BHM Healthcare Solutions

BHM Healthcare Solutions Since 2002, BHM has partnered with leading payers, providers, and health systems dedicated to advancing healthcare excellence.

Behavioral Health and Medical Review Experts

Providing behavioral health and medical review services and performance improvement consulting to health plans, providers, ACOs, TPAs, workers' compensation and other insurers nationally.

We are in the final days of National Kidney Month, but the need to protect kidney health continues all year. This year’s...
03/30/2026

We are in the final days of National Kidney Month, but the need to protect kidney health continues all year. This year’s theme from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) is “Managing Chronic Kidney Disease: Take charge of your health.”

If you or someone you care about has diabetes high blood pressure or a family history of kidney disease:

• Ask a health care professional about getting your kidneys checked
• Learn small daily steps that can help manage or prevent chronic kidney disease

You can find the official National Kidney Month toolkit and resources here
https://www.niddk.nih.gov/health-information/community-health-outreach/national-kidney-month/toolkit?utm_source=fb_page&utm_medium=BHM+Healthcare+Solutions&utm_campaign=publer

To stay ahead of upcoming health observances, explore BHM’s Healthcare Awareness Planning Guide and monthly observance article: https://bhmpc.com/health-awareness-observances-list-monthly-planning-tool/

As CMS-0057 continues to roll out, many healthcare organizations are starting to look closely at how prior authorization...
03/27/2026

As CMS-0057 continues to roll out, many healthcare organizations are starting to look closely at how prior authorization works within their current systems and workflows.

Decision timelines, interoperability requirements, and reporting expectations are all part of the discussion as teams think about how their processes may need to adapt.

We would ilke to know 𝘄𝗵𝗮𝘁 𝗸𝗶𝗻𝗱𝘀 𝗼𝗳 𝗖𝗠𝗦-𝟬𝟬𝟱𝟳 𝗰𝗼𝗻𝘃𝗲𝗿𝘀𝗮𝘁𝗶𝗼𝗻𝘀 𝗮𝗿𝗲 𝗵𝗮𝗽𝗽𝗲𝗻𝗶𝗻𝗴 𝘄𝗶𝘁𝗵𝗶𝗻 𝘆𝗼𝘂𝗿 𝗼𝗿𝗴𝗮𝗻𝗶𝘇𝗮𝘁𝗶𝗼𝗻?

Quality is not a one-time project. Regular audits, feedback loops, and calibration across reviewers help keep utilizatio...
03/26/2026

Quality is not a one-time project. Regular audits, feedback loops, and calibration across reviewers help keep utilization management decisions aligned over time.

We are in the final week of National Nutrition Month® Week 4 highlights “Feel Good with Healthy Habits.” Things like foo...
03/25/2026

We are in the final week of National Nutrition Month® Week 4 highlights “Feel Good with Healthy Habits.”

Things like food safety at home, planning ahead for meals, and staying informed with information backed by science-backed.

We are spotlighting some snippets from a presentation brought to you by The Academy of Nutrition and Dietetics to help turn those ideas into simple, real‑life steps.

🗓️ To stay ahead on upcoming health observances, explore BHM’s Healthcare Awareness Planning Guide and monthly observance article: https://bhmpc.com/health-awareness-observances-list-monthly-planning-tool/?utm_source=fb_page&utm_medium=BHM+Healthcare+Solutions&utm_campaign=publer

Clinical judgment is at its best when it is grounded, tying each determination back to specific evidence makes decisions...
03/24/2026

Clinical judgment is at its best when it is grounded, tying each determination back to specific evidence makes decisions easier to explain, defend, and replicate across teams.

March 24th is World Tuberculosis Day, a time to raise awareness about a disease that is preventable, treatable, and stil...
03/23/2026

March 24th is World Tuberculosis Day, a time to raise awareness about a disease that is preventable, treatable, and still affecting millions of people around the world.

The 2026 theme from the Stop TB Partnership is “Yes! We Can End TB.”
It highlights that ending TB is not just about ambition it is about leadership investment and communities working together.

World TB Day is led by the World Health Organization (WHO) with partners worldwide. Learn more and explore this year’s campaign here
https://www.who.int/campaigns/world-tb-day?utm_source=fb_page&utm_medium=BHM+Healthcare+Solutions&utm_campaign=publer

To stay ahead of upcoming health observances, explore BHM’s Healthcare Awareness Planning Guide and monthly observance article: https://bhmpc.com/health-awareness-observances-list-monthly-planning-tool/

CMS-0057 implementation is underway. Healthcare organizations are beginning to look more closely at how the rule will af...
03/20/2026

CMS-0057 implementation is underway. Healthcare organizations are beginning to look more closely at how the rule will affect day to day operations and reviewing areas such as:

• Prior authorization decision timelines
• Interoperability requirements
• Processes for tracking and reporting prior authorization metrics

As these changes continue to take shape, many organizations are evaluating their systems and workflows to prepare.

What conversations about CMS-0057 are happening in your organization?

🚨 A major CMS prior authorization transparency deadline has arrived🚨 By 𝗠𝗮𝗿𝗰𝗵 𝟯𝟭, 𝟮𝟬𝟮𝟲, impacted payers must publicly po...
03/19/2026

🚨 A major CMS prior authorization transparency deadline has arrived🚨

By 𝗠𝗮𝗿𝗰𝗵 𝟯𝟭, 𝟮𝟬𝟮𝟲, impacted payers must publicly post prior authorization metrics for calendar year 2025 under 𝗖𝗠𝗦-𝟬𝟬𝟱𝟳-𝗙.

That includes data tied to:
• approval and denial rates
• appeal outcomes
• turnaround times
• items and services subject to prior authorization

This is the first mandatory public reporting cycle of its kind, giving providers, beneficiaries, and regulators a new level of visibility into plan-level prior authorization performance. Beyond compliance, this development raises the visibility of utilization management operations and may increase attention on efficiency, consistency, and defensibility.

🔗 Link to the full story in the comments⬇️

Not every surge in volume should become an internal fire drill. Flexible vendor partnerships give plans room to absorb s...
03/19/2026

Not every surge in volume should become an internal fire drill. Flexible vendor partnerships give plans room to absorb spikes in cases while keeping reviews consistent and compliant.

Stable operations depend on knowing the ground will not shift overnight. Tight connection to current regulations and gui...
03/17/2026

Stable operations depend on knowing the ground will not shift overnight. Tight connection to current regulations and guidance helps review teams make decisions that hold up under scrutiny months or years later.

It is National Poison Prevention Week, a time to raise awareness about how quickly everyday items can become dangerous a...
03/16/2026

It is National Poison Prevention Week, a time to raise awareness about how quickly everyday items can become dangerous and how to stay prepared.

In 2026, the theme is “When the unexpected happens, Poison Help is here for you.”
If you have questions or a possible emergency, you can call Poison Help at 1-800-222-1222 any time, day or night, at no cost.

National Poison Prevention Week is led by HRSA’s Poison Help program together with America’s Poison Centers. Find tips, tools, and outreach ideas here
https://poisonhelp.hrsa.gov/what-you-can-do/poison-prevention-week?utm_source=fb_page&utm_medium=BHM+Healthcare+Solutions&utm_campaign=publer

To stay ahead of upcoming health observances, explore BHM’s Healthcare Awareness Planning Guide and monthly observance article: https://bhmpc.com/health-awareness-observances-list-monthly-planning-tool/

03/13/2026

𝗛𝗮𝗽𝗽𝘆 !

This year’s theme, “𝗦𝗹𝗲𝗲𝗽 𝗪𝗲𝗹𝗹, 𝗟𝗶𝘃𝗲 𝗕𝗲𝘁𝘁𝗲𝗿,” highlights how good sleep supports mood, focus, and overall health. Even small changes, like a regular bedtime or fewer screens before bed, can make a real difference.

How are you resting and recharging this week?

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