HFMA

Dive into this business profile to learn how health systems can develop a sustainable strategy to support broader patient access to cell and gene therapies (CGT).

Understanding this key healthcare revenue cycle function One out of five adults say they have experienced a denied claim: when an insurance company refuses to pay for the healthcare services they’ve received or a prescription, according to a recent survey.[1] Yet only half of people appeal a denied claim, mostly because they aren’t sure how…

Value-based care is operating at scale. In 2026, 511 Accountable Care Organizations in the Medicare Shared Savings Program serve approximately 12.6 million people with traditional Medicare, the largest beneficiary population in program history. CMS reports approximately $2.5 billion in net Medicare savings and $4.1 billion in shared savings for the most recently reconciled performance year.…

By integrating proactive compliance and strong revenue cycle management workflows, practices can ensure accurate documentation and secure reliable, timely reimbursement. Dive into this article to learn more.

In this roundtable several revenue cycle management and finance leaders share their top challenges associated with revenue cycle transformation and lessons learned.

Denials are usually discovered after adjudication. The revenue loss, however, often begins much earlier. Hospitals continue to invest significant time and resources in denial management, yet roughly 15% of claims are initially denied. Hospitals spend nearly $19.7 billion each year appealing them and only about half of those denials are ultimately overturned. That raises a…

HFMA presents its comment letter to CMS on the CY 2027 Hospital OPPS and ASC Proposed Rule.

In this roundtable, healthcare revenue cycle leaders and executives explore how to move toward thoughtful AI adoption that makes an impact in protecting revenue integrity.

Healthcare navigation has become an important part of the employer benefits strategy. It can help employees understand coverage, find in-network providers, schedule appointments and work through administrative barriers. But access support and clinical care management solve different problems. That distinction matters when an employee’s need involves symptoms, medication concerns, a recent hospitalization or a worsening…

HFMA presents a spreadsheet comparing the FY 2027 IPPS final rule relative weights and standardized amounts with the final FY 2026 weights and rates.