Latest Industry News

Doctors Increasingly See AI Scribes in a Positive Light. But Hiccups Persist.

When Jeannine Urban went in for a checkup in November, she had her doctor’s full attention.

Instead of typing on her computer keyboard during the exam, Urban’s primary care physician at the Penn Internal Medicine practice in Media, Pennsylvania, had an ambient artificial intelligence scribe take notes. At the end of the 30-minute visit, Urban’s doctor showed her the AI summary of the appointment, neatly organized into sections for her medical history, the physical exam findings, and an assessment and treatment plan for her rheumatoid arthritis and hot flashes, among other details.

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In-office clinics are an emerging health and wellness benefit trend

Leaders are realizing that traditional solutions aren’t enough to combat rising healthcare costs, meaning they’ll need to explore more creative approaches to improve outcomes.

Annual wellness programs — including health risk assessments, online wellness portals, self-guided educational content and on-demand health and lifestyle content — cost organizations between $150 to $1,200 per employee per year, according to data from medical clinic Avion Health. But if those programs aren’t leading to improved health outcomes and reduced spending, leaders should be exploring more innovative solutions to drive engagement and outcomes.

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Trump signs $1.2T spending package that funds HHS, enacts PBM reforms, telehealth and hospital-at-home measures

President Donald Trump on Tuesday afternoon signed a massive funding package that ends a brief government shutdown and provides full-year funding for the federal government through the end of the year.

The House voted earlier in the day to pass the package by a vote of 217-214.

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MEDICARE

Proposed ACA regulations are a win for brokers, consumers

Proposed federal regulations to crack down on fraud and misrepresentation in the Affordable Care Act marketplace will be published Wednesday.

The Centers for Medicare & Medicaid Services said the proposed regulations will strengthen program oversight and integrity, promote competition, and reduce unnecessary costs in the federal and state-based health insurance exchanges.

The proposed regulations would crack down on fraud and misleading practices by agents and brokers, restore accountability for taxpayer-funded subsidies, and remove federal barriers that have limited plan innovation and driven up premiums.

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CMS proposes sweeping ACA exchange rule

The CMS said the regulation should remove barriers to more affordable health plans, like catastrophic coverage, as enrollment on the exchanges falls.

The CMS proposed a sweeping rule Monday making a number of changes to Affordable Care Act plans, including expanding the availability of catastrophic coverage.

The proposal would allow more enrollees to choose catastrophic plans — which have low monthly premiums but high deductibles — for longer terms.

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CMS plans to roll back limits on nonstandard ACA plan options

The Trump administration is aiming to roll back limits on the plan designs insurers can offer on the Affordable Care Act’s (ACA’s) exchanges.

Under the Biden administration, the Centers for Medicare & Medicaid Services (CMS) implemented regulations that limited insurers to two nonstandard plan designs per metal level on the ACA marketplaces, with the goal of simplifying the shopping experience for consumers.

In the proposed Notice of Benefit and Payment Parameters for the 2027 plan year, released Feb. 9, the CMS said it intends to discontinue those limits as well as requirements that plans offer standardized options on the exchanges. To ease potential disruption, the agency said it will allow payers to choose whether to keep the standardized plan options they currently offer, per a fact sheet.

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ICYMI (In Case You Missed It)


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February’s Read • Listen • Watch (RLW)

PINNACLE TPA

Pinnacle TPA
The Pinnacle Advantage in a Volatile Sales Market
Kyle Gerdts brings a decade of third-party administration experience to his role as Vice President of Sales and Account Management at Pinnacle Claims Management Inc. He combines operational expertise in claims, member engagement, and cost containment with a strong broker-centric focus emphasizing service, transparency, and long-term partnerships.
Article Experience Options: Click here to Listen or Click here to Watch the full interview

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DRIVING REFERRALS

Driving Referrals
Referral Momentum Drives Book Value
For California health and life brokers, organic growth and exit value hinge on a deliberate referral and introduction strategy grounded in client advocacy. Bill Cates explains why trusted introductions accelerate growth and increase the long-term value of your book.
Article Experience Options: Click here to Listen or Click here to Watch the full interview

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CROSS SELLING

Cohesive Path to More Revenue with Annuities
Many seasoned brokers look for ways to convert commission-driven careers into reliable retirement income. Peter Buechler shares how annuities can transform accumulated assets and client relationships into guaranteed income streams.
Article Experience Options: Click here to Listen or Click here to Watch the full interview
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COMMISSION PLANNING

Smart Exit Strategies for Health Brokers

Estate planning attorney Daniel Wexler shares insights on minimizing taxes, protecting assets, and structuring succession plans that help brokers keep more of what they earn while preparing for long-term exit strategies.
Article Experience Options: Click here to Listen or Click here to Watch the full interview
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