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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.

Risk Adjustment Solutions for 2027: Moving fr...

Risk adjustment solutions for Medicare Advantage organizations are entering 2027 under a confirmed payment environment and a set of operational changes that require adaptation before January 1. CMS's April 2026 Rate Announcement projects MA payments to increase by 2.48% – over $13 billion – in CY 2027, while CMS expects MA risk scores to increase by 2.50% on average due to underlying coding trends [1]

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risk adjustment companies risk adjustment audits unlinked CRR exclusion 2027 chart review services
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Laboratory revenue cycle management review of billing accuracy, denials, reimbursement trends, and 2027 CLFS readiness
September 18, 2026

Preparing for CLFS Reimbursement Chan...

Laboratory revenue cycle management encompasses every operational process connecting clinical laboratory services to col...

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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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PAMA reporting 2026 clinical lab billing services laboratory revenue cycle
June 01, 2026

What PAMA Reporting Means for Clinica...

The PAMA reporting window for clinical laboratories is open right now – May 1 through July 31, 2026. What applicable lab...

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Leveraging analytics
May 07, 2026

Which Tools Will CMS Use to Combat La...

The conversation around fraud in laboratory billing, especially in genetic and molecular diagnostics, is no longer theor...

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laboratory revenue cycle management
May 01, 2026

Growing Policy Limitations on IHC Sta...

In today’s US healthcare market, laboratory revenue cycle management (lab RCM) is no longer just about clean billing – i...

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pathology billing
March 10, 2026

The Future of Artificial Intelligence...

Artificial Intelligence (AI) is steadily reshaping digital pathology – but not through sudden disruption or autonomous d...

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Laboratory Billing Services
February 05, 2026

Medicare Clawbacks on PCR UTI Testing...

Medicare clawbacks related to urinary tract infection (UTI) testing are no longer isolated compliance events. As we move...

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Market-based logistics efficiency
October 29, 2025

Can Urine Toxicology Lab Services Be ...

With telehealth now a mainstream mode of care, many pathology labs, clinical laboratories, and behavioral health provide...

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U.S. Lab Billing Service
October 16, 2025

2025 CLFS Update: Essential Guidance ...

The 2025 Clinical Laboratory Fee Schedule (CLFS) update has given U.S. labs extra time to prepare for the upcoming Janua...

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