Medical necessity has become a common phrase in healthcare terminology, but what exactly does it mean? Unfortunately, this term has become very subjective and is the primary reason we have been denied...
What will it cost you to stay in the post-acute care game?
By
Steven Littlehale
Apr 22, 2015
More than just collecting data, providers need to use standardized, nationally recognized measures. Especially in this era of ACOs and alternative payment models. In the past, many individual providers...
CMS let the cat out of the bag, but it’s managed care that’s ready to pounce
By
Kimberly Marselas
May 05, 2021
If you work with managed care (and who doesn’t anymore), chances are pretty good you’re already on a collision course that’s been accelerated lately
Salaries increase for DONs, administrators
By
James M. Berklan
Sep 01, 2007
Good nursing leaders are a hot commodity – at least if the most recently compiled salary findings are to be believed.
Baseline proficiency for success with managed care payers
By
Susie Mix
Mar 11, 2024
Setting up a building with proficiencies in working with managed care payers is a key to success at this midpoint of the 2020s. Fifty-one percent of Medicare-eligible Americans are covered by Medicare...
Study reminds providers about the tough prospect of putting up or stepping aside
By
James M. Berklan
Jan 20, 2016
My friend Rich admittedly didn’t know much about the group of school kids he was about to oversee. But as a business manager, he told me he had his own favorite method of ironing out disagreements...
Payment reform: Ready! Set! Don’t go! No, I mean go!
By
Steven Littlehale
Apr 23, 2018
Perhaps you think that the new therapy-payment bombshell (RCS-1) has turned out to be a dud. I hope to make the point that it was not.
One quarter of SNFs stuck with Medicare margins below 4%
By
Danielle Brown
Jul 21, 2022
Medicare margins for all freestanding skilled nursing facilities across the United States varied widely in 2020, according to new data from the Medicare Payment Advisory Commission.
Insurgence of leveled contracts
By
Susie Mix
Jul 14, 2023
By now, we’re all pretty familiar with the fact that managed care is altering the post-acute care payor mix with Medicare Advantage plans. This is a byproduct of national policy, intended to offset our...
2022: What will the technical experts say?
By
Renee Kinder
Dec 09, 2021
The new year is upon us. What new areas of regulatory change will your teams monitor in 2022? CPT? Parity? Survey trends? Quality? Yes, obviously quality, Renee, but the future of quality… where...