In this episode, Shelly Soileau, CFO of Opelousas General Health System, discusses the financial realities facing rural hospitals, including transportation barriers for patients, shifting payer behavior, and workforce costs. She also shares how focusing on revenue integrity, denial management, and…
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In this episode, Pankhuri Sharma, Strategy and Operations Leader at Humana, joins the podcast to discuss gaps between population health strategy and real-world outcomes. She shares key priorities for effective population health programs and offers practical advice for emerging leaders…
In this episode, Sri Narasimhan, VP of Enterprise Customer Experience and Insights at CVS Health, discusses how agentic AI twin simulations are enabling faster, more scalable, and more human-centered decision-making. He shares real-world examples of how this technology is uncovering…
In this episode, Sunitha Reddy, Chief Revenue Officer and Vice President of Operations, Prime Healthcare, discusses how revenue cycle strategy powers hospital turnarounds, tackles payer pressure and denials, and leverages AI to improve efficiency while supporting care access. Learn more…
In this episode, Dr. Arash Motamed, Anesthesiologist and Medical Director of Sustainability with Keck Medicine of USC, shares how his team successfully eliminated nitrous oxide use, highlighting its environmental impact, the path to clinician alignment, and broader opportunities to reduce…
CMS is proposing a mandatory, nationwide episode-based payment model for joint replacements that would hold most hospitals responsible for Medicare spending tied to a patient’s surgery and recovery. Beginning Oct. 1, 2027, the model — referred to as CJR-X —…
CMS on April 10 published its fiscal year 2027 Inpatient Prospective Payment System and Long-Term Care Hospital Prospective Payment System proposed rule, which includes a 2.4% payment increase for hospitals as well as the first mandatory nationwide episode-based payment model.…
Researchers at Rochester, Minn.-based Mayo Clinic used AI to determine that measuring fat around the heart greatly improves the accuracy of predicting long-term cardiovascular disease risk. The investigators applied AI to thousands of study participants’ standard coronary artery scans, finding…
Irving, Texas-based Christus Health has shared plans to open its new multi-specialty clinic in Mount Pleasant, Texas, April 13. The 22,000-square-foot clinic will be located in the same space as the system’s Christus Health Mount Pleasant Emergency Center, which opened…
CMS has proposed extending its prior authorization interoperability framework to cover drugs for the first time, building on its 2024 rule that focused on medical items and services. The proposed rule would also shorten decision timeframes and expand public reporting…