New & Notable
Medicaid losses leave more patients paying cash, Epic finds
Some 7.6% of emergency department visits are currently paid in cash, up from 5.5% in 2022, according to a new study from the EHR giant’s research division.
— Healthcare Dive
Providers warn of another decade of 340B payment problems
Leading provider associations are urging the CMS to reconsider severe cuts to 340B reimbursements to hospitals, warning of another decades-long payment battle.
$15.6B provider payouts fuel surge in No Surprises Act costs
Arbitrators awarded providers $15.6B from 2023-2025 under the No Surprises Act, with median payments at 445% of the QPA, which researchers say could drive up premiums.
Waystar expands AI-powered agentic revenue cycle tools
The company said its AI agents can now tackle claim resolution, conversational performance intelligence, agentic clinical documentation and the patient financial experience.
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Latest News
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Providers warn of another decade of 340B payment problems
Leading provider associations are urging the CMS to reconsider severe cuts to 340B reimbursements to hospitals, warning of another decades-long payment battle.
-
$15.6B provider payouts fuel surge in No Surprises Act costs
Arbitrators awarded providers $15.6B from 2023-2025 under the No Surprises Act, with median payments at 445% of the QPA, which researchers say could drive up premiums.
-
Waystar expands AI-powered agentic revenue cycle tools
The company said its AI agents can now tackle claim resolution, conversational performance intelligence, agentic clinical documentation and the patient financial experience.
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Hospital rate caps could slash health costs by $1T over a decade
A new Urban Institute study finds capping hospital rates at 100% over Medicare prices could reduce U.S. healthcare spending by $114.8B annually and over $1T in 10 years.
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Hospitals feel payer mix shifts as uncompensated care costs grow
New hospital financial performance data show higher uncompensated care costs and ED visits than two years ago, as healthcare coverage reform takes effect.
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Survey: Front-end workflows to blame for most claim denials
Insurance eligibility and benefits verification, prior authorizations and patient registration errors are the top drivers of claim denials, according to RCM leaders in a new survey.
Features
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Payers say AI doesn't deny care. The truth is more complex.
Payers say AI is not clicking the deny button on prior authorizations and provider claims, but the technology does play a key role in deciding which requests need further review.
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How providers can weather Medicaid cuts when many won't
Federal Medicaid reform will affect providers differently, with some more at risk of closing while others can innovate their way out of severe revenue losses.
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Prior authorization automation hinges on human connection
Healthcare is rapidly automating the prior authorization process, but Ochsner Health has found that a new initiative connecting payers and providers is making progress tangible.
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What providers really need to streamline prior authorizations
Providers have yet to see much progress on a pledge last year to streamline prior authorizations, signaling misalignment between payer promises and meaningful change for providers.