You've likely caught the buzz on X and news feeds about President Trump's "The Great Healthcare Plan" framework, released today (January 15, 2026). Per the official White House fact sheet, it calls for insurers to publish "plain-English" comparisons of rates, coverage, denial rates, and...
On December 29, 2025, CMS announced $50 billion in Rural Health Transformation (RHT) awards across all 50 states. This is a five-year initiative with $10 billion available each year from 2026 through 2030.
If you lead a rural clinic, FQHC (Federally Qualified Health Center), RHC (Rural Health Clinic), or a multi-site practice serving rural communities, this is not “telehealth money...
Anthem has quietly made an important update to its clinical policy CG-MED-91, effective December 18, 2025. The change aligns Anthem with CMS’s 2026 Physician Fee Schedule and formally recognizes the new “short-cycle” Remote Physiologic Monitoring (RPM) and Remote Therapeutic Monitoring (RTM) CPT codes...
With 10 days left in the year, practices were bracing for a major UnitedHealthcare shift: a new “Remote Physiologic Monitoring (RPM)” medical policy that—on paper—would sharply narrow coverage to two indications and label most other RPM use as “unproven.”...
If you run an independent practice, rapid RPM growth probably still feels like a win.
For years, the prevailing advice was simple: enroll more patients, deploy more devices, and let scale solve the economics. When reimbursement was loose and audits felt distant, that approach often worked well enough...
If you manage a Remote Physiological Monitoring (RPM) program, CPT code 99454 is likely your biggest source of revenue and, also likely, your biggest headache. This code, which reimburses for the supply of the device and data transmission, has long carried a notorious "all-or-nothing" requirement: the patient must transmit data on at least 16 separate days within a 30-day period...
Most independent practices didn’t launch remote care programs so they could track timers, chase scattered documentation, or argue with spreadsheets at the end of every month. They adopted RPM and CCM because they believed these programs would keep patients out of the hospital...
Over the past several years, I’ve heard it all.
Remote patient care is a scam. It doesn’t work. RPM is designed to fail.
I’ve listened to the frustrations from doctors, managers, and administrators who swear that remote care is nothing but another profit scheme wrapped in good intentions...
Healthcare is on the brink of a fundamental shift. The forthcoming 2026 CMS Physician Fee Schedule updates are far more significant than mere billing adjustments, they signal a new era in remote care coordination. Practices that adapt early will not only enhance patient care but also secure long-term operational advantages...
If your practice adopted APCM by shutting down RPM and RTM programs, you left money on the table. If you're running all three programs separately, you're burning cash on duplicate documentation and exposing yourself to compliance risk...
Advanced Primary Care Management (APCM) represents one of the more meaningful changes in the CMS Physician Fee Schedule. As of January 1, 2025, practices that adopt this model will be reimbursed through monthly, risk-stratified codes rather than only episodic, time-based billing...
The Federal Trade Commission’s Sept. 12 warning to healthcare employers is a simple message with real operational consequences. Overbroad noncompetes, no‑poach language, and “de facto” restraints chill worker mobility and can limit patients’ ability to choose their clinicians. For practices building Advanced Primary Care Management teams, restrictive templates do more than create legal risk...
Advanced Primary Care Management represents Medicare's most ambitious attempt to transform primary care economics. Unlike previous programs that nibbled at the margins, APCM fundamentally restructures how practices organize, deliver, and bill for comprehensive care...
Advanced Primary Care Management (APCM) is Medicare’s newest program, introduced in 2025 with three billing codes: G0556, G0557, and G0558. This represents a pivotal shift toward value-based primary care by offering monthly reimbursements for delivering continuous, patient-focused services. You're already providing these services—why not get paid for it?
At 2 AM, a new mother in rural Alabama feels her heart racing. She's two weeks postpartum, alone with a newborn while her husband works the night shift. Her blood pressure reading on the home monitor shows 158/95. Within minutes, her care team receives an alert. By 6 AM, a nurse has called, medications are adjusted, and what could have been a stroke becomes a story of crisis averted.
Many health systems pay full-service RPM vendors $40–$80 PMPM for services they can in-source for far less. With 2025 Medicare rates and OIG scrutiny, it's time to revisit the build-vs-buy math.
A few months ago, a physician at a 12-doctor practice in rural California called me frustrated. His practice was hemorrhaging money on readmissions, his nurses were burning out from phone tag with chronic disease patients, and his administrator was getting pressure from...
Medical executives today face an uncomfortable reality: while navigating shrinking margins and mounting operational pressures, many are unknowingly surrendering millions in Medicare reimbursements to third-party vendors. The culprit? Poorly structured Remote Patient Monitoring (RPM), Chronic Care Management (CCM)...
If you've spent any time managing a remote patient monitoring (RPM) program, you already know the drill: juggling the 16-day rule, keeping track of clinical minutes, chasing compliance, and often wondering if this is really what patient-centered care was meant to feel like...