What You Should Know:
- A new Strata Decision Technology report on the financial performance of U.S. hospitals and physician groups, drawn from monthly data from over 1,600 hospitals and 135,000 physicians, reveals that health system operating margins dipped to 0.9% in July 2025. While health systems continue to benefit from steady revenue growth, they face persistent pressures from rising expenses.
- The report finds median year-to-date (YTD) health system operating margin was 0.9%
Read More
Health IT | News, Analysis, Insights - HIT Consultant
Ransomware in RCM: Why Your Billing System Is an Overlooked Cybersecurity Risk
When a major healthcare payment processor was hit by a ransomware attack in early 2024, medical practices across the country were thrown into chaos. Routine billing processes, like eligibility checks, claims submissions, and payments, all ground to a halt. Some providers waited weeks to get paid. Others struggled to reassure anxious patients amid financial uncertainty. For small and midsize practices, the disruption wasn’t just inconvenient; it was existential.
The incident exposed an
Read More
Phreesia to Acquire AccessOne for $160M to Expand Healthcare Payment Solutions
What You Should Know:
- Phreesia, Inc., a company specializing in patient activation, has entered into a definitive agreement to acquire AccessOne Parent Holdings, Inc., a portfolio company of Frontier Growth.
- The all-cash transaction is valued at $160M and is expected to close in the third or early fourth quarter of Phreesia’s 2026 fiscal year.
AccessOne Background
AccessOne is a market leader in providing financing solutions for healthcare receivables, working
Read More
US Court Allows Particle’s Antitrust Claims Against Epic to Proceed
What You Should Know:
- A U.S. District Court judge in the Southern District of New York, Judge Naomi Buchwald, has allowed Core Antitrust Claims against Epic to proceed.
- The ruling found that Particle Health, a healthcare data platform, may move forward with its claims that Epic holds a monopoly in the payer platform market with a 90% market share and has engaged in anti-competitive conduct. The ruling marks as the first time an antitrust case against Epic has progressed
Read More
Hello Patient Raises $22.5M to Scale Conversational AI for Patient Communications
What You Should Know:
- Hello Patient, a conversational AI company secures $22.5M in Series A financing led by Scale Venture Partners with participation from 8VC, Bling Capital, Max Ventures, Remus Capital, and FirstLook Partners.
- The Hello Patient platform handles end-to-end patient conversations across voice, text, and chat, helping healthcare practices run leaner, grow faster, and deliver better care. With this new funding, the company plans to continue expanding its product
Read More
Modernizing Medicare Advantage Translations: How AI Streamlines Compliance for Health Payers
For healthcare payers offering Medicare Advantage and Dual Special Needs Plans (D-SNPs), the translation of member-facing materials is a costly, complex and high-stakes process. Translation requirements place an enormous burden on payers and, yet, it is critical for a positive member experience and accessibility in the U.S., where nearly 68 million people speak a language other than English at home.
The Centers for Medicare & Medicaid Services (CMS) mandates that materials such as Annual
Read More
Beyond the Black Box: Why Health Plans Must Redesign Utilization Management for Transparency
For too long, utilization management (UM) has been the most painful source of abrasion between health plans and healthcare providers.
Care decisions are too often made by third-party vendors with opaque regression algorithms trained on old data. Providers are left wondering why medically necessary care is delayed—or denied. And patients, caught in the middle, suffer the consequences. What was intended as a validation of medical necessity has become a byword for inefficiency, and a root of
Read More
HealthEdge and UST HealthProof Merge to Modernize Health Plans
What You Should Know:
- HealthEdge and UST HealthProof have announced the successful completion of their merger, following Bain Capital's acquisition of UST HealthProof from UST.
- The combined company will operate as HealthEdge, with its headquarters in Boston. With a reach that touches over 110 million lives in the U.S., HealthEdge is now positioned to empower health plans with modern, AI-enabled technology and services that can lower total costs and improve operational
Read More
MCG Health and Avo Launch AI Assistant to Reduce Hospital Length of Stay
What You Should Know:
- MCG Health, a part of the Hearst Health network, and Avo, a clinician-created AI platform, have launched a new AI assistant designed to tackle the challenge of hospital length of stay (LOS).
- The partnership integrates recovery milestones from MCG's proprietary guidelines directly into electronic health record (EHR) workflows using Avo's new assistant. This tool gives hospitalists and case managers a real-time picture of each patient’s readiness to go
Read More
SoundHound AI Partners with Primary Health Solutions to Deploy AI Patient Engagement Platform
What You Should Know:
- SoundHound AI, Inc., a global leader in voice and conversational AI, has partnered with Primary Health Solutions (PHS) to deploy a new AI-powered patient engagement platform.
- The initiative makes PHS one of the first Federally Qualified Healthcare Centers in the U.S. to use AI Agents to create a more seamless and engaging patient experience.
Denise: Conversational AI Platform
The new conversational AI platform, named "Denise" in honor of a PHS
Read More
