New & Notable
$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.
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.
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.
Sponsored Sites
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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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RCM Management
ZOLL Data Systems
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Cybersecurity
Commvault + Microsoft
Together, Commvault and Microsoft are redefining cybersecurity and data resilience with a comprehensive, integrated platform, purpose-built to secure, defend, and recover data wherever it lives with true cloud simplicity, intelligence, and scale.
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.
View All Episodes
Latest News
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$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.
-
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.
-
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.
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R1 to acquire Humata Health for AI-driven prior authorizations
The acquisition, expected to close later this year, will leverage agentic AI to accelerate the prior authorization process and bring R1 closer to an autonomous revenue cycle platform.
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.