Operational guidance and analysis for APCM, RPM, RTM, and value-based care execution.
Beginning January 1, 2026, UnitedHealthcare (UHC) will dramatically narrow coverage for Remote Physiologic Monitoring (RPM) across its commercial, Medicare Advantage, and exchange plans.
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On January 1, CMS introduced a brand-new benefit called Advanced Primary Care Management (APCM), a monthly payment designed to roll up the core elements of care coordination under a single code. For primary care leaders, this changes the landscape in profound ways. APCM overlaps…
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Primary care is carrying more risk, more responsibility, and more expectation than ever. The opportunity is that we finally have a model that pays for the work most teams already do between visits. The risk is jumping into tooling and tactics before we agree on the basics. Advan…
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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. F…
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Many health systems pay $40–$80 per patient per month (PMPM) for full-service remote patient monitoring while Medicare's 2025 national averages reimburse approximately $91–$129 monthly depending on engagement time. When clinical teams can deliver the same services internally, th…
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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 their he…
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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 (…
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Remote Patient Monitoring (RPM) has rapidly evolved from emerging healthcare innovation into a strategic necessity. Driven aggressively by CMS reimbursement policies, RPM adoption has accelerated at unprecedented rates, reshaping market dynamics and creating compelling strategic…
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In a single December blog post, CMS just rewrote the playbook for $400 billion in annual Medicare Advantage spending. The termination of the Medicare Advantage Value-Based Insurance Design (VBID) Model (after it generated $4.5 billion in excess costs over two years) isn't just a…
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The healthcare industry still has scars from the ICD-9 to ICD-10 transition. The stories are legendary in Health IT circles: coder productivity plummeting, claim denials surging, and revenue cycles seizing up for months. It was a painful lesson in underestimation.
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Change is inevitable in healthcare. Often, it feels overwhelming—but occasionally, a new shift arrives that genuinely makes things simpler. The upcoming CMS shift toward the MIPS Value Pathways (MVPs) represents precisely that kind of beneficial change.
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When the Department of Justice announces settlements, many of us glance at the headlines and move on. Yet, behind those headlines are real stories about real decisions, choices that felt minor at the time but led to serious consequences. Like the recent settlement involving Live…
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There’s a quiet agreement most of us make in business. It’s not in a contract. It’s not written on a whiteboard. But it runs everything: trust. We trust that what worked yesterday will still work tomorrow. We trust that people we’ve known for years will keep showing up the way…
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When people ask me what Intelligence Factory does, they often expect to hear about AI, automation, or billing systems. And while we do all those things—we do them well—I’ve come to believe something deeper: we’re in the business of trust. And in healthcare, that’s the most valua…
Read MoreFairPath is built on operational work, not theory. We publish the playbooks and checklists we use to keep programs compliant and profitable. Use them whether you run FairPath or not.
Browse the Expert Library →The practical 2026 guide to device rules, day thresholds, management time, and audit defensibility for Remote Patient Monitoring.
Read the RPM Guide →How to run Remote Therapeutic Monitoring for MSK, respiratory, and CBT workflows with the correct 9897x and 9898x rules.
Read the RTM Guide →Calendar-month operations for CCM: consent, initiating visit, care plan requirements, time counting, and concurrency rules.
Read the CCM Guide →The operator blueprint for Advanced Primary Care Management: eligibility, G0556–G0558 tiers, and monthly execution.
Read the APCM Playbook →