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Reimbursement Is Changing. Alignment Will Decide What Works
Reimbursement Is Changing. Alignment Will Decide What Works

Reimbursement Is Changing. Alignment Will Decide What WorksThe future of healthcare reimbursement is being driven less by any single policy and more by mounting pressures across the system. Costs keep rising, administrative complexity remains high, and patients bear...

New CMMI Models Signal a Seismic Shift for Hospitals
New CMMI Models Signal a Seismic Shift for Hospitals

New CMMI Models Signal a Structural Shift for HospitalsThe Centers for Medicare and Medicaid Innovation (CMMI) is reshaping how hospitals are paid, evaluated, and held accountable. The latest generation of payment models extends beyond incremental updates, increasing...

Payers Are Not Making Mistakes. Is Your Strategy Keeping Up?
Payers Are Not Making Mistakes. Is Your Strategy Keeping Up?

Hospitals and health systems are losing money on claims they believed were billed correctly. A claim comes back lower. The case lands on a downgraded DRG. The gap disappears into a pattern that continues to surface in the data.  These DRG downgrades are no longer...

Why Clinical Intelligence Sets AI Apart in Healthcare
Why Clinical Intelligence Sets AI Apart in Healthcare

Why Clinical Intelligence Sets AI Apart in Healthcare Why are DRG downgrades still rising even as AI adoption grows? The answer points to a deeper problem than most AI vendors acknowledge: technology alone does not produce clinical accuracy. Denials keep climbing,...

Everyone Has AI. Few Systems Show Clinical Intelligence.
Everyone Has AI. Few Systems Show Clinical Intelligence.

Everyone Has AI. Few Systems Show Clinical Intelligence.   Thursday, April 2, 2026, 11:00am PT Senior Vice President of Product ManagementClinical Performance SpecialistAI is everywhere in clinical documentation integrity (CDI), but outcomes haven’t always kept pace...

Integrated Teams for Improved Outcomes in Hospital Operations
Integrated Teams for Improved Outcomes in Hospital Operations

Integrated Teams for Improved Outcomes in Hospital OperationsAligning clinical and financial teams in hospitals is now central to effective revenue cycle management. Documentation, coding, and financial outcomes no longer sit in separate operational lanes. Each...

Reimbursement Is Changing. Alignment Will Decide What Works
Reimbursement Is Changing. Alignment Will Decide What Works

Reimbursement Is Changing. Alignment Will Decide What WorksThe future of healthcare reimbursement is being driven less by any single policy and more by mounting pressures across the system. Costs keep rising, administrative complexity remains high, and patients bear...

New CMMI Models Signal a Seismic Shift for Hospitals
New CMMI Models Signal a Seismic Shift for Hospitals

New CMMI Models Signal a Structural Shift for HospitalsThe Centers for Medicare and Medicaid Innovation (CMMI) is reshaping how hospitals are paid, evaluated, and held accountable. The latest generation of payment models extends beyond incremental updates, increasing...

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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...