Wednesday, July 29, 2026 - Updated Daily
Wednesday, July 29, 2026 - Updated Daily
Medicare post-acute care (PAC) reimbursement is increasingly driven by stricter federal spending controls, closer Medicare Advantage (MA) utilization oversight, and limited rate increases. Current policy priorities center on value-based accountability, shifts to lower-intensity care settings,…
A review of Medicare Advantage prior authorization starts with an operational reality: a clinically appropriate service can be delayed, redirected, or denied before the provider ever has an opportunity to deliver it. For hospitals, skilled…
The report that CMS is withholding $1B in Medicaid payments from California and Minnesota is not merely another Washington-versus-state-capital political skirmish. It is a reminder that Medicaid is financed through a conditional partnership, and federal…
A hospital can fill beds, a skilled nursing facility can maintain census, and a physician group can increase visits while the broader system still produces avoidable cost and uneven outcomes. That is the central tension…
CMS is launching a streamlined review process for higher-performing nursing homes and making them easier for consumers to find on Medicare.gov. A new Quality, Safety, & Oversight memo outlines the risk-based survey process, which helps…
Rural providers are being asked to preserve access with urban-level expectations and far thinner margins. That is the core tension any rural health transformation program must confront. For hospitals, post-acute operators, clinics, and community-based organizations…
A life plan community can look stable from the outside – full campus, strong reputation, long wait list history, predictable monthly fees. Then interest rates move, labor costs stay elevated, refund obligations come due, and…
For years, and littered throughout this site, are pieces (and presentations) I have done on compliance. Some goodies are below. https://rhislop3.com/2023/09/07/five-quality-and-compliance-tips/ https://rhislop3.com/2018/11/16/the-real-impacts-of-poor-quality-inadequate-compliance-and-weak-risk-management/ https://rhislop3.com/2018/11/29/follow-up-real-impacts-of-poor-quality-and-lax-compliance/ https://rhislop3.com/2019/06/14/the-connection-between-quality-and-revenue/ The one major implication of solid (or not) compliance is the…
Earlier this year, in January, I wrote a piece on the start of site-neutral payments via a CMS final rule tied to the Outpatient PPS (OPPS). This post is a follow-up of sorts to the…
Budget math is about to collide with operating reality. When executives ask about the top healthcare policy risks 2026, they are not asking for a Washington headline recap. They are asking which policy moves could…
Healthcare executive, consultant, and author covering post-acute care, senior living, and the economics behind both - for 30+ years.
No noise - just what changed in healthcare policy and economics, and why it matters to your operation.