Key Takeaways on How 340B Works The federal 340B Program is a drug price control program. It lets qualifying facilities purchase outpatient drugs at 20 to 50% below the average manufacturer price. In this article, we answer “how does 340B work?,” who qualifies, and what 340B participation can mean for your rural healthcare facility and […]
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Key Takeaways on the Value-Based Care Mode Many healthcare providers are paid based on the volume of services they deliver, such as the number of tests or procedures. The fee-for-service (FFS) vs value-based care model can result in overtreatment, poorer care, and higher costs.1 How a Value-Based Care Model Works A value-based care (VBC) model,
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Key Takeaways on a Revenue Cycle Dashboard Healthcare revenue cycle management (RCM) is no small task. Constantly changing requirements, regulations, and complex processes make it laborious and error prone. But you have to make revenue cycle management second only to patient care to survive. In this article, we share why a healthcare revenue cycle dashboard
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Key Takeaways on Clinically Integrated Networks A clinically integrated network, or CIN, is a structured alliance of hospitals, clinics, and/or providers. Members work together around shared quality outcomes, coordinated care, and collective payer strategy. For independent and rural healthcare organizations, a CIN offers a way to improve performance. It also helps reduce unneeded cost variations,
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Key Takeaways on What Is a Critical Access Hospital A critical access hospital, or CAH, is a small rural hospital that meets federal criteria to receive cost-based reimbursement from Medicare. These hospitals keep emergency and essential inpatient services available in communities too small to support a full acute-care facility. They provide 24×7 emergency care, short-stay
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Key Takeaways on CMS Final Rule 2026 The Centers for Medicare & Medicaid Services (CMS) announced its CMS final rule 2026 policy changes for the Medicare Physician Fee Schedule (PFS) on October 31, 2025.1 Actual changes go into effect on or after January 1, 2026. Other recent regulatory changes are also finalized. Changes that will
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Key Takeaways: What Are RVUs in Healthcare RVUs stands for Relative Value Units. RVUs in healthcare are non-monetary units used to quantify the value of medical services. RVUs reflect the relative amount of work, practice expense, and malpractice risk used to deliver different procedures or services. Each service or procedure provided is assigned an RVU
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Key Takeaways to Maximize RHC Reimbursements In 2023, hospitals absorbed $130 billion in Medicare and Medicaid underpayments — a roughly 14% annual increase over 2019.1 And underpayments are one reason providers can benefit from knowing how to maximize reimbursements for rural health clinics (RHCs). Why? Because a higher portion of RHC payments come from public sources compared
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Key Takeaways for the G2211 Procedure Code Last updated December 9, 2025 Procedure code G2211 is a Medicare-specific billing code used as an add-on to codes for standard office, home, or telehealth outpatient and management (E/M) visits. It recognizes the complexity providers face in managing complex conditions and ongoing care needs. In this article, I
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Last updated November 2025 Providers forced to jump through hoops to get prior authorizations for patients know the pain of waiting. But, according to AHIP, prior authorizations ensure a patient gets safe, timely, evidence-based care that’s both affordable and efficient. To help providers ensure patients get that, try the tips in this prior authorization cheat
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