The revenue cycle management (RCM) landscape for healthcare is poised for significant transformation over the next few years. As the industry continues to evolve, RCM providers and their customers face a complex web of challenges and opportunities. Among the key trends shaping RCM in 2025 are:
Rising Costs Driven by Cybersecurity and Regulatory Compliance Demands and Increasing Patient Bad Debt Rates The cost of doing business is increasing. RCM providers invest in robust
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Medicare Advantage Organizations: 7 Ways to Ensure Your Document Management Platform Offers Full Automation
For Medicare Advantage Organizations (MAOs), the summer months have historically been defined by the high stakes, tight turnarounds and document management challenges of the Annual Enrollment Period (AEP). From the first Monday in June to late September, employees of MAOs clear personal calendars to carry out the demanding responsibilities of modifying all plan documents to reflect a variety of updates, including those for each individual plan offering, as well as the model document language and
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8 Way AI Can Optimize Revenue Cycle Management in 2025
Revenue Cycle Management (RCM) is essential to healthcare operations, yet today's complex environments add increasing challenges. Too often, providers are in a difficult position to finance care due to growing challenges, such as experiencing over 30% of claims being denied and over a third of accounts receivable aged beyond 90 days, which can lead to a financially unsustainable situation. But there is promising news: Artificial Intelligence (AI) can be a game-changer for RCM. Today, healthcare
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The Quintuple Aim: Redefining Patient-Centered Care in the Digital Age
Patient-centered care is constantly evolving, driven by fresh insights, innovative resources, and advancements in technology and healthcare delivery.
The Quintuple Aim is a healthcare framework at the heart of patient-centered care. It broadens the focus of healthcare improvement by prioritizing health equity alongside enhancing patient experiences, improving outcomes, reducing costs, and supporting clinician well-being. The Quintuple Aim emphasizes trust, open communication, and
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The Digital Doctor Is In: How AI Self-Triage Redefines Virtual Care
Imagine a world where your smartphone becomes your first line of defense against illness – where artificial intelligence (AI) can assess symptoms, offer personalized advice, and guide you to the right care faster than ever before. This isn’t science fiction; it’s the rapidly emerging reality of AI-powered self-triage in healthcare. As patient needs grow more complex and healthcare systems strain under increasing demand, these innovative tools are poised to revolutionize how we access and
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Is AI Failing Drug Development? The Unseen Challenges
For over a decade, we've heard about AI's transformative potential in therapeutics (Tx), but where's the evidence? Has it all been hype? Can AI still revolutionize Tx? Or is there something the AI experts aren't telling us?
First, some facts. The process of Tx development—from early clinical trials to FDA approval—is excruciatingly slow (over 10 years), expensive (over $2B, especially for immunotherapy drugs), and comes with a low probability of success (5% in Immune-Oncology, and similarly
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How Clinical Pharmacist-Led Telehealth Models Are Transforming Diabetes Care
Diabetes, a chronic condition affecting millions of Americans, is on the rise. According to the CDC, 15.8% of the U.S. population now lives with diabetes. With over 38 million people managing this complex disease, effective care is essential. Yet, access to diabetes care has become increasingly challenging, especially for underserved communities. The closure of primary care clinics by major retail pharmacy chains has further strained access to care, leaving vulnerable populations without the
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Increasing Participation in Muscular Dystrophy Clinical Trials
Muscular Dystrophy (MD) refers to a group of rare genetic conditions that cause progressive muscle weakness and degeneration in patients. Some forms of MD, such as Duchenne Muscular Dystrophy (DMD), can be life threatening to heart and respiratory functions.
But recent research found that among 3,661 U.S. patients with Muscular Dystrophy, only 33% of those with Duchenne and 12% of those with Becker Muscular Dystrophy - a similar but milder and later-onset MD condition - have previously
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New President – What’s Going to Happen to Healthcare?
High insurance premiums and medical costs don’t discriminate or differentiate based on your political affiliation. Therefore, healthcare should be one of your top priorities for the new administration. As a country we have been passengers passively watching the medical costs increase while the services deteriorate, only reacting when the problem lands on our doorstep.
This is a complex topic with fingers pointing everywhere passing the blame game like a hot potato. In my
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Rethinking Long-Term Care Infection Control for an Aging America
From April to August 2020, 45% of U.S. COVID deaths occurred in long-term care (LTC) facilities, even though LTC residents made up only 0.45% of the population. This stark disparity revealed that nursing homes were particularly vulnerable during the pandemic, with high transmission and fatality rates in these congregate settings. Skilled Nursing Facilities (SNFs), commonly known as nursing homes, represented about 80% of LTC COVID deaths, making them the deadliest place to live during COVID.
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