Revenue Cycle and Payer News – June 25, 2025
Reported payers and health insurance industry news from Humana, AHIP, Anthem Blue Cross and Blue Shield, Cigna, CareSource, Independence Blue Cross, Aetna, and more.
Read MoreHealthcare Revenue Cycle and Finance
Specialized Bookkeeping Approaches for Virtual Healthcare Services
By Devin Partida – Healthcare IT and accounting work hand in hand to provide patients with safe and affordable virtual services. Maintaining secure environments protects customer data and increases trust, encouraging people to return for more services when needed.
The Perfect Storm: Surging Audits, Clawbacks, and the Future of Healthcare Revenue Integrity
By Ritesh Ramesh – Healthcare finance executives face an intensifying storm of audits, denials, and clawbacks that threaten their organization’s financial stability. Couple that with an environment of heightened regulatory and payer scrutiny, and it becomes clear that proactive risk monitoring and AI-driven compliance strategies are no longer optional—they are imperative.
The Future of Value-Based Care: Aligning Payers & Providers for Better Outcomes
By Chris Lally – Over time, lawmakers, payers, and clinicians recognized that misaligned incentives produced waste, clinician fatigue, and uneven results. Value-based care (VBC) reshapes the equation by tying payment to quality, equity, and cost control. But how do you get there?
Revenue Cycle and Payer News – May 28, 2025
Reported payers and health insurance industry news from Independence Blue Cross, Anthem Blue Cross and Blue Shield, Humana, Cigna, Curative Health Insurance, CareFirst BlueCross BlueShield, As One Insurance Group and more.
Cross-Industry Partnerships: Navigating Healthcare’s Complex Reimbursement Landscape
By Frank Forte – Despite the widespread adoption of electronic health record systems and advances in interoperability, healthcare organizations continue to face significant hurdles in managing their revenue cycle operations, particularly when handling the most challenging areas of reimbursement.
State Medicaid Program Reports Cost Savings and Quality Boost by Integrating Social Care
By Halima Ahmadi-Montecalvo PhD MPH – Improving health outcomes requires more than medical care alone—it demands a holistic approach that addresses Social Drivers of Health (SDOH), such as housing, food security, transportation and interpersonal safety. The evidence is clear: addressing these factors not only improves health but also…
Revenue Cycle and Payer News – April 23, 2025
Reported payers and health insurance industry news from The Sequoia Project, CVS Health, Anthem Blue Cross and Blue Shield, Independence Blue Cross, AmeriHealth Caritas, CareSource, Humana, Cigna, Medica, UnitedHealthcare, and more.
Denials Management: Unintended Consequences of the Good Enough Mentality
By Ryan Chapin – With hospitals, health systems, and other provider organizations already squeezed by higher operating costs and lower operating margins, a surge in the volume and complexity of claim denials is an unwelcome source of a potentially multimillion-dollar revenue leakage that few organizations can afford to ignore.