Digital quality measurement now has dates attached. In the Calendar Year 2027 Physician Fee Schedule proposed rule, the Centers for…
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Over the past few months, I have sat in on more than a dozen conversations with health plan quality teams about digital quality…
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On July 14, 2026, CMS released the Medicare Shared Savings Program (MSSP) 2027 Proposed Rule as part of the CY2027 Physician Fee Schedule…
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On June 9, 2026, CMS informed Clover Health that its 2026 Medicare Advantage Star Rating was no longer 3.5 stars —…
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The impact of rising claims denials goes far beyond reimbursement delays – it leads to staff rework, billing disputes with…
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For risk adjustment VPs, directors, and managers, the CY 2027 CMS Advance Notice signals lower MA scores, stricter diagnosis-source rules,…
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CMS recently released its Contract Year (CY) 2027 Proposed Rule – a 465-page set of proposed updates that could reshape both Medicare Advantage Star Ratings performance and…
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The U.S. Food and Drug Administration (FDA) recently announced a significant policy shift that reshapes how real-world evidence (RWE) fits…
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CMS released their Proposed Rule, and it signals meaningful change for the Medicare Advantage Star Ratings program. From methodology updates to measure removals and enrollment flexibility,…
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For those who oversee skilled nursing facilities, the Minimum Data Set (MDS) is a regular part of life. For facilities…
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It’s no longer a question of if, but when. In May 2025, the Centers for Medicare & Medicaid Services (CMS)…
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In today’s post-acute care landscape, excellence in care delivery doesn’t come from simply meeting requirements. It comes from anticipating what’s…
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The Centers for Medicare & Medicaid Services (CMS) has finalized updates to the Medicare Advantage (Part C) and Medicare Prescription…
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Many quality professionals are feeling anxious about the transition to digital quality measures (dQMs).
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Big data analytics in healthcare turns raw information into actionable insights — driving smarter decisions, better patient outcomes, and more…
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Patient safety isn’t just a benchmark – it’s a foundational element of quality care. The Patient Safety Structural Measures (PSSM)…
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The Medicare landscape is poised for significant changes with the release of proposed rules from the Centers for Medicare &…
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Are you ready to tackle the challenges of HEDIS® Measurement Year 2024 (MY24)? Whether you are a seasoned expert or…
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Star Ratings for Medicare Advantage (MA) plans affect reimbursement and member retention, so it’s important for plan leaders to understand…
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Since 1996, with the introduction of HIPAA, interoperability has often taken center stage in the healthcare arena. Today, amid new…
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In what can be seen as a huge win for all segments of the healthcare ecosystem, which was two years…
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