Revenue Cycle Management & Finance  Archives

Revenue Cycle Management & Finance

Telehealth Secured, PBMs Scrutinized in Latest Spending Bill

The newly signed federal funding bill marks a pivotal moment for U.S. healthcare policy by pairing short-term budget stability with long-term shifts in care delivery and drug pricing regulation. Signed into law by President Trump on February 4, the legislation extends key telehealth flexibilities, prolongs the Acute Hospital Care at Home waiver, and implements the most substantive pharmacy benefit manager (PBM) reforms to date.

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Stopgap Policy Extensions Are Undermining Long-Term Care Innovation

With the federal government approaching yet another deadline to renew a suite of critical healthcare policies, the Medical Group Management Association’s (MGMA) January 2026 letter to congressional leadership makes clear what many in the provider space already know: temporary fixes are eroding strategic stability. From telehealth access to clinical lab reimbursement to the core viability of value-based care, the short-term extensions embedded in the latest continuing resolution reflect a dangerous pattern of legislative hesitation at precisely the moment long-term certainty is most needed.

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Improper Payments Remain a Quiet Risk to Federal Health Program Integrity

Improper payments across federal healthcare programs continue to absorb tens of billions of taxpayer dollars each year, posing a persistent operational risk that too often escapes strategic scrutiny. The Centers for Medicare & Medicaid Services (CMS) has released its Fiscal Year 2025 estimates, revealing a complex and often misunderstood picture of payment accuracy, documentation failures, and structural compliance breakdowns.

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Closing Financial Gaps: How Texting Strengthens Every Stage of Patient Collections

Revenue cycle teams are operating under sustained pressure. Patient financial responsibility keeps climbing, staffing shortages make manual outreach harder to maintain, and organizations are fighting to prevent revenue leakage at every step of the patient journey. Yet much of the communication that underpins collections still depends on time-consuming phone calls, letters, and portals that patients either ignore or struggle to access.

Hippocratic AI lands $126M series C

With a $3.5 billion valuation and more than 50 enterprise clients, Hippocratic AI has rapidly positioned itself as a category leader in patient-facing healthcare agents. Its $126 million Series C round, led by Avenir Growth Capital and supported by major health systems including WellSpan Health, Universal Health Services, and Cincinnati Children’s Hospital Medical Center, reflects more than investor confidence.

AI-Driven Diagnostics and the Strategic Stakes of Tempus AI’s Surge

The recent 200 percent year-to-date surge in Tempus AI stock has captured the attention of investors, traders, and technology analysts alike. But the true implications of Tempus’s momentum stretch well beyond technical indicators and price targets.

Microsoft Backs Revenue Cycle Fix for Rural Hospitals

More than 700 rural hospitals in the United States are at risk of closure. That figure is a systems-level indicator that current reimbursement structures, staffing models, and administrative expectations are fundamentally misaligned with the operating realities of small, low-margin health facilities.

Financial Pressures Reshape UnitedHealth’s Leadership and Strategy

UnitedHealth Group’s ‎July 31 announcement that Wayne DeVeydt will succeed John Rex as chief financial officer caps a turbulent six-month stretch punctuated by a profit warning, the return of founding leader Stephen Hemsley, and a dramatic retreat from Medicare Advantage (MA).

Strategic Oversight Defines the Future of RCM Automation Strategy

Revenue cycle automation strategy now defines resilience in healthcare finance under mounting regulatory, payer, and labor pressures. As reimbursement models shift and payer behaviors change frequently, health systems are under increasing pressure to embed automation within governance, compliance, and forecasting frameworks. Technology adopted without strategic rigor risks backfiring.

AI Partnerships in Revenue Cycle Are No Longer Experimental

The new strategic partnership between Ensemble Health Partners and Methodist Le Bonheur Healthcare (MLH) marks a decisive turn in the healthcare industry’s approach to revenue cycle management (RCM). It is an operational realignment built on a belief that revenue cycle functions are now too complex, too tech-driven, and too strategic to remain fragmented or under-resourced.

RCM Automation Emerges as Strategic Linchpin for Hospital Financial Resilience

Revenue cycle automation has moved beyond operational efficiency to become a core strategic asset for health systems navigating financial instability. With hospitals facing heightened pressure from staffing shortages, contract variability, and rising patient financial responsibility, the demand for intelligent automation in revenue cycle management (RCM) is now a structural imperative.

Mobile Engagement Platforms Redefine Post-Acute Risk

Readmission penalties have turned the quiet hours after discharge into the most expensive minutes on the hospital balance sheet. Leadership teams that once viewed patient portals as convenience tools must now treat mobile engagement platforms as critical infrastructure for value-based payment survival.

Policy and Market Currents will Define JanusIQ’s Long-Term Impact

Revenue cycle platforms such as JanusIQ gained initial traction by correcting upstream inefficiencies in authorization and claims workflows. The true test, however, lies in navigating regulatory enforcement, vendor competition, and long-term enterprise integration. This follow-up editorial analyzes those emerging pressures and the decisions revenue leaders must now anticipate.

Retail Exit Accelerates Founder-Led Hospital at Home Expansion

Best Buy has sold Current Health back to co-founder Christopher McGhee, ending a US$400 million retail foray and returning operational control of roughly one-third of national hospital-at-home episodes to the company’s original leadership. The transaction, confirmed by Home Health Care News(homehealthcarenews.com), reunites McGhee with fellow co-founder Stewart Whiting and several early engineers whose platform once powered remote acute care for Mass General Brigham and Atrium Health.

Altera’s Sunrise 25.1 Recasts EHR Vendor Expectations in an Era of Performance-Linked Technology

One week after the rollout of Altera Digital Health’s Sunrise 25.1, the conversation has shifted from feature analysis to strategic implications. This release redefines how health systems should evaluate their electronic health record (EHR) vendors, not just for functionality, but for alignment with performance-linked, modular modernization.