In mid-November 2018, the CMS, under the direction of the Trump administration, proposed highly anticipated modifications to managed care regulations that were put in place back in 2016. These modifications would grant states more flexibility in determining network adequacy standards…
As the payer market in Georgia has consolidated through mergers/acquisitions; one of their key goals was increased efficiencies that they could leverage through size. Unfortunately, their provider partners have seen the exact opposite: consolidation has taken significant power out of…
In the age where Buzzfeed listicles dominate and memes have replaced words, it’s difficult to figure out how to create blog content that will keep a reader engaged past the title. The good news? We have some tips on how…
When recruiting for a job, companies look for many things before they even pick up the phone to call you for an interview. Most people think that when you, the potential job candidate, submit a resume online, it gets screened…
Medicare Advantage (MA) plans have continued in popularity with over 22 million enrollees for 2019 according to CMS, an increase of over 32% since 2015. While beneficial, is still a confusing product for most. As a result, most on Medicare…
Everyone has a friend/colleague that we like to discuss things with such as work or other colleagues in the workplace. We like to discuss the good, bad, and ugly of our workplace stresses, frustrations, and annoyances with our friend/colleague…does this…
As 2018 came to a close, the Centers for Medicare & Medicaid Services (CMS) released substantial adjustments to the Medicare Shared Savings Program (MSSP), most of which are arguably the most impactful since its inception. “Medicare can no longer afford…
Health plans, Centers for Medicare and Medicaid Services (CMS), and national news are touting the ongoing move from straight fee-for-service healthcare into fee-for-value healthcare. Upon initial glance, fee-for-value models absolutely provide new revenue streams for healthcare providers. However, when considering…
With 82% of hospitals and 64% of Merit-Based Incentive Payment System (MIPS) Eligible Clinicians using EHR technology supported by Fast Healthcare Interoperability Resources (FHIR®), it might be time for patients, providers, and health systems to finally expect complete and centralized…
Between 2013 and 2017, nearly twice as many rural hospitals (64) closed their doors than the previous 5-year period; predominately located in the south, according to a recent publication by the U.S. Government Accountability Office. Through shrinking commercial reimbursement rates,…