're going to modernize this across the board," Pool said.

Spare Tire has raised $3 million from ShelterZoom in a Series A financing round to expand its EHR backup service. The service provides access to essential data during system outages, ensuring continuity of care and billing.