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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.

How Will the CMS TEAM Model Impact Home Healt...

Late last year, CMS introduced the Transforming Episode Accountability Model (TEAM). It addresses five surgical categories with the intent of improving the quality of care and reducing expenditures. This model directly impacts home health billing from multiple angles.

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TEAM Model
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Market-based logistics efficiency
October 27, 2025

Accuracy Isn't Enough in Risk Adjustm...

Accuracy gets all the attention in risk adjustment coding, and rightly so. It’s the backbone of compliance, reimbursemen...

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RADV Audits
September 25, 2025

RADV Audits & Risk Adjustment Coding ...

RADV audits just got real. In 2025, Medicare Advantage (MA) plans are facing the true financial impact of inaccurate or ...

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Risk Adjustment Medical Coding
June 30, 2025

The Vital Role of Risk Adjustment Med...

In today’s value-based healthcare environment, risk adjustment medical coders are essential to the financial health, reg...

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Risk Adjustment Coder
June 24, 2025

Risk Adjustment Coding Update: CMS Ra...

Changes from the Centers for Medicare & Medicaid Services (CMS) have been plentiful in recent months—and now things are ...

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Risk Adjustment
June 17, 2025

Elevate Your Reimbursement Strategy ...

Prospective risk adjustment is rapidly becoming essential for healthcare providers navigating the Centers for Medicare &...

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Risk Adjustment Coding
June 10, 2025

HCC Risk Adjustment in 2025: Advanced...

HCC risk adjustment in 2025 is more than just a compliance checkbox – it’s a strategic driver of revenue and regulatory ...

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Risk Adjustment Medical Coding
June 06, 2025

The 2026 Medicare Advantage Final Rul...

The Centers for Medicare & Medicaid Services' (CMS) CY 2026 Rate Announcement introduces significant updates that direct...

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Accurate HCC Risk Adjustment
May 16, 2025

How Accurate HCC Risk Adjustment Can ...

As the healthcare industry continues to shift toward value-based care, precise Hierarchical Condition Category (HCC) ris...

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Risk Adjustment Medicare Advantage
February 25, 2025

Risk Adjustment and Social Determinan...

Revenue cycle leaders face increasing pressure to manage costs, optimize revenue, and improve revenue cycle functions. T...

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