Today, the Supreme Court released their decision regarding a hospital lawsuit against the Department of Health and Human Services (DHHS). Several hospitals had joined together to sue DHHS regarding a previous rule change in the calculation of disproportionate share hospital…
The Centers for Medicaid and Medicare Services (CMS) released yet another voluntary payment model intended on restructuring financial reimbursement for primary care services. At face value, Primary Care First furthers many of the underlying concepts utilized in CPC+ by generally…
Healthcare operations continue to stride forward in new directions; Forbes published an article this week detailing how BCBSGA, UHC and Aetna are running pilot programs where they are directly employing providers that circumnavigate the existing healthcare delivery systems. From the…
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…