New & Notable
New value-based payment model aims to boost tech use
A new payment model from the CMS Innovation Center will use fixed, value-based payments to support technology-supported care for chronic disease management.
Home health agencies face 1.3% decrease in Medicare payments
CMS finalized the CY 2026 Medicare payment rates for home health agencies, issuing a significantly smaller cut to payments than the $1.135 billion proposed reduction.
Site-neutral pay, 340B clawback to offset new 2.6% OPPS boost
CMS will proceed with site-neutral payment expansion and the 340B clawback plan as it finalizes an overall 2.6% increase to Medicare outpatient hospital reimbursement.
Urban safety-net hospitals: The unseen victims of Medicaid cuts
A Harvard analysis shows urban safety-net hospitals facing the greatest financial distress as a result of Medicaid cuts under the One Big Beautiful Bill Act.
Democrats introduce bill to repeal Medicare prior authorization pilot
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Revenue Cycle Management
Greenway Health
Improving healthcare through innovation is at the heart of Greenway Health’s work. We provide electronic health records (EHR), practice management, and revenue cycle management solutions that help practices in multiple specialties grow profitably, remain compliant, work more efficiently, and improve patient outcomes.
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Risk Adjustment Compliance
RAAPID
RAAPID develops AI-powered risk adjustment solutions for healthcare payers, providers, and supporting organizations. The company's HITRUST-certified platform uses Neuro-Symbolic AI to identify chronic conditions, determine HCC codes, and provide explainable documentation for complete audit defense. Backed by M12 (Microsoft's venture fund), RAAPID serves organizations participating in Medicare Advantage, ACA, Medicare ACO, and Medicaid programs with both retrospective and prospective risk capture capabilities. Founded by healthcare technology veterans with over 20 years of experience, RAAPID is headquartered in Louisville, Kentucky.
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Autonomous Coding
Solventum
Healthcare Strategies: A Podcast
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A podcast for healthcare professionals seeking solutions to today's and tomorrow's top challenges. Hosted by the editors of Xtelligent Healthcare Media, this podcast series focuses on real-world use cases that are leading to tangible improvements in care quality, outcomes, and cost.
Guests from leading provider, payer, government, and other organizations share their approaches to transforming healthcare in a meaningful and lasting way.
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Latest News
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Home health agencies face 1.3% decrease in Medicare payments
CMS finalized the CY 2026 Medicare payment rates for home health agencies, issuing a significantly smaller cut to payments than the $1.135 billion proposed reduction.
-
Site-neutral pay, 340B clawback to offset new 2.6% OPPS boost
CMS will proceed with site-neutral payment expansion and the 340B clawback plan as it finalizes an overall 2.6% increase to Medicare outpatient hospital reimbursement.
-
Urban safety-net hospitals: The unseen victims of Medicaid cuts
A Harvard analysis shows urban safety-net hospitals facing the greatest financial distress as a result of Medicaid cuts under the One Big Beautiful Bill Act.
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Providers prepare to fight Anthem's new out-of-network policy
Over 80 physician groups oppose an upcoming Anthem policy that penalizes hospitals when members receive care from an out-of-network provider in the facility setting.
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Google Cloud, Conifer team up for end-to-end AI RCM
Conifer is leveraging AI capabilities from Google Cloud to power end-to-end revenue cycle management workflows within its proprietary technology platform.
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Survey: Most providers not ready for TEAM bundled payments
Despite new requirements coming in January, 77% of providers don't feel prepared for new TEAM bundled payments as they continue to suffer from data challenges.
Features
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Meet the 6 vendors participating in the CMS WISeR Model
The vendors selected to lead a new CMS model will apply their technologies leveraging AI to streamline the Medicare prior authorization process in six states.
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ACA enhanced tax credit fight exposes healthcare's funding crisis
Enhanced premium tax credits are at the center of the latest government shutdown, creating concerns for providers and exposing a history of patchwork solutions for a cracked system.
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Provider pay caught in the middle during government shutdown
The ongoing government shutdown will impact Medicare reimbursement, particularly for telehealth services, putting revenue cycle teams in a tight spot.
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Athenahealth revamps revenue cycle management in the era of AI
Athenahealth is adding AI features to its practice and revenue cycle management capabilities, at no additional cost, as the health IT company leans toward becoming AI native.