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Category: Reimbursement Services

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Swing Bed Utilization: Optimizing for Hospitals

A well-managed swing bed program is essential to a critical access hospital. This program can improve patient outcomes and provide additional reimbursement opportunities creating a “win-win” for the patient and […]

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5 Quality Components for mLTSS

Managed Long Term Services and Supports (mLTSS) refers to the delivery of long-term services and supports through Medicaid managed care programs. mLTSS’s strategy is to expand home and community-based services, […]

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Contract Services: Impact on Wage Index

In the past several years, hospitals have continued to feel the impact of increased utilization of contract nursing and other contract services. Although these services have developed into a major […]

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Period 4 Reporting Now Open: PRF Update

We’re entering the final weeks of Period 4 reporting period that closes on March 31, 2023. Period 4 reporting is required for any organization that received more than $10,000 in […]

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CMS Changes to Hospital Price Transparency

On November 21, 2025, CMS finalized updates to Hospital Price Transparency regulations in the CY 2026 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Final Rule. These […]

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Plan governance committee meeting

Benefit Briefs: Plan Governance Committee Meetings

By Debbie Herbert, CPA, Director at Blue & Co. Have your plan auditors ever asked you for plan governance committee meeting minutes or agendas? There’s a good reason for that. […]

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Outpatient Therapy: Improving Margins and Referral Flow

Outpatient Therapy: Improving Margins and Referral Flow

Hospital outpatient physical and occupational therapy is one of the few levels of care that has not been forced into a capitated environment. For most hospitals, this service is paid […]

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