payers
publication date
Revenue Cycle
HL Shorts: The Payer-Provider AI Arms Race
Data is power in the provider-payer "AI arms race," says Christina Slemp of UNC Health, who explains how providers can...
Revenue Cycle
Who Benefits from $5B Generated by IDR Arbitration?
The arbitration process established by the No Surprises Act has generated $5 billion in costs and significant operational challenges, yet...
Payer
Senators Press Deloitte, Other Contractors on Errors in Medicaid Eligibility Systems
Failures have resulted in the erroneous loss of health coverage and other vital safety-net benefits for low-income people.
CFO
Infographic: 3 Notes on the Medicare Advantage Prompt Pay Act
A new piece of legislature might ease Medicare Advantage reimbursement struggles for providers.
Revenue Cycle
Providers Face $32B Revenue Loss Amid Stalemate on ACA Subsidies
The Urban Institute projects a $32.1 billion single-year revenue loss for providers if ACA subsidies expire, a threat magnified by...
Revenue Cycle
Price Transparency Data Reveals 'Startling Spread' in Payer Rates
A new analysis of price transparency data reveals massive and often irrational variations in payer rates, arming providers with powerful...
Revenue Cycle
Infographic: How Healthcare Affordability Affects Your Rev Cycle
A new HFMA report highlights a national healthcare affordability crisis with significant implications for your revenue cycle.
Revenue Cycle
Can AI Rein in Claim Denial Rates?
While denial rates continue to climb, few health systems are using AI in claims management despite its potential to address...
CFO
How CFOs Are Navigating Medicaid Cuts, AI Skepticism, and Site Neutrality Risks
At this week's Healthleaders CFO Exchange, CFOs are bracing for financial turbulence under the new administration, with a renewed focus...
Revenue Cycle
Why HFMA's 'Serious Condition' Warning Matters to Your Revenue Cycle
A new HFMA report diagnoses the healthcare industry as being in "serious condition," providing a link between declining national affordability...
Infographic: Making the AHIP Prior Auth Pledge Matter
Beyond voluntary promises, standards and a federal mandate for FHIR-based APIs create a powerful framework for real prior authorization reform...
Revenue Cycle
Provider Advocacy Group Blasts 'Highly Problematic' Aetna Payment Policy
Aetna is following Cigna's lead with a new payment policy that will initially pay inpatient claims at a lower observation...