New & Notable
CMS rule targets suspect billing in Shared Savings Program
A new CMS rule is addressing "significant, anomalous, and highly suspect" billing activity within the Medicare Shared Savings Program to mitigate financial impacts for ACOs.
Do hospital mergers and acquisitions drive physician burnout?
Half of physicians said hospital mergers and acquisitions affect their job satisfaction, contributing to medicine's physician burnout woes.
CMS issues updated rural emergency hospital guidance
Updated CMS guidance walks organizations through the process of becoming a rural emergency hospital provider type.
AMA 2025 CPT code set updates focus on novel genetic testing
The AMA's 2025 CPT code set has 420 updates, including new codes for genetic testing, AI medical services, remote therapeutic monitoring and novel surgical techniques.
Insights
Insights is the research division of Xtelligent Healthcare Media. Our work aims to leverage Xtelligent’s diverse readership of healthcare professionals across various sectors of the industry to understand real-world challenges and identify effective solutions.
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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.
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Latest News
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WEDI explores issue of diagnosis codes in good faith estimates
WEDI encouraged HHS to weigh whether the inclusion of diagnosis codes should be required for good faith estimates sent to health plans by providers on behalf of insured patients.
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Hospital finances are stabilizing, Kaufman Hall data finds
Hospital finances continue to stabilize with a 3.8% operating index in July 2024, driven by increased outpatient revenue and shorter stays, according to recent Kaufman Hall data.
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Private equity hospice ownership data scant despite PE moves
Hospice ownership data is hard to come by, limiting efforts to understand the impacts of private equity activity.
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Judge blocks FTC noncompete ban
A Texas judge blocked the FTC noncompete ban just weeks before it was set to take effect, sparking mixed reactions from the healthcare community.
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16,000 No Surprises Act complaints yield $4M in relief
The 16,000 No Surprises Act complaints primarily related to air ambulance services.
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SNF integration might discourage BPCI-A participation
A study found that SNF integration was linked to a statistically significant reduction in BPCI-A participation for major joint replacement of the lower extremity (MJRLE) episodes.
Features
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Exploring the role of medical claim clearinghouses
Medical claim clearinghouses manage claim submissions for providers, increasing efficiency, reducing costs and improving payment accuracy.
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Unpacking the mid-revenue cycle, strategies for success
The mid-revenue cycle includes coding, CDI, and compliance, making its processes vital to a provider organization’s success.
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How Robotic Process Automation Optimizes Revenue Cycle Management
Robotic process automation (RPA) saves practices money and time by automating manual, repetitive tasks within revenue cycle management.
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Breaking Down the Back-End Revenue Cycle, Key Best Practices
When a patient encounter ends, the back end of the revenue cycle gets busy creating claims and managing A/R to optimize revenue collection and integrity.