By April of last year, seemingly every news station in American was featuring the heroic efforts of physicians, nurses, and other clinicians fighting COVID-19. These providers transformed healthcare, implementing telehealth and virtual care.

For years, providers have been plagued with defending claims for medically necessary services that have been denied due to insufficient documentation and technical reasons. This leads to the Medicare program and commercial...

Understanding how to clinically validate sepsis and differentiate between sepsis and septicemia is not easy, and requires a lot of time and effort. Sepsis is an overwhelming non-homeostatic response of the immune system to...

Skilled nursing facility (SNF) staffing levels across several provider types have fallen since Medicare implemented new payment rules meant to drive value over volume of services, according to a new Health Affairs study.

A new report from the Department of Health and Human Services' Office of the Inspector General uncovered a possible reason: Many hospitals are increasingly billing for inpatient stays at the highest severity level, which is...

For readers of and listeners to RACmonitor and Monitor Mondays, overthinking things is what we do. It’s the only explanation for our hand-wringing over the death of the Medicare inpatient..