New & Notable
New CMS model goes after healthcare fraud through prior auths
A new CMS Innovation Center model plans to reduce healthcare fraud, waste and abuse in Traditional Medicare by using AI to improve and expedite the prior authorization process.
Gen AI company Abridge raises $300M, targets revenue cycle
The rapidly growing healthcare AI start-up Abridge raised more funding to expand its generative AI for clinical documentation to revenue cycle management, per a new announcement.
'Big Beautiful Bill' puts rural hospitals at even greater risk
The House-passed reconciliation bill would push the 338 rural hospitals already at risk of closing, converting or stopping service lines to shutter their doors, new data shows.
Uncompensated care to rise by $283B under reconciliation bill
The House reconciliation bill and the expiration of enhanced premium tax credits for Marketplace plans would increase the level of uncompensated care, particularly at hospitals.
Insights
Insights is research conducted by and for TechTarget Xtelligent Healthcare. Our work aims to leverage Xtelligent’s diverse readership of healthcare professionals across various sectors of the industry to understand real-world challenges and identify effective solutions.
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Sponsored 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.
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Financial Responsibility
CareCredit
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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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House bill would lead to provider revenue problems: Analysis
An analysis estimates more than $770 billion in provider revenue losses and substantially higher uncompensated care costs over the next decade under the House reconciliation bill.
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Initial claim denial rates put revenue cycle in tough spot
New data shows an increase in initial claim denial rates, which are putting pressure on patient collections and the overall healthcare revenue cycle.
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R1 secures investment for agentic AI in revenue cycle management
Khosla Ventures has invested an undisclosed amount in R1 to further the vendor's use of agentic AI in revenue cycle management, including medical billing and denials management.
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Private practice can’t keep up with current payment rates
A new analysis finds inadequate payment rates were the top motivator for independent physicians to sell their private practices to hospitals, private equity firms and insurers.
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Patient payment plans leave much to be desired
A survey reveals that current patient payment plans offered by providers don't align with healthcare affordability needs, while tying up significant provider revenue.
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Value-based care revenue to grow, but risk is a challenge
Healthcare organizations expect higher value-based care revenue in 2025, with 64% predicting growth despite challenges like financial risk and lagging data interoperability.
Features
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Key takeaways from hospital price transparency updates
Federal agencies unveiled hospital price transparency updates requiring more dollar-and-cents pricing, marking a pivotal shift from complex codes to consumer-friendly pricing data.
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What MAHA means for the CMS Innovation Center, APMs
Under Trump's "Making America Healthy Again," the CMS Innovation Center is overhauling alternative payment model design to include more downside risk and prospective payments.
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The state of revenue cycle management software
Revenue cycle management software supports operational efficiency and financial outcomes for healthcare providers, leading to a robust and growing market for solutions.
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Understanding the Fundamentals of Accountable Care Organizations
Accountable care organizations, or ACOs, promote higher care quality at lower costs while shifting risk to healthcare providers, making the model a staple of value-based care.