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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.

Prospective, Concurrent, and Retrospective Ri...

Risk adjustment is often discussed as a Medicare Advantage problem. In actuality, it affects every organization whose reimbursement, shared savings, or quality performance depends on accurately reflecting the complexity of their patient population.

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prospective concurrent retrospective risk adjustment 2026 guide MA plans ACOs
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outsourcing medical billing healthcare accounts receivable management revenue cycle 2026
June 10, 2026

Outsourcing Medical Billing for Healt...

Most healthcare organizations don't decide to outsource medical billing because of a single crisis. The decision builds ...

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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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home healthcare billing
May 20, 2026

New HCBS Quality Measures Impact Home...

Workforce pressures on billing for home health services are impacted every time The Centers for Medicare & Medicaid Serv...

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Home Health Billing Service
May 14, 2026

How Home Health Billing Denial Preven...

The home health revenue cycle has officially entered its “Prove It” era. For years, many home health agencies approache...

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Medical Coding
April 20, 2026

Why Generic AI Solutions Are a Risk f...

The healthcare revenue cycle has recently seen a flurry of coding solutions from some of the most recognized names in AI...

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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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