AI

With the advent of AI, many industry observers say the U.S. healthcare industry is standing at the brink of a sea change. As industrywide adoption of AI accelerates, now is a good time for the industry’s stakeholders to pause for a moment and take stock of what this new technology means for the healthcare system.…

As a Peace Corps volunteer in Liberia, West Africa, I witnessed the transformative power of connecting isolated rain-forest villages to road networks. Suddenly, never-before-seen goods and services appeared. Villagers could travel for education, work and pleasure. A road’s arrival was both exciting and disruptive. New opportunities emerged as old ways disappeared. Based on its traditional…

Patients are behind one of the latest applications of AI to the healthcare revenue cycle, and they are using it to review their bills. Stories of consumers using ChatGPT or other generative AI tools to trim thousands from their medical bills by questioning charges are appearing in the news and social media. YahooFinance wrote about…

In 2026, revenue cycle performance is inseparable from workforce design. Health systems are navigating sustained margin pressure, rising patient cost responsibility and escalating payer complexity — all while competing for limited domestic talent. Recent Kaufman Hall National Hospital Flash Reports continue to show margin volatility across U.S. hospitals, with labor costs and payer-related delays remaining…

Healthcare finance leaders are confronting a new reality: Revenue cycle performance now directly influences organizational stability, capital planning and access to care. Rising denial rates, expanding prior authorization requirements and persistent staffing constraints have transformed revenue operations from a transactional function into a strategic enterprise capability. Recent reporting from Kaufman Hall shows denials and revenue…

Hospitals today continue to experience revenue leakage, defined as the unintentional loss of income due to inefficiencies, missed billing opportunities and underpayments. Despite their significant investment in electronic health records (EHRs) and billing systems, they continue to lose about 3% to 5% of net revenue annually, amounting to tens of billions of dollars across the…

UMass Memorial Medical Center’s radiology department has been able to sidestep a lack of bill coding professionals by adopting AI in the medical center’s coding for radiology.   “It’s really hard to get certified coders these days,” said Barbara Scully, associate vice president, physician billing with UMass Memorial, which is located in Worcester, Massachusetts.   “It’s one…

Healthcare organizations face unrelenting financial pressures, with rising costs and shrinking margins. Dealing with reimbursement challenges, they face an uphill battle to maintain a profitable revenue cycle. This leaves no room for inefficiency. There is a way out, but healthcare leaders must look beyond traditional methods to automation to expand capacity and improve operational efficiency. 

Revenue cycle management (RCM) is a critical component of healthcare operations, yet providers face mounting challenges in ensuring timely and accurate reimbursements. Manual processes, evolving regulatory requirements and administrative inefficiencies contribute to revenue leakage and operational burdens. Traditional RCM processes are labor-intensive, relying heavily on manual billing, coding and claims submission. These inefficiencies not only…

UChicago Medicine discovered that they are ahead of other healthcare institutions in their use of AI for revenue cycle, and they are focusing on using AI to strengthen business outcomes, supporting a culture of AI innovation, implementing a governance framework, and measuring and optimizing performance.