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3 things to know about the 2027 IPPS proposed rule

By Brian Murphy The 2027 IPPS proposed rule is out… here’s 3 things I found interesting. (There are more than 3 things in it… but…

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A must watch: New CMS video signals new metric for Medicare Advantage

By Jason Jobes The 2027 Medicare Advantage final rate notice is out—and the buzz is everywhere. Let me just say I rarely pause to watch…

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The Downgrade Era: How Payers Are Changing the Game with (My) Richelle Marting

Listen to the podcast here. Payers are constantly shifting tactics to find new and creative ways to do their favorite thing: Not pay claims. And if…

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Grassley Report of UnitedHealth Group takes aim at these 20 diagnoses: Here’s why

By Brian Murphy   The Grassley Report examining the risk adjustment practices of UnitedHealth Group (UHG) is much more than just a one-time media splash….

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Medicare Advantage plans: Should healthcare organizations care about payer audits, fines? Hint: Yes

You are a CDI Director at a large integrated healthcare system, with oversight of staff working in acute care hospitals and clinics. You have patients…

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