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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.

Increasing Revenue Leakage Calls for Improved...

Sometimes in healthcare, times emerge when status quo approaches to revenue cycle strategy are no longer enough. This time has arrived for accounts receivable services.

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accounts receivable services 2026 accounts receivable management services AR discipline hospital
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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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HCC risk adjustment coding Medicare Advantage
July 07, 2026

Why HCC Risk Adjustment Coding Is a B...

Two things converged in 2026 that make HCC risk adjustment coding a more consequential financial function than it has ev...

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prospective concurrent retrospective risk adjustment 2026 guide MA plans ACOs
June 22, 2026

Prospective, Concurrent, and Retrospe...

Risk adjustment is often discussed as a Medicare Advantage problem. In actuality, it affects every organization whose re...

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HCC risk adjustment coding defensible Medicare Advantage RADV
June 12, 2026

The New Era of HCC Risk Adjustment: W...

For years, many Medicare Advantage organizations treated HCC risk adjustment as a volume exercise: capture more diagnose...

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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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OIG Medicare Advantage HCC risk adjustment coding audit 2026
June 07, 2026

OIG Flags $462 Million in Medicare Ad...

On June 1, 2026, the HHS Office of Inspector General published one of the most significant Medicare HCC risk adjustment ...

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underpayment revenue leakage medical billing
June 06, 2026

"Paid" Isn't the Same as "Paid Correc...

When a claim comes back paid, the workflow closes. The case moves out of the queue. Someone marks it resolved. The prob...

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HCC risk adjustment Medicare Advantage RAF optimization 2026
June 03, 2026

RiskGen-i & Risk Adjustment in 2026: ...

In 2026, Medicare Advantage risk adjustment is no longer just a coding exercise. It has become a high-stakes operational...

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medical billing
May 24, 2026

RPM Billing in 2026: A Day in RPM Ser...

Remote Patient Monitoring (RPM) billing sounds like one of those healthcare ideas that should be simple: Patients stay h...

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