Tag: Payment

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….
Healthcare Private Equity Oversight Is Tightening

Assisted Living

Private Equity Oversight Is Tightening

Healthcare private equity oversight is changing deal risk, board governance, and accountability for providers, investors, and policymakers alike nationwide….
Managed Care Contracting Is Now a Margin Test

Health Policy and Economics

Managed Care Contracting Is a Margin Test

Managed care contracting now determines far more than a rate sheet. For post-acute and senior living leaders, it is a test of margin, access, and control….
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…

Health Policy and Economics

The Future of Healthcare Reimbursement Models

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…

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…

Health Policy and Economics

Why Rural Health Transformation Matters

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…

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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.