Revenue Cycle Strategy

Key Takeaways The FY 2027 IPPS Final Rule was released July 31, 2026 and takes effect October 1, 2026 The 2.3% payment increase (down from 2.4% proposed) masks meaningful DSH, wage index, and payer-mix variation Three new MS-DRGs require CDI preparation: extensive spinal fusion (523–525), PJI hip/knee (403–404), and cardiac pacemaker revision (210–211) A new sepsis readmission measure raises the stakes on sepsis documentation on both the front and back ends of the stay TEAM r

Six months into the fiscal year is the best time a hospital CFO will get to course-correct before year-end close — not because the calendar says so, but because it's the first point where enough claims have fully adjudicated to see real patterns instead of noise. By July, denials from January and February have worked their way through appeals. DNFB accounts from Q1 have settled into a steady-state number instead of a start-of-year anomaly. The data is finally telling the trut

When an experienced inpatient coder or CDI specialist resigns, the job posting goes up the same week. What doesn't get replaced that quickly is everything that left with them: the payer-specific quirks they'd memorized, the documentation patterns that got claims paid the first time, the instinct for when a chart needs a query and when it doesn't. A req can be filled. Institutional knowledge can't be reposted. That gap is widening. The AAPC has reported a roughly 12% nationwid

In 2026, healthcare organizations face unprecedented revenue cycle challenges. The shift to value-based care demands exceptional clinical documentation and risk adjustment. AI-powered prior authorization creates new workflow complexities. Federal funding volatility threatens margins. Denial rates persist despite sophisticated appeal programs. Meanwhile, physician resistance remains the single biggest barrier to revenue cycle improvement initiatives. Traditional revenue cycle

Key Takeaways: 2026 Healthcare Revenue Cycle Changes Policy & Payment Model Transformations Telehealth Flexibility Extended Through 2026 - DEA extends controlled substance prescribing flexibility for a fourth time, requiring organizations to maintain updated coding knowledge, payer-specific policies, and proper telehealth documentation standards. 340B Program Protected from $400M Loss - Federal court injunction halts rebate model pilot, providing temporary relief while unders

From Patient Registration to Final Payment The healthcare revenue cycle is a complex process that spans from the moment a patient schedules an appointment to the final payment collection. Understanding each step is critical for healthcare organizations seeking to optimize cash flow, reduce denials, and improve financial performance. With claim denials costing U.S. healthcare providers billions annually—and more than 80% of these denials being preventable—mastering the revenue