How price transparency improves patient trust and collection rates
Price transparency in healthcare has moved well beyond being a regulatory obligation. In today’s consumer-driven environment, it has become a strategic capability that directly influences patient trust, access to care and revenue cycle performance. Patients increasingly expect clear, upfront information about what care will cost, what their insurance will cover and what they will be…
Susan Dentzer: Extending the ACA’s enhance premium tax credits — It’s the right thing to do
Winston Churchill is often credited with the assertion that Americans always do the right thing after exhausting all the other alternatives. Whether or not he actually said it, current U.S. healthcare policy underscores the underlying truth. The latest evidence is Congress’s inability to broker an extension of the enhanced premium tax credits (EPTCs) established under the ACA,…
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…
The WISeR prior authorization model for Medicare is set to pose challenges for hospitals
Hospitals and other healthcare providers soon will have a larger set of prior authorization requirements to account for in traditional Medicare as a new pilot model gets underway. Technology companies participating in the six-year, six-state Wasteful and Inappropriate Service Reduction (WISeR) Model are supposed to have their portals up and running by Jan. 5, with…
More hospitals adopt tech-driven screenings for charity care eligibility
Hospitals are increasingly implementing technology-driven screenings to automatically qualify patients for charity care, as recommended by the American Hospital Association, in order to reduce administrative burdens and ensure all eligible patients receive financial assistance.
Reimagining the patient financial experience
Patients judge their healthcare experience long before they see a clinician. In an era of consumer-driven healthcare, transparency, affordability and ease of use are now as critical as clinical outcomes. Yet, while the care experience has evolved, the financial journey still lags behind. Hospitals that elevate the patient financial experience — making it as seamless,…
Survey of revenue cycle executives points to the need to move from reactive to proactive clinical documentation
Review this report to learn how to swap out the processes and technologies that don’t support an effective, sustainable approach to clinical documentation. Revenue cycle teams will get key takeaways to rethink documentation as a proactive strategy rather than a back-end fix.
How principles of 4DX helped a health system transform its revenue cycle
On observing successful applications of the 4 Disciplines of Execution (4DX) across multiple industries, Emory Healthcare undertook an innovative approach in strategically using the performance management tool to solve revenue cycle challenges. Health systems nationwide face profound challenges in the revenue cycle, including those posed by preauthorizations, coding intricacies and payer denials, where solutions often…
Nov. 17, 2025: The shutdown is over, plus Aetna’s update to a controversial payment policy
Nick Hut and Shawn Stack discuss the longest shutdown in American history, and what might come next. Then, they tackle Aetna’s latest policy update.
Redesigning denials management in the OBBBA era
Under OBBBA, executives face denials as a continuous operational and financial pressure. Traditional reactive approaches — reviewing and appealing after denials occur — are no longer sustainable. The organizations that succeed in this new era will use predictive analytics, automation and disciplined processes to prevent denials before they happen. The problem with the traditional model For decades,…