New & Notable
California hospitals sue Elevance over out-of-network penalty
The lawsuit seeks to block Elevance's expansion of its policy in California, which would penalize facilities with a 10% fee if care is delivered by an out-of-network physician.
DOJ forms West Coast Strike Force to stop healthcare fraud
In the administration's latest healthcare fraud crackdown, it created a West Coast Strike Force to root out fraud, waste and abuse in Arizona, Nevada and Northern California.
Skin substitute spending driven by patients, products, prices
A new analysis shows continued growth in Medicare's skin substitute spending, driven by higher prices, more patients and greater product use.
Health system CEOs in hot seat over their role in raising healthcare prices
During a high-profile congressional hearing on Tuesday, one lawmaker said hospitals charge “an insane amount” for care. Still, the CEOs largely passed the buck, arguing their prices are justified.
— Healthcare DivePrices rose after No Surprises arbitration for some care: analysis
— Healthcare DiveSponsored Sites
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Revenue Cycle Management
Brault
Brault is a revenue cycle and practice management organization that partners with hospitals and independent physician groups. Their intelligent practice solutions include coding and billing, MIPS optimization, provider documentation training, and practice management.
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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California hospitals sue Elevance over out-of-network penalty
The lawsuit seeks to block Elevance's expansion of its policy in California, which would penalize facilities with a 10% fee if care is delivered by an out-of-network physician.
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DOJ forms West Coast Strike Force to stop healthcare fraud
In the administration's latest healthcare fraud crackdown, it created a West Coast Strike Force to root out fraud, waste and abuse in Arizona, Nevada and Northern California.
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Skin substitute spending driven by patients, products, prices
A new analysis shows continued growth in Medicare's skin substitute spending, driven by higher prices, more patients and greater product use.
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AMA alerts officials of health plans' No Surprises Act abuse
More than 100 provider groups call for greater enforcement of the No Surprises Act after accusing health plans of circumventing its intent and raising patient costs.
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When brand-name drugs need a prior auth, brace for delays
A study uncovered friction at the pharmacy, revealing days-long delays and frequent denials when brand-name prescription drugs need a prior authorization.
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Before revenue cycle AI, payers and providers need to get along
A survey shows that most providers say disagreements with payers over claims prevent timely and full reimbursement.
Features
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The U.S. finally bent the healthcare cost curve, one economist says
Health economist David Cutler's new analysis shows a deceleration in U.S. healthcare spending as technology advancements make care cheaper.
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How AI scribes are shifting coding intensity, reimbursement
The proliferation of AI scribes for clinical documentation has started a shift in coding intensity, raising concerns about reimbursement and affordability.
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Agentic AI evolution begins to pave way for autonomous revenue cycle
A fully automated revenue cycle in which staff work hand-in-hand with AI is looming, but success will require a mature AI strategy.
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How NGHS balances revenue cycle AI adoption, ROI
Northeast Georgia Health System is accelerating AI adoption, especially in revenue cycle management, but leaders have learned to balance speed of innovation with ongoing ROI.