On December 10, 2024, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule introducing significant policy and technical changes to the Medicare Advantage (MA) Program, Medicare Prescription Drug Benefit Program (Part D), Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly (PACE) for Contract Year 2026.
Recent AI legislation suggests an increase in regulations on the horizon, particularly concerning high-risk applications like healthcare. Is your organization prepared to comply?
Part 1 of 2 Analyze recent data on AI hallucination in healthcare, exploring its occurrence, implications, and strategies to mitigate associated risks.
An analysis of recent data on AI hallucination in healthcare, exploring its occurrence, implications, and strategies to mitigate associated risks.
Explore why hospital admissions spike during the holidays and what healthcare providers can do to manage the surge. From delayed care to seasonal illnesses and mental health challenges, this article dives into the data and offers actionable tips to improve outcomes and ease the strain on healthcare systems during the busiest time of year.
With the election of a new president who is signaling significant interest in overhauling healthcare policies, the stakes are high for providers, payers, and policymakers.
What lessons can be drawn from the past, and what predictions can we make about the road ahead?
The landscape of data-driven management in healthcare has transformed in ways that were both anticipated and unforeseen. Revisiting the predictions from that article provides a unique opportunity to evaluate what has changed, where expectations aligned with reality, and what new challenges have emerged.
An exploration of evidence based strategies and policy implications that may reduce hospital readmission rates. Readmission rates, defined by the frequency with which patients return to the hospital within 30 days of discharge, are influenced by multiple factors ranging from socio-demographic attributes to the quality of post-discharge care.
The rising costs of healthcare make finding new, effective strategies critical for hospitals, insurance payers, and other healthcare organizations. Efforts for reducing healthcare costs not only aim to control expenses but also improve patient care quality.
A well-structured medical review program helps healthcare payers and providers reduce payment errors, ensure compliance, and improve patient outcomes. By leveraging data analysis, targeted reviews, and corrective actions, medical review programs create a framework for efficient, high-quality care.
BHM is a high-quality partner with over 20 years of experience and credentialed by URAC, NCQA, and HITRUST.
