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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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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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