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.

Last week, EnableComp Chief Strategy Officer Mike Esworthy laid out a clear and compelling framework for tackling one of the most persistently underestimated problems in healthcare finance: the drag of complex claims. These are the 10 to 15 percent of encounters that exist outside the logic of routine reimbursement. They resist automation, evade standard EHR logic, and disproportionately strain revenue cycle teams already operating with fewer resources and tighter margins.

The legacy revenue cycle architecture in U.S. hospitals is nearing collapse under the weight of administrative inflation, payer friction, and regulatory acceleration. Janus Health’s introduction of JanusIQ is not merely a vendor product release but a signal that artificial intelligence is becoming the strategic core of revenue cycle performance. Hospitals cannot scale manual workflows to meet rising complexity. They require platforms that translate data volume into operational precision, and JanusIQ represents a decisive move in that direction.

One week after Altera Digital Health and Managed Care Advisory Group (MCAG) announced their collaboration to streamline class action claims filing for healthcare providers, it is clear that the partnership is more than a one-off response to a $2.8 billion Blue Cross Blue Shield (BCBS) settlement. It is a directional signal, and one that other health IT vendors would be wise to study closely.

Sunrise 25.1 delivers nearly 700 new features, including a significant overhaul to revenue management through its Financial Manager module. This module consolidates billing requests, claims, and self-pay actions into a single interface, enabling streamlined processes that reduce administrative burden and improve charge accuracy. These functions directly support the objectives of revenue integrity programs promoted across leading health systems and are increasingly essential in a reimbursement climate shaped by increasing charity care, persistent labor shortages, and payer complexity.

The $2.8 billion Blue Cross Blue Shield (BCBS) provider settlement may represent one of the most substantial class action victories for U.S. healthcare providers in recent memory, but for many hospitals, it’s a test. A test of bandwidth, compliance readiness, and whether resource-constrained organizations can capture what they’re rightfully owed.

Hospital margins may be nudging upward, but the forces behind those gains are fragile, fickle, and policy-contingent. Kaufman Hall’s latest Flash Report reveals a modest increase in median hospital margins to 3 percent in April, an improvement over March,but the broader context makes this less a sign of stability and more a reminder of how unpredictable external shocks can reverberate through healthcare operations.

Hospitals have digitized. They have automated. They have consolidated. But despite more than a decade of transformation in revenue cycle operations, most health systems are still losing efficiency in one costly corner: the complex claims that do not fit inside commercial or Medicare billing templates. These edge cases such as Veterans Affairs encounters, workers’ compensation claims, TRICARE submissions, and motor vehicle accidents, consume disproportionate resources and often delay payment for months.