New & Notable
Jefferson Health sues Aetna over Medicare Advantage ‘downcoding’ policy
The health system claims the policy, which reduces reimbursement for some inpatient hospital stays, violates federal law and its reimbursement contract with Aetna.
— Healthcare Dive
Waystar tackles $40B denials problem with new AI capability
As part of creating an autonomous revenue cycle, Waystar is now using AI to identify silent denials from post-payment adjustments.
CMS proposes Medicare payment rules for SNFs, 3 others
CMS is seeking to increase payments to skilled nursing facilities, hospices and inpatient rehabilitation and psychiatric facilities next year, while cracking down on hospice fraud.
Hospitals lost over $48B from claims denials, uncollected bills
Revenue leakage worsened for hospitals in 2025, as payers denied more claims and bad debt increased significantly, according to a new report.
Over 130 hospitals sue HHS over DSH payments
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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.
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Latest News
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Waystar tackles $40B denials problem with new AI capability
As part of creating an autonomous revenue cycle, Waystar is now using AI to identify silent denials from post-payment adjustments.
-
CMS proposes Medicare payment rules for SNFs, 3 others
CMS is seeking to increase payments to skilled nursing facilities, hospices and inpatient rehabilitation and psychiatric facilities next year, while cracking down on hospice fraud.
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Hospitals lost over $48B from claims denials, uncollected bills
Revenue leakage worsened for hospitals in 2025, as payers denied more claims and bad debt increased significantly, according to a new report.
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Ensemble, Cohere partner on LLM for revenue cycle management
Ensemble said it will build a revenue cycle management-native LLM with the enterprise AI company to manage specific RCM workflows and payer rules.
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Adonis raises $40M to accelerate AI in revenue cycle
With users like Mount Sinai Health System, Adonis raised $40M in Series C funding to further drive the application of AI in its revenue cycle platform.
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AMA: Blended physician compensation model prevails
New data from the American Medical Association reveals major changes in physician compensation, with a blended model based on salary and productivity being most popular.
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.