Skilled Nursing Facility

Nurses and clinicians talking in a hallway

Aug 01 | Jeff Lagasse

CMS updates SNF payments in new rule

There will be a net increase of 4.2%, or approximately $1.4 billion, in Medicare Part A payments to SNFs next year.

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Irvine, California buildings and palm trees

Jun 19 | Susan Morse

CalOptima invests $526.2 million to raise reimbursement rates for Medicaid providers

The increase counteracts some of the financial uncertainty caused by the California state budget deficit,…

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Apr 26 | Susan Morse

HIMSSCast: The need for home care continues

The Acute Hospital Care at Home waiver is set to expire this year unless Congress acts.

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Apr 02 | Susan Morse

CMS finalizes 3.7% payment increase for Medicare Advantage plans

The policies put pressure on benefits and premiums as insurers are already facing regulatory changes and higher utilization,…

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Mar 29 | Susan Morse

Proposed rule gives skilled nursing facilities a 4.1% increase

CMS wants to expand its ability to impose financial penalties for health and safety deficiencies.

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Executive and two health professionals at a meeting

Mar 26 | Jeff Lagasse

Private payers deny 15% of claims, survey finds

An average of 3.2% of all claims denied include those that are preapproved via the prior authorization process.

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Mar 25 | Susan Morse

Cybersecurity bill would add caveat to provider payments

Sen. Mark Warner's legislation would require providers and their vendors to meet minimum cybersecurity standards to qualify.

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Feb 02 | Jeff Lagasse

Medicare Advantage profitability on the decline, Moody's finds

A significant spike in utilization is putting cost pressure on insurers, which will likely affect earnings.

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The lawsuit accuses Humana of cutting payments prematurely for rehabilitative care based on its AI model’s ‘highly inaccurate’ recovery predictions.

Dec 19, 2023 | Jeff Lagasse

Humana sued for allegedly using AI for Medicare Advantage denials

The lawsuit accuses Humana of cutting payments prematurely for rehabilitative care based on its AI model's "highly…

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Nov 15, 2023 | Susan Morse

Nursing homes are required to disclose more ownership information in final rule

The largest 10 nursing home chains own more than 10% of facilities, a share that raises market concentration…

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Improving the Patient Financial Experience Throughout the Patient Journey While many healthcare providers believe that improving the patient financial experience is a critical step for their organization, few have done so successfully. Read this brief to learn strategies that increase patient ...

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