Advanced Claims Management: Tackling Healthcare Underpayment Challenges
Explore advanced claims management to address healthcare underpayment challenges, improve revenue cycle stability, and leverage AI solutions for better profitability.
Explore advanced claims management to address healthcare underpayment challenges, improve revenue cycle stability, and leverage AI solutions for better profitability.
Explore Medicaid intergovernmental transfers (IGTs) abuse, federal oversight challenges, and policy reform opportunities to restore Medicaid fiscal integrity and ensure equitable provider payments.
Rising cost pressures and demographic shifts fuel intensified disputes between payers and providers over Medicare Advantage contracts, impacting reimbursement and network participation.
Vermont Blue Advantage will discontinue Medicare Advantage plans in 2026, impacting 26,000 enrollees. HealthSpring assumes retiree plans amid market exits by UnitedHealthcare. State braces for enrollment shifts.
Explore how AI-powered automation addresses health insurance claims denials by improving coding accuracy and streamlining claims management in hospitals and health systems.
Healthcare leaders are assessing if Advanced Practice Providers can solve physician shortages and budget pressures amid rising healthcare costs.
Rural hospitals in New Hampshire face growing financial losses due to increased Medicare Advantage enrollment, driven by lower reimbursements and administrative complexities, impacting patient care and hospital operations.
Federal budget cuts are reducing public health insurance in Massachusetts, affecting DACA recipients and low-income immigrants, with significant impacts on Medicaid and health safety net programs.
Physician incomes from Medicare have fallen over 33% since 2016 due to stagnant reimbursements and increased costs, prompting health systems to reconsider Medicare Advantage participation. This shift threatens patient access and could reshape Medicare's physician landscape.
The August 2025 EMS Financial Index from PWW Advisory Group delivers critical financial benchmarks and reimbursement trend analysis to support EMS agencies' revenue cycle management and financial stability amid changing regulations.