In late 2023, a multi-hospital health system in the Southeast saw a sudden spike in payer requests for documentation. The compliance team had been running routine retrospective audits, but the pace of incoming denials and takebacks began to outstrip their ability to respond. Within six months, the organization reported more than $11 million in at-risk revenue and a doubling of external audit activity.
Despite their best efforts, the system was playing defense.
This story
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Why Ambient AI is Now a Deciding Factor in Clinician Recruitment
Health systems nationwide are grappling with a critical and intensifying challenge: how to attract and retain the next generation of clinical talent.
With the physician shortage not showing signs of slowing down, organizations are in dire need of new strategies to retain the talent they’ve cultivated, while also appealing to younger clinicians who will be essential to meeting the rising demand for care.
Unlike many of their more seasoned counterparts who may be comfortable with
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From Chatbots to Agents: How GPT-5 is Reshaping Healthcare and Pharma
Pharma is embracing GPT-5, shifting AI from chatbot to enterprise agent as it accelerates productivity amid regulatory challenges.
Large pharmaceutical and biotech companies have spent the last couple of years running specific pilots involving artificial intelligence (AI). Learnings from these forays have formed a basis for AI readiness and a guide for industry to weave generative AI into enterprise strategies. Even regulators have been experimenting with AI to offset staff shortages and
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Why AI in Healthcare ERP is the Biggest Opportunity for Cost Reduction
When most healthcare executives hear about artificial intelligence, they think of drug discovery or clinical trials, but the bigger opportunity is happening behind the scenes. Enterprise resource planning (ERP) systems are the backbone of finance, supply chain and compliance, and they’re beginning to leverage AI to transform how healthcare companies understand and act on their data.
By 2025, most major ERP platforms will ship with built-in AI features, but the question is how advanced and
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ACOs Must Lead on Specialty Care to Control Costs
Both the greatest strength and weakness of the ACO shared savings (MSSP) model is its focus on primary care, particularly chronic disease. ACOs have put patients with diabetes, hypertension, and other conditions usually handled through primary care physicians at the center of care coordination, population health, and care management. But as CMS Value-Based Care’s central goal has shifted to cost control, ACOs will need to broaden scope to optimize specialty care. TEAM (Transforming Episode
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Is Your Patient Portal Obsolete? Why a Basic Portal No Longer Meets 2025 Patient Expectations
The goal of a patient portal is to facilitate patient engagement – to give patients a more integral and active role in their own healthcare.
But recent research shows that 65 percent of patients believe that coordinating and managing healthcare – two areas where a portal should be helping – is overwhelming and time-consuming. This friction can have an impact on care outcomes: 54 percent of patients believe their health would be better if they had more support navigating the healthcare
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How Technology Is Transforming Modern Pain Management
Advancements in technology continue to change the way healthcare professionals handle pain management. More effective solutions like wearable devices and non-invasive procedures that improve patient outcomes and quality of life are becoming more popular.
These modern tools better support more personalized and precise treatments. Besides improving clinical effectiveness, tech is enabling patients to play a more active role in managing their health. Read on to learn how technology is
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How Visitor Management Can Make or Break Safety Plans
Workplace violence was estimated to cost healthcare organizations $18.27 billion in 2023. This spend included treatment for victims, security staffing for facilities, and violence prevention programs, among other costs. But more often than not, one of the biggest vulnerabilities to violence in healthcare often goes overlooked: visitor management.
Violent incidents aren’t solely caused by patients. Many times, incidents involve the visitors who enter healthcare facilities without proper
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“How to Make Wound Recovery and the Healing Process More Accessible in America”
My great-grandfather developed a diabetic wound that ultimately led to a series of amputations, and, not long after, to his death. His story is tragically common: every year, millions of Americans suffer from chronic wounds that could have been managed or healed with timely, adequate care. Instead, they progress to amputation and premature death. The stakes are high. Within a year of a diabetes-related lower-limb amputation, nearly 1 in 5 patients will die.
The toll is
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Life or Death Logistics: Why 1 in 5 Donated Organs Are Not Transplanted Due to Communication Failure
In organ transplantation, timing isn’t just critical. It is the difference between life and death. Every transplant is a race against the clock, requiring precise coordination among donor hospitals, transplant centers and surgical teams. Yet despite the stakes, the system designed to save lives is often hindered by something deceptively simple: poor communication.
The problem: Outdated tools in a high-stakes process
Even as medicine advances, many transplant teams still rely on fragmented,
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