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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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documentation to code integrity medical coding services audit exposure 2026 CMS improper payments U.S. healthcare providers specialty
September 10, 2026

Most Healthcare Audit Exposure Doesn'...

Most of what gets called a coding problem is not a coding problem. It is a documentation problem that surfaces in the co...

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August 28, 2026

How Screening-to-Diagnostic Colonosco...

In 2026, screening-to-diagnostic colonoscopy conversions remain one of the most overlooked reimbursement risks for gastr...

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June 29, 2026

Gastroenterology Billing Services Upd...

Gastroenterology practices are navigating revenue cycle changes on multiple fronts in 2026. The 2026 Physician Fee Sched...

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September 12, 2023

Changed Your Service Lines? It's Time...

In the wake of COVID, budget crunches, and labor shortages, many hospitals and health systems have been making the smart...

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