The idea you carried home from Las Vegas has about a nine-day life expectancy. Not because it's a bad idea — because it never gets built into how the week runs. That changed this year. Want a required new step in your KAFO fabrication process? Ten minutes, and it's live for your whole team. Here's the recap from the show floor.

There's a modifier that's supposed to get your claim out of prior authorization. Half the practices about to lean on it don't know it triggers prepayment review 50% of the time. That's not a workaround — that's a coin flip you're volunteering for.

Someone in your office is retyping a patient's history into an AI tool right now to get an answer about a patient OPIE already knows everything about. That stopped being necessary this year. It's one of over 100 things that changed since last year, and at least two of them will increase your profitability. Give me five minutes and read this blog!

Are you legacy, or are you a fossil? They sound the same, but one is your greatest asset and the other is exposure with a good story attached. The checklist nobody's questioned since 2019, the "we've always done it this way" that used to be wisdom — that's the fossil talking. This week, a look at how proven practices stay proven: not by holding still, and not by chasing whatever's newest, but by doing the harder thing in between. 

UnitedHealth just poured $20 million into neighborhood health hubs built around diabetes and blood pressure, no new payment code required. It is the same instinct primary care chased a decade ago with the patient-centered medical home movement, just moved further into the community. Good O&P practices have been running a quieter version of that model for years, coordinating gait, comorbidities, and follow-up care one patient at a time. The real question is not whether you fit this model. It is whether your community knows you belong. 

Practice owners often struggle with operational decisions because they think that making the wrong one may be a costly mistake. Should you keep stocking a product line as margins tighten? Send more work to central fabrication or hire another technician? Stop incomplete orders before they clog the schedule? This week’s blog explores why smart leaders overthink, how to separate productive deliberation from the loop that drains time, and a simple decision check your team can use right away, starting today. 

The person stealing from your practice isn't the shifty new hire. It's the one you'd never suspect — twelve years in, never takes a vacation, knows your billing system better than you do. The typical practice loses 5% of revenue this way, and the median case runs $145,000, enough to wipe out a year's margin. Most of it hides in plain sight, in habits you've always read as loyalty. This week: nine quiet warning signs, and the fifteen-minute check that catches them. 

The audit letter lands on your desk Monday morning. Or your only technician suddenly quits. Watch what you do in the first ten minutes — do you rush to fix, rally the troops, or go cold and logical? You have a default reaction under pressure, and in a small practice where you're usually the only one at the wheel, that unnamed reflex runs the whole show. Knowing your reflex and making sure you're not the only one who can handle a crisis might be the cheapest resilience you can buy. 

CMS just proposed dropping traditional MIPS and pushing more doctors into ACOs. You don't bill Medicare that way, so why should you care? Because every referring surgeon you work with is about to get judged on outcomes you're already creating and probably not measuring. There's research proving your care saves the system real money. The question is whether you can prove it about your own patients, or whether you're leaving that conversation to someone else. Here's the sixty-day fix. 

Competitive bidding program is coming back for 2028…and now requires mail order!  What started as just two O&P categories in 2021 has grown to three, with no clear sign of stopping. Nobody's published real numbers on what practices lost last round, but the rules for who gets paid are about to get more strict. If you fit OTS back, knee, or upper extremity braces, this could reshape a chunk of your revenue before you even see it coming. 

Next week, don’t let your momentum slow down. As we hit the halfway point of the year and celebrate America’s 250th birthday, it’s the perfect time to take a hard look at what’s actually moving your practice forward and what’s holding it back. In this midyear reflection, we break down the simple habits, processes, and leadership behaviors that separate steady practices from stressed ones—and how to refocus your team for a stronger, smoother second half before the year gets away from you. 

Think compliance is just paperwork? A single audit slip, accreditation miss, or False Claims Act misstep can cost your O&P practice thousands. Discover how Medicare audits, accreditation rules, and the FCA collide in real practice life—and what daily habits actually protect you. You’ll learn the workflow gaps that can trigger red flags, why “busy” is not a defense, and how smarter documentation and billing tools can be your best shield against regulatory disaster. Don’t wait for an audit letter to find out you’re exposed. 

Insurance companies aren't saving money when they deny a prosthesis. They're just moving the cost — onto your patient, onto the system, and often right back onto themselves. The research is unambiguous. The problem is what you do about it at the practice level, today, with the staff and systems you already have. Here's a practical look at what may help. 

You just hired a new clinician.  Fresh out of residency, this person you found seems ideal. They are smart, they believe in your vision…maybe they will take the reins someday. You’re training them, introducing them to your patients, trusting them with your reputation. And statistically, there's a real chance they won't be in your clinic in ten years. That's not pessimism. That's the first real data we've ever had on O&P career attrition — and it's worth your attention. 

Two days. Packed sessions. Conversations that actually mattered. From outcome measure discipline to LCD updates that will affect every practice in the country, LAOP 2026 delivered. Oh, and OPIE 2.0? Let's just say people had questions — a lot of them. 

If you're wondering what the sharpest practitioners in O&P are thinking about right now, this one's worth three minutes of your time. 

Your front office just clicked a phishing link. Your systems are locked. Everything grinds to a halt. Sound far-fetched? It's happening to small medical and allied healthcare practices just like yours every day. A 2025 Healthcare Cyber Resilience Report confirms what many of us have been slow to accept — cybersecurity is no longer an IT problem, it's a business survival problem. Here's what small O&P practices need to know. 

Your Medicare playbook just changed again—and if you missed the fine print, your eligibility checks, prior auths, and even expansion plans could already be at risk. Between new HETS vendor rules, fresh DMEPOS appeal routing, updated benefit‑category guidance, and added prior‑auth requirements on key HCPCS codes, it’s getting harder to tell where your real exposure is hiding. In this post, I’ll show you how a 60‑minute SWOT turns all that noise into a clear, actionable O&P leadership game plan. 

Medicare says it wants to CRUSH DMEPOS fraud—but right now, it can’t even see who actually treated the patients. That blind spot is exactly why honest O&P clinics keep getting hammered with audits and prior auth chaos while bad actors slip through. There’s a ridiculously simple fix CMS isn’t using yet: put the treating clinician’s NPI on every O&P claim. Want less nonsense from payers? It might start with one short message to your DME MAC. 

Limb Loss Awareness Month ended yesterday but the fight for our patients continues. 

This year, the Amputee Coalition, AOPA’s Policy Forum, and the So Every BODY Can Move campaign quietly shook the ground under payers and policymakers. Coverage rules are shifting, states are rewriting laws, and O&P voices are finally being heard (maybe?). 

What are you doing about it? Will your practice help sustain the wave…or watch from the shore wringing your hands? 

If setting goals in your practice mostly falls flat, you’re not alone. Research shows the way we usually set goals practically guarantees overload, firefighting, and burnout—not meaningful change. This week, I am flipping the script: one goal per “season,” behavior-based targets instead of abstract wishes, and guardrails, so you don’t accidentally break the rest of your practice while chasing a metric. If you’re ready for goals that actually work in real life, start here.