Tag: CMS

Senior Housing

In-House v. Contract Therapy: Know the Risks

The in-house versus contract therapy decision is usually framed as an operating question — margin, staffing burden, flexibility. It is actually a liability question, and too many SNF operators make the choice without fully pricing…

CMS Staffing Rule Review After the Reversal

Policy and Politics - Federal

CMS Staffing Rule Review Post Reversal

CMS staffing rule review: what its reversal means for senior care quality, reimbursement, workforce policy, and operator strategy for 2026 nationwide….
Top Regulatory Compliance Risks in Healthcare

Home Health

Top Regulatory Compliance Risks in Healthcare

Top regulatory compliance risks are reshaping healthcare strategy. See where senior living and post-acute leaders face the greatest exposure this year….
Hospice Quality Measures Are Now a Strategy Test

Hospice

Hospice Quality Measures and Strategy

Hospice quality measures now shape payment, oversight, referrals, and reputation. Leaders should treat reporting as an operating and governance priority….
ACO REACH Versus MSSP and the Cost of Risk

Health Policy and Economics

ACO REACH vs MSSP and the Cost of Risk

ACO REACH versus MSSP demands a strategic choice on risk, equity, governance, and capital. Here is what healthcare leaders need to assess in 2026….
Medicare Overpayment Demands Are a Strategic Risk

Health Policy and Economics

Medicare Overpayment Demands and Risk

Medicare overpayment demands can expose weak controls, strain cash flow, and invite scrutiny. Providers need a disciplined response before recoupment begins….
CMS Changes to SNF Quality Measure Thresholds

Policy and Politics - Federal

CMS Changes to SNF Quality Measure Thresholds

CMS changes SNF quality measure thresholds can reshape ratings, reimbursement risk, and survey exposure. Operators need to know what will move and why….
Medicare Advantage vs Traditional Medicare

Health Policy and Economics

Medicare Advantage vs Traditional Medicare

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…

How Reimbursement Cuts Affect Margins in Post-Acute Care

Health Policy and Economics

How Reimbursement Cuts Affect Margins

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,…

Health Policy and Economics

Update: Medicare Advantage Prior Authorization

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…

Picture of Reg

Reg

Healthcare executive, consultant, and author covering post-acute care, senior living, and the economics behind both - for 30+ years.

The Weekly Briffing

No noise - just what changed in healthcare policy and economics, and why it matters to your operation.