To understand this dynamic, you need to know who the customer is. One of the key questions arising from looking at financial statements is this: how do we “get to the bottom line” in healthcare? In our society and culture, we have a fascination with the term “net income,” but it may have little meaning […]
As expected, the COVID-19 PHE (Public Health Emergency) was extended for the 11th time, on October 13th, 2022, another 90-days, which will extend many of the CARES Act 1135 Waivers through January 11th, 2023. This extension confuses many healthcare professionals because in a 60-Minutes news interview, President Joe Biden, stated, that the “pandemic is over.” […]
Most physicians spend their sleepless nights worrying about malpractice lawsuits but not medical board complaints. However, a complaint to a medical board is a considerable challenge posing as much risk to a physician’s career as a malpractice case. Such a complaint often can be very trying and potentially damaging to one’s reputation. Some of the […]
Five priorities are identified in the mission of CMS Office of Minority Health, “Working to Achieve Health Equity.” The Centers for Medicare & Medicaid Services (CMS) has five key priority areas that are expected to drive how the agency will, within a span of 10 years, accomplish its stated goal to achieve health equity. Priority […]
The home- and community-based services quality measure set also aims to advance health equity and reduce health disparities for older adults and people with disabilities. CMS has released a quality measure set for home- and community-based services (HCBS), aiming to promote consistent quality measurement and data collection in the Medicaid HCBS program and improve health […]
To excel in value-based care, providers must lean on strategies for managing population health and skillful risk stratification. Amid the COVID-19 pandemic, organizations observed the ramifications of fee-for-service, leading to communication and revenue challenges for both providers and patients. While value-based care is not a novel idea, the pandemic greatly accelerated the adoption of this […]
Being a physician comes with certain baseline stressors. For most, the culprits are pretty familiar: patient care responsibilities, high debt loads that compel long working hours, system complexities, and mounting administrative chores. COVID-19 has added yet another layer to the burdens that already contribute to physician burnout. As an emergency physician, walking into work every […]
CMS set the reimbursement rate for Medicare Administrative Contractors covering the main type of coronavirus antibody test at approximately $42, per an update Tuesday. That rate exceeds investment firm William Blair’s $25 estimate for the category of tests, boding well for future reimbursement policy for antigen testing, analysts noted. Last month, the agency doubled its reimbursement for high-throughput molecular […]
As with last week, RACmonitor asked Dr. Ronald Hirsch, vice president of R1 RCM, to summarize the most pertinent regulatory changes recently arising. The following is a transcript of his reporting today on Monitor Mondays. “First, thank you, everyone, for continuing to care for patients and continuing to take this pandemic seriously,” Dr. Ronald Hirsch […]
The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would update Medicare Advantage plan (MA, or Part C) and the Medicare prescription drug benefit (Part D) program. In years past, CMS has also issued a “call letter,” not subject to the regulatory process, to provide additional information for plans to use […]










