New & Notable
Athenahealth unveils over 80 revenue cycle AI features
The company announced its revenue cycle management roadmap, including new AI capabilities in its flagship platform for prior authorizations, coding and denial resolution.
Eli Lilly issues data sharing ultimatum to 340B hospitals
Select hospitals have refused to share data to prove they’re not double-dipping drug discounts, the drugmaker said. Lilly is giving them until Monday to comply, or lose out on 340B savings altogether.
— Healthcare Dive
No Surprises Act IDR gets major overhaul from CMS
A new final rule slashes IDR fees to $15, speeds up eligibility checks to 5 days, expands claim batching and boosts transparency to fix No Surprises Act bottlenecks.
Innovaccer keeps humans in the loop with CaduceausHealth deal
Innovaccer's latest acquisition supports its autonomous revenue cycle goals, while also underscoring the role RCM experts play in getting there.
Sponsored Sites
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Healthcare
Huron
Change is constant in healthcare, and its speed is accelerating. Huron works with healthcare organizations every day to strengthen and innovate their businesses and build more resilient operations to thrive now and in the future.
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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.
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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Athenahealth unveils over 80 revenue cycle AI features
The company announced its revenue cycle management roadmap, including new AI capabilities in its flagship platform for prior authorizations, coding and denial resolution.
-
No Surprises Act IDR gets major overhaul from CMS
A new final rule slashes IDR fees to $15, speeds up eligibility checks to 5 days, expands claim batching and boosts transparency to fix No Surprises Act bottlenecks.
-
Innovaccer keeps humans in the loop with CaduceausHealth deal
Innovaccer's latest acquisition supports its autonomous revenue cycle goals, while also underscoring the role RCM experts play in getting there.
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CMS proposes new cap on supplemental Medicaid payments
The proposed rule would align state-directed Medicaid payments with Medicare rates in a move to save $775B over the next ten years.
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Private payer rates outpaced Medicare's by 47%: KFF
New data shows a widening gap between what private payers and Medicare pay for hospital care as lawmakers blast hospitals for rising costs and seek reform.
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The 'corporate takeover' of physician practices accelerates: study
A new report details nearly a decade of hospitals and corporations buying physician practices, leaving just 18% of physicians practicing in physician-owned settings.
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.