Prior authorization is draining revenue, which is why automation has become a strategic imperative
Prior authorizations have entered a different era. The process has become one of healthcare’s most expensive administrative bottlenecks, affecting far more than physician practices. Across hospitals and health systems, it slows patient access, adds labor-intensive work, increases denial risk, and puts pressure on reimbursement and cash flow. For organizations focused on growth, margin, and operational…
Intelligent, trustworthy operating model key to the hospital of the future
AI and automation are becoming foundational to healthcare operations, with leaders focused on building proactive, data-driven systems that improve revenue cycle performance, reduce friction and support better decision making.
How to protect revenue in a digital-first ecosystem
As hospitals become more digitally connected and AI-enabled, revenue cycle operations must shift from reactive problem-solving to proactive prevention by embedding data integrity, automation and revenue protection directly into care workflows.
The accuracy imperative and the hospital of the future
The hospital of the future will rely not just on advanced technologies like AI and robotics, but on accurate, complete healthcare data that supports better clinical, financial and operational decisions. Large language models are transforming healthcare finance by helping teams identify documentation gaps, improve reimbursement accuracy, reduce waste and create a more reliable picture of patient care.
The Hospital of the Future Part I: Can healthcare leaders deliver a healthier future?
With support from: It’s a scene “The Jetsons” might have portrayed: A patient scheduled for surgery checks into the hospital by scanning a QR code with her smartphone, then is digitally led to her room. There, a smart TV welcomes her and orients her to the room. Soon, a robot arrives, delivering the gown she’ll change into…
Operational resilience is the revenue cycle management imperative of the OBBBA era
The One Big Beautiful Bill Act (OBBBA) has altered Medicaid eligibility in ways hospitals can no longer treat as a background policy issue. Reverification of Medicaid coverage now happens so frequently that patients lose coverage for administrative reasons that have nothing to do with whether they actually qualify. Much of the industry dialogue has centered…
Ascension systems remain down after cyberattack
Executives with Ascension health system, St. Louis, are keeping in contact with leading law enforcement agencies and industry organizations as they work to restore systems that were shuttered by a cyberattack. The apparent ransomware attack has led to a shutdown of different systems that will last for an undetermined period of time. The attack also…
How predictive analytics and AI shed light on payer behavior
Providers and payers have become more collaborative as payment models evolve toward value. Still, payer-provider relationships can seem one-sided — decidedly in favor of the payer — as hospitals continue to face declining reimbursement and rising costs. The increase in denials is a great example, with rates skyrocketing by 20% over 5 years, according to…
Vanderbilt Health harnesses data to improve revenue cycle management
Close to half of healthcare finance professionals say in a survey that their organizations are experiencing a severe shortage of revenue cycle management (RCM) talent — and many are exploring automation as a way to keep RCM operations working properly. It’s a move that Vanderbilt Health in Nashville, Tennessee, made just prior to the pandemic — and…