New & Notable
Financial risk, perseverance pays off for Medicare ACOs
New data show that higher levels of financial risk and time spent in the Medicare Shared Savings Program result in stronger outcomes for ACOs.
Providers warn of the risk skin substitutes pose to ACOs
Provider groups are worried ACOs will suffer from the recent spike in skin substitute spending, raising concerns about the broader impact fraud, waste and abuse has on value-based care.
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.
Sponsored Sites
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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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Specialty Drug Management
Optum Specialty Fusion
At Optum, we’re evolving health care so everyone can have the opportunity to live their healthiest life. It’s why we put your unique needs at the heart of everything we do, making it easy and affordable to manage health and well-being. Together, for better health.
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Financial Responsibility
CareCredit
We do something very simple at CareCredit: We help people get the care they want for themselves and their families.
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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Financial risk, perseverance pays off for Medicare ACOs
New data show that higher levels of financial risk and time spent in the Medicare Shared Savings Program result in stronger outcomes for ACOs.
-
Providers warn of the risk skin substitutes pose to ACOs
Provider groups are worried ACOs will suffer from the recent spike in skin substitute spending, raising concerns about the broader impact fraud, waste and abuse has on value-based care.
-
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.
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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.
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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.
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.