Tuesday, October 13, 2026 - Updated Daily
Tuesday, October 13, 2026 - Updated Daily
Medicare Advantage vs traditional Medicare is no longer a beneficiary-choice discussion alone. It is a market-structure issue affecting referral patterns, hospital utilization, post-acute length of stay, network access, risk-bearing arrangements, and the financial viability of…
For years, healthcare operators have heard the same directive: move from volume to value. The future of healthcare reimbursement models, however, will not be settled by a slogan or a single CMS demonstration. It will…
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 practical question is not whether value-based care affects operators. It already does. The more consequential question is whether an organization recognizes the change early enough to redesign how it manages referrals, clinical performance, workforce…
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…
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…
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…
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.