Audit Readiness (OIG/MAC/UPIC) Why Audit Readiness Matters In today’s healthcare environment, medical practices are under constant scrutiny from federal and commercial payers. Audits by the Office of Inspector General (OIG), Medicare Administrative Contractors (MACs), and Unified Program Integrity Contractors (UPICs) can appear suddenly — often with little...
Chronic Care Management (CCM) Why Chronic Care Management Matters Chronic diseases account for nearly 90% of healthcare spending in the U.S., according to the CDC. Conditions like diabetes, hypertension, COPD, and heart disease require ongoing attention—but many practices struggle to manage these patients outside of office visits. This...
Transitional Care Management (TCM) Why Transitional Care Management Matters Transitional Care Management (TCM) is one of the most critical — and most underutilized — services in modern healthcare. Each time a patient transitions from an acute care hospital stay back to their home or community setting, they...
Remote Physiological Monitoring (RPM) Introduction: Why RPM is No Longer Optional In today’s value-based care environment, providers can no longer afford to manage patients reactively. Chronic disease management is consuming over 90% of the nation’s $4.5 trillion in healthcare costs—and the majority of those costs come from...
Improving Whole-Person Care While Unlocking New Revenue Streams Behavioral Health Integration (BHI) Why Behavioral Health Integration Matters Behavioral health is deeply tied to physical health. Patients with untreated mental health conditions often have poorer outcomes, higher hospitalization rates, and increased costs of care. For providers, failing to address...
Unlocking Revenue, Compliance, and Patient Health Outcomes AWV Optimization Why Annual Wellness Visits Matter The Annual Wellness Visit (AWV) is more than a regulatory requirement. It’s a powerful opportunity to strengthen patient relationships, boost compliance, and capture otherwise lost revenue. Yet, many practices underperform in AWV completion rates—often...
MIPS/QPP Reporting Why MIPS/QPP Matters More Than Ever The Merit-based Incentive Payment System (MIPS) and the Quality Payment Program (QPP) aren’t just about regulatory checkboxes—they directly affect provider reimbursement. Poor performance can mean negative payment adjustments, while strong compliance unlocks bonuses and protects your bottom line. The Challenge...
Gap-Closure Outreach Why Providers Cannot Ignore Gap-Closure Outreach Healthcare practices are increasingly held accountable for closing care gaps—whether for quality reporting, value-based contracts, or patient satisfaction. Missed annual exams, overdue screenings, and incomplete follow-ups cost providers revenue, compliance penalties, and patient trust. Gap-Closure Outreach is not just about...
VBC Readiness & P&L Modeling Why Value-Based Care Readiness Matters The shift from fee-for-service to value-based care (VBC) is no longer optional—it’s inevitable. Practices that fail to prepare risk declining reimbursement rates, shrinking margins, and being excluded from payer-preferred networks. VBC readiness is not just compliance—it’s a...
(Why Every Practice Needs It to Succeed in Value-Based Care) Attribution Validation & Roster Management The Core Challenge In the shift to value-based care (VBC), accurate attribution—knowing exactly which patients are assigned to which providers—can make or break a practice’s financial and quality performance. Yet, many providers discover...
