On August 17, 2020, the Centers for Medicare & Medicaid Services (CMS) issued a new policy to clarify that a 20% Medicare add on payment for services provided to beneficiaries with presumed or diagnosed coronavirus disease 2019 (COVID-19) can only be paid if the beneficiary had a positive COVID-19 test. The goal of this new guidance is to combat fraudulent add-on payment claims.

The details were presented in “New COVID-19 Policies For Inpatient Prospective Payment System (IPPS) Hospitals, Long-Term Care Hospitals (LTCHs), & Inpatient Rehabilitation Facilities (IRFs) Due To Provisions Of The CARES Act.” Providers . . .

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Strategy & Strategic Planning

Strategic planning is an essential business process for health and human service provider organizations. A strategic plan provides clarity and transparency from the board on performance expectations and priorities and serves as the overall foundation for organizational infrastructure development and operating plans. However, strategy is only one factor of the overall strategic planning process. Rather, strategy and strategic planning require a scenario-based, tactical, and detailed implementation and execution plan with the right management team and performance metrics to ensure the organization is progressing toward its strategic initiatives. Amid changing reimbursement models, consumerism, and other market disruptors, a strategic plan that is both market-focused and nimble is key for sustainability in an uncertain future.


Adults with a usual source of primary care were more likely to receive preventive screenings and less likely to experience acute care utilization, according to an analysis published by the Milbank Memorial Fund. Data from the 2016–2022 Medical Expenditure Panel Survey (MEPS) showed that adults with a primary care physician (PCP) had substantially higher rates of preventive services. For cardiovascular risk factors, 95.5% of adults with a PCP had their blood pressure checked, compared to… Read