For years, hospital finance teams have run revenue cycle on a familiar loop: a claim goes out, a claim comes back denied or underpaid, and staff spend the next several weeks working it back. That loop was manageable when denial rates held fairly steady and reimbursement was reasonably predictable. Neither of those things is true anymore, and the gap between how revenue cycle is typically run and what today's payer environment actually demands is widening fast.
Denials are climbing, and they
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Health IT | News, Analysis, Insights - HIT Consultant
FDA Launches Rare Disease Framework Initiative to Modernize Small-Cohort Trial Design
What You Should Know
The U.S. Food and Drug Administration (FDA), an operating division of the U.S. Department of Health and Human Services (HHS), officially announced the launch of the Rare Disease Framework Initiative.Accompanied by the publication of a new agency white paper outlining a "fit-for-purpose" regulatory model engineered to match trial requirements to the realistic evidentiary constraints of ultra-small, geographically dispersed patient populations.Addresses a critical clinical
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Agilent to Acquire Proscia for Up to $270M to Build Scientific Intelligence Layer in Digital Pathology
What You Should Know
Analytical and clinical laboratory technology giant Agilent Technologies Inc. announced that it has entered into a definitive agreement to acquire digital pathology software and AI company Proscia®.Transaction financial terms: an all-cash acquisition valued at $240M in cash at closing, plus up to an additional $30M contingent on achieving future operational and financial performance milestones (total potential deal value of $270M).Closes the loop on a four-year commercial
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Brellium Raises $23M and Launches CortexLM with a Financial Guarantee Against Payer Clawbacks
What You Should Know
Healthcare clinical compliance and revenue integrity platform Brellium raises $23M in venture financing, co-led by Left Lane Capital and First Round Capital, with participation from Digital Health Venture Partners (and prior backing from Menlo Ventures).Directly tackles the escalating "healthcare bot war" over claims adjudication and post-payment clawbacks, positioning itself as a shared, objective standard between healthcare providers and health insurance payers rather
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Diverge Health Merges with Medical Home Network: Creating a Premier Value-Based Care Platform for Underserved Communities
What You Should Know
Diverge Health and Medical Home Network (MHN) PBC announced a definitive merger agreement to form one of the nation's largest value-based care platforms dedicated entirely to safety-net populations and under-resourced communities.The combination establishes one of the largest value-based care platforms in the United States dedicated to underserved communities, entering 2027 with nearly 500,000 attributed Medicaid and Medicare lives and $3 billion in managed medical spend
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Why Calling ICD-10 a Diagnosis Is Healthcare’s Costliest Design Flaw
Healthcare software colleagues of mine often describe a recurring discussion they have with their outsourced development teams. They recount that when they try to explain the difference between a billing diagnosis and a clinical diagnosis, the engineers on the other end deliver a common platitude: “a diagnosis is a diagnosis.”
That answer is defensible in ordinary English. In healthcare data, however, it is wrong in a way every team that accepts it inherits. The formal name of the
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Nextech Embeds Assort Health and EliseAI to Deliver 24/7 Agentic AI Across Specialty Practices
What You Should Know
Specialty practice EHR and practice management leader Nextech announced major strategic partnerships with Assort Health and EliseAI in October 2026 (showcased at the AAO 2026 Annual Meeting in New Orleans), embedding conversational and agentic AI directly into its specialty healthcare operating system.Directly addresses the front-office access bottleneck: specialty practices face growing clinical demand and acute administrative staffing shortages, where unanswered calls,
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When Cybercriminals Impersonate Care: Why Trust Is Part of the Treatment
For years, healthcare organizations have encouraged patients to become more digitally connected to their care.
Use the patient portal. Check your test results online. Respond to appointment reminders. Communicate electronically with your care team. Use digital tools to take a more active role in managing your health.
Patients listened.
That progress has made digital engagement an important part of the healthcare experience. Unfortunately, cybercriminals understand that relationship,
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Healthleap Raises $38M for Clinical AI Screening Platform Targeting Overlooked Inpatient Conditions
What You Should Know
Clinical artificial intelligence platform Healthleap announced that it has raised $38M in combined seed and Series A financing backed by Sequoia Capital, First Round Capital, and Hummingbird Ventures (consisting of an $8M seed round co-led by Sequoia and First Round and a $30M Series A led by Hummingbird).Directly targets an entrenched inpatient diagnostic blind spot: up to 50% of hospitalized patients are clinically at risk for disease-related malnutrition, yet
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Health Systems Can’t Optimize What They Can’t See: TeleTracking on Ambulatory Capacity, Leakage, and Operational AI
For decades, health systems have invested in creating operational visibility inside the hospital. Leaders are accustomed to tracking bed capacity, anticipating demand, identifying bottlenecks and coordinating the movement of patients and resources within the four walls of the hospital.
But healthcare no longer begins and ends at the hospital doors.
Care continues to move into physician practices, specialty clinics, imaging centers, ambulatory surgery centers, and at home with virtual care.
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