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Insights That Move Healthcare

Expert perspectives on revenue cycle, risk adjustment, compliance, and healthcare strategy – designed to help providers, plans, and leaders make smarter operational and financial decisions.

Why Ambulatory Surgical Center Billing Requir...

Ambulatory Surgery Centers (ASCs) are one of the fastest-growing segments of U.S. healthcare. Advances in minimally invasive techniques, improved anesthesia, and increasing patient demand for lower-cost care continue shifting complex surgical services out of hospitals and into outpatient surgery settings.

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ambulatory surgical center billing ASC medical billing ASC medical coding 2026
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ACO risk adjustment MSSP 2027 CMS proposed rule benchmark ACO REACH risk adjustment solutions revenue cycle
August 01, 2026

What CMS's July 14 Proposed Rule Mean...

CMS's proposed rule arrives against a backdrop of sustained program success....

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physician billing services 2026 Medicare physician fee schedule conversion
July 22, 2026

The 2026 Medicare Physician Fee Sched...

CMS finalized the 2026 Medicare Physician Fee Schedule (MPFS) in October 2025, with policies effective January 1, 2026. ...

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laboratory revenue cycle management clinical lab billing services pathology billing services
July 17, 2026

What the 2026 OIG Lab Spending Data M...

For clinical laboratory and pathology executives, 2026 presents a reimbursement landscape that looks fundamentally diffe...

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HCC risk adjustment coding Medicare Advantage
July 07, 2026

Why HCC Risk Adjustment Coding Is a B...

Two things converged in 2026 that make HCC risk adjustment coding a more consequential financial function than it has ev...

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prospective concurrent retrospective risk adjustment 2026 guide MA plans ACOs
June 22, 2026

Prospective, Concurrent, and Retrospe...

Risk adjustment is often discussed as a Medicare Advantage problem. In actuality, it affects every organization whose re...

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physician coding mistakes payer denials medical billing 2026
June 19, 2026

Top 7 Physician Coding Mistakes Trigg...

Why is physician coding creating more revenue risk in 2026? Physician coding is no longer just a compliance function sit...

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home health billing services audit compliance
June 17, 2026

Why Home Health Billing Services Are ...

On May 13, 2026, the Centers for Medicare and Medicaid Services imposed an unprecedented nationwide six-month moratorium...

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HCC risk adjustment coding defensible Medicare Advantage RADV
June 12, 2026

The New Era of HCC Risk Adjustment: W...

For years, many Medicare Advantage organizations treated HCC risk adjustment as a volume exercise: capture more diagnose...

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denial prevention vs denial management healthcare revenue cycle
June 08, 2026

Denial Prevention vs. Denial Manageme...

In 2025, U.S. hospitals spent $18 billion overturning claims denials. Not losing those claims. Not writing them off. Ov...

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