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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.

Risk Adjustment Solutions for 2027: Moving fr...

Risk adjustment solutions for Medicare Advantage organizations are entering 2027 under a confirmed payment environment and a set of operational changes that require adaptation before January 1. CMS's April 2026 Rate Announcement projects MA payments to increase by 2.48% – over $13 billion – in CY 2027, while CMS expects MA risk scores to increase by 2.50% on average due to underlying coding trends [1]

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risk adjustment companies risk adjustment audits unlinked CRR exclusion 2027 chart review services
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orthopedic billing services PE-backed practice EBITDA revenue cycle medical billing
July 28, 2026

Why Orthopedic Billing Accuracy Is a ...

Orthopedic billing services are the specialized revenue cycle functions that manage claim submission, coding accuracy, p...

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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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Predictive AR Management for Healthcare Providers | 2026
May 27, 2026

Predictive Accounts Receivable Manage...

Here's a question your AR team probably isn't asking: which unpaid claim is most likely to block your cash flow this wee...

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Market-based logistics efficiency
October 29, 2025

Can Urine Toxicology Lab Services Be ...

With telehealth now a mainstream mode of care, many pathology labs, clinical laboratories, and behavioral health provide...

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Pathology Billing
August 12, 2025

The Pathologist's RCM Checklist: Are ...

Your pathologists are diagnosing cancer. But your billing team? They’re diagnosing something else entirely: denials, und...

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Revenue Cycle Management
July 03, 2025

Emerging U.S. Regulatory and Payer Tr...

U.S. clinical labs face mounting regulatory challenges and shifting payer dynamics that are fundamentally changing how l...

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Physician's Guide to Financial Success
April 17, 2025

Mastering Payor Contracting: A Physic...

Physician practices face mounting financial pressures from rising operational costs, increasing claim denials, and compl...

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Providers Should Stay the Course
March 13, 2025

The No Surprises Act Is in Jeopardy, ...

Recent federal layoffs have added a new layer of uncertainty for providers impacted by the No Surprises Act. The federal...

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Medical Coding Outsourcing Companies
January 29, 2025

Why You Need Medical Coding Outsourci...

The healthcare industry in the United States is undergoing rapid transformation. As 2025 develops, healthcare leaders fa...

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