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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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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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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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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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risk adjustment coding companies
May 05, 2026

Risk Adjustment & HEDIS in 2026: Why ...

In 2026, health plans, Medicare Advantage organizations, and risk adjustment coding companies across the US face growing...

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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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Market-based logistics efficiency
October 31, 2025

Risk Adjustment Services Update: 2023...

Risk adjustment audits are changing again, and leaders in charge of risk adjustment services should take note as the imp...

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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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