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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.

Which Tools Will CMS Use to Combat Lab Fraud?...

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

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Leveraging analytics
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Medical Billing
April 07, 2026

The CRUSH Healthcare Initiative Alrea...

Fraud detection has taken center stage with this administration, and the latest effort is the Comprehensive Regulations ...

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TEAM Model
January 27, 2026

How Will the CMS TEAM Model Impact Ho...

Late last year, CMS introduced the Transforming Episode Accountability Model (TEAM). It addresses five surgical categori...

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Market-based logistics efficiency
January 12, 2026

Home Health Quality Reporting & OASIS...

As Home Health Agencies (HHAs) move into 2026, the finalized CMS CY 2026 Home Health Prospective Payment System (HH PPS)...

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Market-based logistics efficiency
November 25, 2025

The Home Health Stabilization Act's I...

Home health care billing is experiencing yet another change, this time in the form of legislation designed to address pa...

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CMS Announces Plans
October 23, 2025

CMS Announces Plan to Repeal Nursing ...

The home health revenue cycle has experienced ongoing changes in recent years, and this year is no different. The Center...

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Home Health Billing Service
September 15, 2025

Home Health PPS 2026 Fact Sheet Overv...

As part of an aggressive rate cut, CMS has issued the Health Prospective Payment System (HPPS) Proposed Rule for CY 2026...

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Healthcare Upcoding
November 04, 2024

Healthcare Leaders Are Increasingly C...

The risks around upcoding have incentivized many healthcare providers to consider medical coding outsourcing companies, ...

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Home Health Denial Management Services
October 15, 2024

Addressing Home Health Denial Managem...

Denials remain a significant challenge for providers, especially within home health organizations. Ineffective denial ma...

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Market-based logistics efficiency
April 09, 2024

Home Health Billing Alert: CMS Calls ...

Home health aide visits have been plummeting in recent years, and the Centers for Medicare & Medicaid Services (CMS) has...

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