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Physician Advisors, Case Managers, CDI, and Audit Teams:
Your hospital’s revenue is at stake. AGAIN.
This live session will take a clear-eyed look at the shifting terrain of Medicare Advantage and its direct impact on hospital reimbursement.
We’ll unpack the two‑midnight rule’s application to Medicare Advantage plans, the controversial changes in Aetna’s policy that pay some inpatient stays at observation rates, and the broader pull‑back by insurers that includes cutting supplemental benefits and exiting unprofitable markets.
Clinicians and revenue‑cycle professionals will gain insight into how these moves translate into contracting challenges, cash‑flow pressure, and greater documentation risk.
We'll discuss regulatory background with concrete financial analyses and targeted strategies for case management, CDI, utilization review, coding and billing teams.
We’ll outline steps hospitals can take to protect reimbursement—ranging from meticulous documentation and clinician education to contract renegotiation and coordinated advocacy.
Bring your questions and join us to learn how to prepare your organization for the upcoming changes and maintain financial resilience.
Here’s what we’ll cover:
✔️ Background on the Two-Midnight Rule & MA Plans
✔️ Aetna’s New Policy
✔️ Hospital Community Response
✔️ Industry Trends & Pull-Back
✔️ Financial Impact on Documentation & Revenue Cycle
✔️ Preparation Strategies
✔️ Final Thoughts & Recommendations
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