Birmingham 205-631-5969

Montgomery 334-277-6201

Client Login

Request Demo

Blog

Pediatric Care Is Becoming More Complex: 6 Key Findings

Posted on

A new JAMA Network Open study analyzing more than 26 million pediatric discharges (2000–2022) shows a major shift in the intensity, cost, and location of pediatric inpatient care — especially for children with complex chronic conditions. 1. Sharp rise in medically complex cases Hospital discharges for children with at least one complex chronic condition increased 24.3%, while discharges for children without chronic conditions fell 9.7%, signaling a growing concentration of medically complex patients. 2. Higher…
Read Full Article

What Providers Need to Know About Final 2025 MIPS Eligibility & Preparing for 2026

Posted on

Check Final 2025 MIPS Eligibility Status Enter your 10-digit National Provider Identifier (NPI) in the Quality Payment Program (QPP) Participation Status Tool and review your final 2025 eligibility status for the Merit-based Incentive Payment System (MIPS).  We’ve updated your eligibility status based on our review of Medicare Part B claims and Medicare Provider Enrollment, Chain, and Ownership System (PECOS) data from the second segment of the MIPS Eligibility Determination Period (October 1, 2024 – September 30, 2025).  Review Your 2025 Eligibility…
Read Full Article

CRI Physician Services Planning for 2026

Posted on

CRI has summarized CMS’s newly released telehealth guidance following the 43-day government shutdown. The update confirms retroactive payments for eligible shutdown-period claims, outlines telehealth flexibilities set to expire Jan. 30, and clarifies practice-location requirements for home-based and virtual-only clinicians. Full details are available in the attached CMS FAQ. Resource: CRI Physician Services Planning for 2026

CMS Finalizes 1.3% Payment Cut for Home Health in 2026: 8 Key Updates

Posted on

CMS has finalized a 1.3% decrease in home health payments for 2026, part of its annual Home Health Prospective Payment System update released Nov. 28. The rule includes permanent and temporary payment adjustments tied to the Patient-Driven Groupings Model (PDGM) and several policy changes aimed at easing administrative burdens while strengthening fraud prevention. Here are the eight main updates: Resource: CMS cuts home health pay: 8 things to know 

UnitedHealthcare Announces Key 2026 Medicare Advantage Plan Changes

Posted on

UnitedHealthcare has outlined several updates to its Medicare Advantage plans for 2026, including new referral requirements and changes to supplemental benefit eligibility. 1. Most HMO and POS plans will require referrals.Beginning Jan. 1, 2026, members enrolled in UnitedHealthcare Medicare Advantage HMO and POS plans will need a referral from their primary care provider before seeing certain specialists in outpatient, office, or home settings. PCPs must submit the referral to UnitedHealthcare prior to the specialist visit….
Read Full Article

Flu Activity Still Low but Rising: 5 Key Virus Updates

Posted on

Flu activity across the U.S. remains relatively low but is beginning to increase — especially among children and young adults — according to the CDC’s latest FluView report published Dec. 1. In the week ending Nov. 22, flu-related hospitalizations rose sharply to 3,264, a 39% jump from the previous week. Outpatient visits for flu-like illness also edged up to 2.5%, still below the national baseline of 3.1%. Young children (ages 4 and under) continue to…
Read Full Article

RSV Admissions Remain Low but Are Starting to Rise: 4 Key Respiratory Virus Updates

Posted on

Hospitals are beginning to see a gradual uptick in respiratory syncytial virus (RSV) admissions, although national numbers remain limited due to delayed federal reporting. Cincinnati Children’s Hospital is among those noting earlier-than-usual activity, with Hamilton County recording 32 RSV admissions in the week ending Nov. 15 — slightly up from 28 the week prior. National CDC estimates, last updated Oct. 25, show RSV hospitalizations remain low at 0.2 per 100,000 people, but are trending upward….
Read Full Article

CMS Releases 2026 Medicare Parts A & B Premiums, Deductibles & Coinsurance

Posted on

CMS has announced the 2026 cost updates for Medicare Parts A and B, outlining new deductible and coinsurance amounts that will take effect next year. These changes impact inpatient hospital stays, skilled nursing facility care, and outpatient services. Medicare Part A – Inpatient Hospital Costs The Part A inpatient hospital deductible will increase to $1,736 in 2026, up from $1,676 in 2025. This deductible applies to the first 60 days of Medicare-covered inpatient care.For longer…
Read Full Article

CMS Moves CLIA Program to Electronic Fee Coupons & Certificates

Posted on

CMS is modernizing the Clinical Laboratory Improvement Amendments (CLIA) program by shifting from mailed paper fee coupons and certificates to fully electronic delivery. Beginning March 1, 2026, laboratories and providers that perform lab testing must opt in to receive CLIA certificates and fee notices by email. After this date, CMS will no longer send paper versions. To transition to electronic notifications, labs can choose one of three options: This new process does not apply to…
Read Full Article

Alabama Physicians Driving Innovation in Advanced GI Care

Posted on

Alabama continues to strengthen its leadership in advanced gastrointestinal care thanks to a major clinical milestone led by Dr. Mohamad Eloubeidi, director of endoscopy at Northeast Alabama Regional Medical Center and president of the Alabama Gastroenterology Society. Dr. Eloubeidi recently performed Alabama’s first next-generation EUS-guided biopsy, using a device capable of collecting larger, higher-quality tissue samples. This advancement improves diagnostic accuracy for complex pancreatic and GI conditions and marks a significant step forward in the…
Read Full Article

CMS Requests Feedback on the MIPS Final Performance Feedback Experience

Posted on

If you’ve reviewed your 2024 MIPS final performance feedback on the QPP website, CMS is inviting clinicians and practices to share their experience through a brief survey. This is an opportunity to help shape how MIPS performance information is delivered moving forward and ensure it better supports the needs of participating providers. The survey takes no more than 15 minutes to complete and is voluntary, confidential, and conducted by independent contractors. No individuals or organizations…
Read Full Article