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Thought Leadership

When it comes to thought leadership and staying informed, we’ve got you covered. See below for recent articles, webinars, and downloadable resources available.

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Contract Labor Impact on Wage Index

Contract Labor: Impact on Wage Index

Outsourcing is a common practice in all areas of business, including the healthcare sector. Although this is a major expense for a hospital, it can have an effect on the […]

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Medicare Updates and Notices

Medicare Updates and Notices

Beginning July 1, 2019, Medicare will reject hospital outpatient claims if the service location address on the claim does not exactly match the address on record in the Provider-Enrollment, Chain and Ownership […]

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Proposed Changes to the Wage Index

Proposed Changes to the Wage Index

On April 23, 2019, the Centers for Medicare and Medicaid Services (CMS) released the Proposed Rule for the Hospital Inpatient Prospective Payment System (IPPS) for Acute Care Hospitals. The proposed […]

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CMS Proposed Rule for Updates to PDPM, QRP, & VBP for FY 2020

CMS issued proposed rule on April 25, 2019, with updates to the Patient-Driven Payment Model (PDPM), Quality Reporting Program (QRP), and the Value Based Purchasing Program  (VBP) for fiscal year […]

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Swing Beds: Medicare Regulatory and Program Design Changes You Need to Know

Swing Beds: Medicare Regulatory and Program Changes You Need to Know

Swing Bed Groundwork must be in place. CAH and PPS swing bed programs need to understand the reason behind the initiation of swing beds and the reliance on understanding skilled […]

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As of October 1, 2019, CMS will Begin Enforcing Accounting Classification Rule for Crossover Bad Debts

CMS to Begin Enforcing Accounting Classification Rule for Crossover Bad Debts

On April 4, CMS announced that for cost reporting periods beginning on or after October 1, 2019, providers must comply with a “longstanding” rule to claim reimbursement for crossover bad […]

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Five Star and Nursing Home Compare Changes Clarified

Five Star and Nursing Home Compare Changes Clarified

Centers for Medicare & Medicaid Services (CMS) issued a memorandum, about changes to the Five-Star Rating system on Nursing Home Compare that will go into effect in April 2019. CMS […]

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Worksheet S-10 Update

Worksheet S-10 Update

Over the past six months, CMS instructed all MACs to complete audits of the FFY 2015 Medicare Cost Report Worksheet S-10s. Each MAC was required to complete 50 audits (approximately […]

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How Clinical Documentation Improvement Can Increase the Bottom Line

How Clinical Documentation Improvement Can Increase the Bottom Line

As value-based healthcare becomes the norm, strong clinical documentation improvement (CDI) programs are becoming more important than ever. Value-based healthcare is a healthcare delivery model in which providers are paid […]

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CMS Improvements to Nursing Home Compare in April 2019

CMS Improvements to Nursing Home Compare in April 2019

On March 5, CMS announced updates coming in April 2019 to Nursing Home Compare and the Five-Star Quality Rating System. Per CMS, these changes will strengthen the tool for consumers […]

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New Requirements by Anthem for 340B Participants

New Requirements by Anthem for 340B Participants

Attention 340B covered entities participating with Anthem Blue Cross and Blue Shield: Effective April 1, 2019, Anthem requires that a “JG,” “TB,” or another relevant modifier be added to claims […]

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Are you ready for the transition to PDPM?

Are you ready for the transition to PDPM?

In less than nine short months the RUG-IV payment system will be replaced by the Patient-Driven Payment Model (PDPM). Did you know? RUG-IV payment system ends on September 30, 2019. […]

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CMS Releases Revised FFY 2020 Public Use File

CMS Releases Revised FFY 2020 Public Use File

On January 31, 2019, the Centers for Medicare and Medicaid Services (CMS) released the revised Federal Fiscal Year (FFY) 2020 Public Use File (PUF). If your hospital requested any changes […]

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Change to the Indiana Medicaid Home Health Cost Report

Change to the Indiana Medicaid Home Health Cost Report

Effective January 20, 2019, the process for calculating Indiana Medicaid reimbursement rates for home health services has been repealed. In addition, the requirement to file the Indiana Medicaid home health […]

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New Requirements by Humana for 340B Participants

New Requirements by Humana for 340B Participants

Attention 340B covered entities participating with Humana – Managed Care Medicare: Effective January 1, 2019, Humana requires that a “JG,” “TB,” or another relevant modifier be added to claims involving […]

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Webinars

New 340B Rebate Model Pilot Program: What to Know

New 340B Rebate Model Pilot Program: What to Know

The Health Resources and Services Administration (HRSA) has approved a 340B Rebate Model Pilot Program that will significantly change how 340B discounts are accessed for covered entities for certain medications.  […]

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Wage Index Impacts of MAC Reviews - Do you have a plan for challenges?

Wage Index Impacts of MAC Reviews – Do you have a plan for challenges?

With the September 2, 2025, deadline for hospitals to submit revision requests to their Worksheet S-3 wage data for the Federal Fiscal Year (FFY) 2027 Wage Index now passed, and […]

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The Importance of Therapy in a Post-RUG World

Why Therapy Compliance and Documentation Integrity Must Remain Top Priority

Since October of 2019, the Patient Driven Payment Model, or PDPM, has been the payment system for Medicare Part A in Skilled Nursing Facilities. Prior to this, payment was made […]

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The 1-2-3 of Therapy: Importance of Communication with the Team

The 1-2-3 of Therapy: Importance of Communication with the Team

The Importance of Communication with the Team Medicaid is changing the way it pays for care in most states, but that doesn’t preclude us from treating patients and “providing care […]

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White Paper: SNFs Key Takeaways from the RAI Manual v1.20.1

White Paper: SNFs Key Takeaways from the RAI Manual v1.20.1

Executive Summary The Centers for Medicare & Medicaid Services (CMS) has released the final version of the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) User’s Manual v1.20.1. This […]

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The Value of Conducting Productivity Analysis in Hospitals

The Value of Conducting Productivity Analysis in Hospitals

As financial pressures continue to challenge hospitals and with many uncertainties still looming related to the “One Big Beautiful Bill,” hospitals must act now in looking at operational opportunities. The […]

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