Provider Operations & Efficiency
Expert articles and analysis related to provider operations & efficiency.
AI Summary — Last 24 Hours
CMS has released the FY 2027 Inpatient Rehabilitation Facility PPS proposed rule, prompting stakeholder concerns that payment updates may not keep pace with actual hospital costs, intensifying pressures on provider operations and sustainability in value-based environments. Meanwhile, new multipayer primary care payment reform initiatives are being piloted in California’s Medi-Cal program, aiming to unify administration and network access—moves that could serve as national models for simplifying operations and aligning incentives across payers. These developments signal both immediate financial headwinds and potential structural changes for ACOs and population health-driven organizations. HFMA summary of the FY 2027 IRF PPS proposed rule | Medi-Cal Bold Idea — Multipayer Primary Care Payment Reform Model
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Prior authorization by the numbers: 10 stats that show the strain
A 2024 CMS rule now requires payers, including Medicare Advantage plans, Medicaid, CHIP and ACA exchange carriers, to publicly report prior authorization metrics for the first time. The public report...
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How patient portal message volume drives physician burnout
A patient sends a portal message at 9:17 p.m. on a Tuesday. “Hey, I’ve been having some chest tightness when I climb stairs. It comes and goes. Also can you refill my metformin and check if my last A1...
Proposed CMS rule would set prior auth deadlines for drugs
Proposed CMS rule would set prior auth deadlines for drugs  Fierce Healthcare
The second victim label ignores patient safety reality
Ask any clinician about the drive home after a case goes bad and the patient outcome is tragic. It is a specific kind of heavy silence. We have all had the experience. You do not forget it. You replay...
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