New & Notable
Healthcare affordability crisis sparks calls for better billing communication
Surveys show consumers need a better patient financial experience, flagging AI as a tool to improve price transparency and communication about medical bills.
FTC warns 24 large health systems of price transparency deficiencies
The FTC letters warn of deceptive pricing practices just as the Trump administration revamped healthcare price transparency requirements for payers.
AKASA launches AI for autonomous mid-cycle coding
A new solution from AKASA promises to fully code inpatient cases with no human intervention as the company continues to apply advanced AI to the mid-cycle.
CJR Model's $180M savings pave way for nationwide expansion
Medicare's bundled payment model for joint replacements cut costs by $180 million in its final three years without compromising care quality, according to a new CMS report.
Sponsored Sites
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Risk Adjustment Compliance
RAAPID
RAAPID develops AI-powered risk adjustment solutions for healthcare payers, providers, and supporting organizations. The company's HITRUST-certified platform uses Neuro-Symbolic AI to identify chronic conditions, determine HCC codes, and provide explainable documentation for complete audit defense. Backed by M12 (Microsoft's venture fund), RAAPID serves organizations participating in Medicare Advantage, ACA, Medicare ACO, and Medicaid programs with both retrospective and prospective risk capture capabilities. Founded by healthcare technology veterans with over 20 years of experience, RAAPID is headquartered in Louisville, Kentucky.
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Cybersecurity
Commvault + Microsoft
Together, Commvault and Microsoft are redefining cybersecurity and data resilience with a comprehensive, integrated platform, purpose-built to secure, defend, and recover data wherever it lives with true cloud simplicity, intelligence, and scale.
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Revenue Cycle Management
Brault
Brault is a revenue cycle and practice management organization that partners with hospitals and independent physician groups. Their intelligent practice solutions include coding and billing, MIPS optimization, provider documentation training, and practice management.
Healthcare Strategies: A Podcast
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A podcast for healthcare professionals seeking solutions to today's and tomorrow's top challenges. Hosted by the editors of Xtelligent Healthcare Media, this podcast series focuses on real-world use cases that are leading to tangible improvements in care quality, outcomes, and cost.
Guests from leading provider, payer, government, and other organizations share their approaches to transforming healthcare in a meaningful and lasting way.
View All Episodes
Latest News
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Healthcare affordability crisis sparks calls for better billing communication
Surveys show consumers need a better patient financial experience, flagging AI as a tool to improve price transparency and communication about medical bills.
-
FTC warns 24 large health systems of price transparency deficiencies
The FTC letters warn of deceptive pricing practices just as the Trump administration revamped healthcare price transparency requirements for payers.
-
AKASA launches AI for autonomous mid-cycle coding
A new solution from AKASA promises to fully code inpatient cases with no human intervention as the company continues to apply advanced AI to the mid-cycle.
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CJR Model's $180M savings pave way for nationwide expansion
Medicare's bundled payment model for joint replacements cut costs by $180 million in its final three years without compromising care quality, according to a new CMS report.
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Site-neutral payments could save over $12B
A new analysis from EBRI finds significant cost savings for health plans and employers under site-neutral payments, although patients would have to wait for relief.
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8% of hospital-insurer contract disputes go public: study
For-profit hospitals are more likely to publicly threaten to leave an insurer's network, although very few of these disputes end contractual relationships, according to a study.
Features
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Payers say AI doesn't deny care. The truth is more complex.
Payers say AI is not clicking the deny button on prior authorizations and provider claims, but the technology does play a key role in deciding which requests need further review.
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How providers can weather Medicaid cuts when many won't
Federal Medicaid reform will affect providers differently, with some more at risk of closing while others can innovate their way out of severe revenue losses.
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Prior authorization automation hinges on human connection
Healthcare is rapidly automating the prior authorization process, but Ochsner Health has found that a new initiative connecting payers and providers is making progress tangible.
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What providers really need to streamline prior authorizations
Providers have yet to see much progress on a pledge last year to streamline prior authorizations, signaling misalignment between payer promises and meaningful change for providers.
