CMS’s expanding RADV audit activity is changing the economics of risk adjustment. The question is no longer whether organizations can optimize retrospective chart chase. The question is whether their operating model can withstand continuous audit scrutiny at enterprise scale. Retrospective…
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For most health systems, the pharmacy is treated as a cost center. A growing number are proving it can be a growth engine instead, and KLAS just took a closer look at how. In its first Emerging Company Spotlight on…
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Clinical training rarely prepares physicians to run the business side of an independent practice. Drawing on lessons from orthopedic entrepreneur and practice owner Pamela Mehta, MD, and healthcare financing leader Daniel Miller, this whitepaper explores how intentional operating models, upfront…
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For cardiorenal populations, costs don’t rise gradually. They accelerate at each stage of kidney disease progression. These findings suggest that important opportunities for intervention may exist much earlier in the disease trajectory than traditionally recognized. A new analysis of 2024…
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Picture a revenue cycle where surgical cancellations are rare, A/R runs below the national benchmark and leadership can see workflow performance in real time. That’s where one Indiana orthopedic practice landed after three years of continuous revenue cycle automation. The…
Prolonged operative times and prone positioning make spine surgery one of the highest-risk settings for pressure and nerve injuries. The consequences land on patients, staff and margins alike. That risk is about to carry new accountability. Beginning in calendar year…
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Health systems spent years expanding ambulatory access through clinics, outpatient centers and multispecialty networks. Now many organizations are confronting a different challenge: managing increasingly distributed ambulatory portfolios that were not originally designed to operate at scale. This whitepaper explores how…
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94 percent of consumers say healthcare needs to be easier. Yet friction starts long before the bill arrives. Thirty-eight percent struggle to find an in-network provider. Seventy-nine percent have been surprised by a medical bill. Half have delayed or skipped…
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EMS clinicians routinely identify and treat patients with conditions like hypoxia, hypotension, shock or sepsis before reaching the emergency department. By the time an emergency physician evaluates the patient, the initial instability may have resolved but clinical complexity, monitoring needs…
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DSO affiliation among U.S. dentists more than doubled over the past decade, rising from 7.2% in 2015 to 16.1% in 2024. That growth creates opportunity, but it also raises the operational stakes. A revenue cycle that works cleanly across two…
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A regional health system was running its urgent care network at a loss and struggling to meet patient demand. Rather than retreat, it partnered to rebuild the service line around a retail-style operating playbook attracting new patients to the system,…
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Clinicians at CHRISTUS Health keep describing their AI platform the same way: ”This is life-changing.” But when it came time to deepen the partnership, leadership did not rely on early wins alone. They looked at how much the platform had…
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