The CFO playbook for revenue cycle performance
Discover how healthcare CFOs improve revenue cycle performance and protect margins through an integrated, AI-enabled approach to documentation, coding, compliance, and denial prevention.
CMS updates prior authorization transparency requirements for health plans
As part of efforts to improve prior authorization, CMS has bolstered its transparency requirements for health plans. Based on 2024 regulations that partially took effect in 2026 and are intended to promote electronic prior authorization, new requirements apply to health plans in Medicare Advantage (MA), Medicaid managed care and the Affordable Care Act marketplaces, along with state…
HHS report raises scrutiny of gender-affirming care billing and coding
HHS followed up its final rule blocking Medicaid funding for gender-affirming care in minors by publishing a commissioned report alleging “potentially fraudulent” billing and coding among providers of the services. The report, released Aug. 13, alleges that financial incentives drove hospitals and physicians to expand access to the care, and that deceitful billing practices took…
CMS proposes new 340B reporting and HOPD attestation requirements
Recently published editions of two annual Medicare proposed rules both included provisions creating new administrative tasks for hospitals. CMS’s proposed rule for hospital outpatient care would formalize a system of required attestation for off-campus hospital sites starting in 2028, while the rule for physician payments would establish obligatory submission of 340B-related data to a centralized…
Patient matching bill could save $2.5M per hospital
Support is growing in Congress and in the healthcare industry to enact a national patient matching framework that would save billions of dollars in denied claims for hospitals and health systems. Most recently, two U.S. Senators, Mark Warner (D-Va,) and Jim Banks (R-Ind.), introduced the MATCH IT Act, a companion bill to House Bill HR…
Overcoming mid-revenue cycle bottlenecks: Leaders share tips for improvement
Several healthcare industry leaders were brought together to discuss the challenges they’re facing within the mid-revenue cycle. Dive into this roundtable that explores how these leaders are using AI and other solutions to uncover bottlenecks and future-proof the revenue cycle while minimizing administrative burden.
2026 Revenue Cycle Benchmark Report: Where Leading Providers Are Adapting and Where They’re Struggling
Based on a survey of 102 healthcare leaders, this report examines key revenue cycle challenges, including denials, audits, and staffing shortages. This white paper also explores how providers are using AI, automation, and outsourcing to improve performance. Download to learn more.
Beyond outsourcing: The strategic value of global RCM
Revenue cycle management is no longer just billing. For hospitals and health systems, it now directly shapes financial performance, operational stability and the ability to invest in patient care. Pressure is coming from every direction. Payer rules continue to change. Prior authorization remains burdensome. Documentation standards are more demanding. At the same time, patients are…
RCM Staffing Benchmarks: What High-Performing Revenue Cycle Teams Cost and Deliver
Discover how to benchmark the true cost of RCM staffing, compare onshore and offshore models, and measure key revenue cycle performance metrics. This white paper provides a practical framework to build a data-driven business case for improving efficiency and reducing costs.
Medicare skin substitute reimbursement changes have raised provider risks
A formerly high-revenue healthcare service has been diminished on several fronts in 2026. Medicare Part B spending on skin substitutes increased by 640% between 2022 and 2024, reaching nearly $3 billion per quarter, according to a government report. Steps taken by CMS and policymakers to counter that trend include an overhauled payment system and an…