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Medical billing, coding, denials, credentialing, PCMH and practice operations, written to be useful on Monday morning.
Medicaid Work Requirement Rule Takes Effect July 31: A Front-Desk Guide
CMS's June 1, 2026 interim final rule on Medicaid work requirements takes effect July 31. States must finish initial outreach by August 31, run the 80-hour test by January 1, 2027, and move expansion adults to six-month renewals. Here is the timeline and the front-desk workflow.
PCMH Quality Measure Dashboards: Choosing Measures, Setting Goals, Reporting
The quality improvement concept in PCMH is where practices produce the most paper and the least change. We describe a quality measure dashboard that satisfies the QI criteria and actually runs the practice: which measures to pick, how to set a defensible goal, how to report to clinicians, and what evidence to keep.
A Patient Experience Survey for PCMH: Questions, Sample Size and What to Change
NCQA expects a recognized medical home to survey patients across at least three dimensions and act on the results. Here is how to build a patient experience survey for PCMH: which CAHPS-style questions to ask, how many responses you need, how to score them and how to turn a low score into a change.
PCMH Annual Reporting: A Mid-Year Check and NCQA's Proposed 2027 Changes
Recognized practices report to NCQA once a year, and the ones that struggle are the ones that start in the month it is due. Here is the June check we recommend, the evidence that takes longest to assemble, a worked care management example, and what NCQA proposed this spring for the Care Management criteria in 2027.
MIPS 2024 Data Preview Closes June 11, 2026; PI Window Must Start by July 5
Two MIPS dates land in the next five weeks. Physicians can preview their 2024 MIPS performance data before it is posted on Medicare.gov compare until June 11, 2026, and the 2026 Promoting Interoperability 180-day window must begin by July 5. Here is what to check in each.
The CMS ACCESS Model Starts July 5, 2026: Should Your Practice Look at It?
The Innovation Center's ACCESS model begins its ten-year run on July 5, paying participating organizations outcome-aligned payments for chronic condition tracks instead of fee-for-service. Here is how the payment works, the fee-for-service exclusion most summaries skip, and the questions to answer first.
Medication Reconciliation Workflow for PCMH: Who, When and How to Document
Every practice says it reconciles medications; few can show a report proving it. We lay out a medication reconciliation workflow that satisfies NCQA PCMH criteria KM 14 and KM 15: who collects, who reconciles, who signs, the triggers that start it, what the note must contain and the numbers to report each month.
Closing Care Gaps Before Mid-Year: Turning Q1 Payer Gap Lists Into Visits
Payer gap lists for measurement year 2026 arrived in the first quarter and most of them are sitting in an inbox. April to June is when closing them is easiest. Here is how to reconcile the lists against your own data, which measures to prioritize, how to code closures so they count, and how to run the outreach.
A Pre-Visit Planning Template for Primary Care: The Huddle That Closes Care Gaps
Most care gaps that stay open were missed at a visit where the patient was already in the room. We share the pre-visit planning template for primary care we build with practices: who does it, what fields it has, how the ten-minute morning huddle uses it, what it does for PCMH evidence and the numbers to track.
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