Off the Chart

Revenue cycle consultant Taya Gordon explains what practice administrators and billing teams should do this week to prepare for Medicare's final 2027 fee schedule, from the same-day visit cut to the switch from G2211 to modifier B1.

Pear Suite CEO Colby Takeda explains how practices can partner with community health workers to help patients keep Medicaid coverage as work requirements take effect Jan. 1.

Two Mayo Clinic preventive cardiologists share how practices can make home blood pressure data, simple patient goals and short visits work for heart disease prevention.

Four health policy experts preview the proposed 2027 Medicare physician fee schedule and what the same-day visit cut, prior authorization and alternative payment models mean for practices.

A six-month downcoding check, the one number to benchmark next year and what staff turnover costs a practice were among the takeaways from MGMA's centennial conference in San Antonio.

Sandra Johnson of CliniComp explains why cost has become the biggest barrier to interoperability and why practices should tell their IT teams where fragmented data slows down care.

Dina Taylor of HireVue explains how practice managers can use AI to screen a flood of job applicants and how the interview changes when they already know the candidate.

MGMA Acting CEO Akash Madiah explains where practices leak revenue, why staff retention pays off and two habits administrators can start on Monday.

Kate Atchley, Ph.D., of the Haslam College of Business at the University of Tennessee, Knoxville, explains how organizations can develop leaders before promoting them into the role, and the five skills she sees as essential for leading a health care organization.

Family physician Kenneth Qiu, M.D., explains the compliance, staffing and cybersecurity demands that come with growing a direct primary care practice, and why he thinks many stall around five physicians.

Patient Prism co-founder and CEO Amol Nirgudkar explains how practices can use AI voice agents to cover overflow and after-hours calls, and which calls still need front desk staff.

Minc Law partner Michael Pelagalli explains what a practice should do the moment a fake review appears, from documenting and flagging it to deciding when to call a lawyer.

D2 Solutions President and CEO Dean Erhardt explains how practices can catch the administrative errors behind most prior authorization rejections and why staff training on AI can start with a couple of classes a year.

Sage Growth Partners CEO Dan D'Orazio explains what capitation and value-based contracts demand of an organization and why physician-led groups are where he sees the most promise.

Buzz Health President Joseph Kleiman explains why price checks still fall to staff after the visit and what it would take to put drug pricing inside the EHR.

Anders Gilberg of MGMA walks practice leaders through the same-day payment proposal, the practice expense overhaul and the mandatory specialty model that starts Jan. 1 with no participant list.

Rebecca Schoon, Ph.D., who helped lead the Oregon arm of a national moral injury report, explains how visit quotas, noncompete clauses and prior authorization feed the distress costing practices their physicians.

A tool that costs little to run can be billed many times over, and Caroline Pearson of the Peterson Health Technology Institute says that math is what makes clinical AI lucrative now and precarious under the next payment model.

Health care economist Wayne Winegarden, Ph.D., says state bans on corporate ownership won't keep a practice independent, and that control over decision-making is what separates an MSO partnership from an acquisition.

Most practices have no protocol for the hour after a medical error, and Anthony Orsini, D.O., says that gap is what turns a minor mistake into a lost patient and sometimes a claim.

A former MedPAC commissioner argues that whether clinicians feel like professionals or like interchangeable parts decides the quality of everything a measurement program cannot see.

Flat malpractice premiums are masking a severity trend running well ahead of inflation, and the cushion holding rates down is running out.

The rules on who can own a hospital are shaping consolidation in local markets, and the evidence behind them hasn't held up.

Vaccine inventory is getting more expensive, the counseling time around it is not reimbursed, and the practices that stop stocking lose more than the margin.

The insurer pledge on prior authorization carried no enforcement. The federal rule arriving Jan. 1, 2027 does, and it lands on payers, on EHR vendors and, through a new attestation measure, on practices themselves.

Denials that surface a week late, a hybrid revenue cycle split across internal staff and outside vendors, and payer contracts multiplying faster than anyone can track them. Veradigm's Aaron Ledbetter breaks down which of those an administrator can fix with better tooling and which still need payer reform.

Jay Bregman of Andel explains how employers are carving high-cost drugs out of the pharmacy benefit, and what happens to a patient's price when the contribution stops.

Shawntea Gordon of Atlas & Perpetua Healthcare Consulting says a cost cut made without benchmarking data is a guess, and the wrong guess costs more than it saves.