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The New Payer Contracts: Why Rate Increases Are the Wrong Fight
The New Payer Contracts: Why Rate Increases Are the Wrong Fight

For decades, managed care contracting has been organized around a single objective: get a better rate. Health system negotiating teams prepare detailed market analyses, benchmark against regional competitors, and enter renewal cycles focused almost entirely on the...

CMS FInal Rule CMS-1849-F
CMS FInal Rule CMS-1849-F

CMS Fiscal Year 2027 Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) Final Rule    CMS-1849-F  August 10, 2026    Overview  On July 31, 2026, CMS released the Fiscal Year 2027 Hospital Inpatient...

The New Economics of Healthcare Reimbursement
The New Economics of Healthcare Reimbursement

The New Economics of Healthcare Reimbursement What’s Driving the Pressure on Healthcare Reimbursement Models? The traditional healthcare reimbursement model is under pressure and health system leaders know it. National health expenditures grew 7.2% in 2024, reaching...

The New Payer Contracts: Why Rate Increases Are the Wrong Fight
The New Payer Contracts: Why Rate Increases Are the Wrong Fight

For decades, managed care contracting has been organized around a single objective: get a better rate. Health system negotiating teams prepare detailed market analyses, benchmark against regional competitors, and enter renewal cycles focused almost entirely on the...

CMS FInal Rule CMS-1849-F
CMS FInal Rule CMS-1849-F

CMS Fiscal Year 2027 Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) Final Rule    CMS-1849-F  August 10, 2026    Overview  On July 31, 2026, CMS released the Fiscal Year 2027 Hospital Inpatient...

The New Economics of Healthcare Reimbursement
The New Economics of Healthcare Reimbursement

The New Economics of Healthcare Reimbursement What’s Driving the Pressure on Healthcare Reimbursement Models? The traditional healthcare reimbursement model is under pressure and health system leaders know it. National health expenditures grew 7.2% in 2024, reaching...

Root Cause to Revenue: Winning the Battle Against DRG Downgrades
Root Cause to Revenue: Winning the Battle Against DRG Downgrades

Root Cause to Revenue: Winning the Battle Against DRG Downgrades  07.29.2026 11:00 AM PT Executive Vice President Vice President, Denials Management ServicesHospitals and health systems face mounting revenue challenges from denials to evolving payer tactics, making...

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A Chargemaster Strategy for Revenue Integrity and Pricing Accuracy
A Chargemaster Strategy for Revenue Integrity and Pricing Accuracy

For years, hospitals could afford to treat the chargemaster as a technical file maintained somewhere in the background. That is becoming much harder to defend. The hospital chargemaster now sits underneath claims, contract modeling, public price files, and...

What Observation vs. Inpatient Decisions Are Really Costing Hospitals
What Observation vs. Inpatient Decisions Are Really Costing Hospitals

One of the most consequential decisions in a hospital can happen before a patient reaches the floor: whether the stay should be classified as observation or inpatient. This observation vs. inpatient decision can change reimbursement by thousands of dollars, even when...