Why Primary Care Denial Management Is Now a Boardroom KPI in 2026

Image
In 2026, denial management is no longer just a billing department responsibility. For many primary care organizations, denial performance is now discussed alongside patient access, provider productivity, staffing, and financial growth. Boards, physician owners, health system executives, and private equity investors increasingly view Primary Care Denial Management as a key indicator of operational efficiency and financial health. This shift reflects a broader reality: claim denials directly affect cash flow, net collections, compliance exposure, and long-term profitability. A practice can maintain strong patient volume and clinical quality while still experiencing financial pressure if denied claims continue to rise. As payer complexity grows, leading organizations are investing in specialized Primary Care Billing Services , comprehensive medical billing services , advanced RCM services , and proactive Revenue Integrity programs to treat denial management as a strategic business funct...

Proposed Updates for Skilled Nursing Facility Quality Reporting Program (SNF QRP)

 Proposed Updates for Skilled Nursing Facility Quality Reporting Program (SNF QRP)

On April 11, 2022, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would update Medicare payment policies and rates for skilled nursing facilities (SNF) for the year 2023. This SNF PPS (Skilled Nursing Facility Prospective Payment System) includes proposals for the SNF Quality Reporting Program (QRP) and the SNF Value-Based Program (VBP) for FY 2023 and future years. This proposed rule CMS is publishing this proposed rule consistent with the legal requirements to update Medicare payment policies for nursing homes on an annual basis. 

What is the SNF QRP?

The SNF QRP creates SNF quality reporting requirements, as mandated by the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act).  Every year, by October 1, CMS publishes the quality measures SNFs must report. The IMPACT Act requires the reporting of standardized patient assessment data with regard to quality measures and standardized patient assessment data elements. The Act requires the submission of data pertaining to quality measures, resource use, and other domains. In addition, the IMPACT Act requires assessment data to be standardized and interoperable to allow for the exchange of data among post-acute providers and other providers. The IMPACT Act intends to standardize post-acute care data to improve Medicare beneficiary outcomes through shared-decision making, care coordination, and enhanced discharge planning. If an SNF fails to submit the required quality data, the SNF will be subject to a two percentage (2%) point reduction in the Annual Payment Update (APU) for the applicable performance year.

To know more about Proposed Updates for the SNF QRP click here: http://bit.ly/3Zuoyn9 Contact us at info@medicalbillersandcoders.com888-357-3226.

Comments

Popular posts from this blog

Is Your Neurology Billing Outsourcing Helping or Hurting You at Year-End?

How Hidden OB-GYN Billing Errors Are Quietly Costing You Millions Each Year

The #1 Reason ASCs Lose Revenue from Medicare Claims (And How to Fix It)