This is shaping up to be another challenging year for healthcare system finances. It is not exactly beach reading. But neither is missing payroll.
The 2026 Costs of Caring Report from the American Hospital Association (AHA) spells it out:
Hospital expenses rose by 7.5% in 2025.About 56% of hospital costs are tied to service lines where reimbursement falls short of (or is less than) the cost of delivering care, including behavioral health, obstetrics, infectious disease, and burns and
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Revenue Cycle Management | News, Analysis, Insights - HIT Consultant
Why Exception-Driven RCM Is the Only Sustainable Operating Model
Healthcare has spent years trying to optimize a revenue cycle operating model that no longer works. Every new wave of technology has promised to make work queues more efficient. Better analytics. Better automation. Now AI.
We've spent years asking, "How do we work every claim faster?" The better question is, "Why are people working so many of these claims at all?"
The problem isn't that revenue cycle teams can't keep up. The problem is that we've built operating models where people are
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Inovalon Research Identifies Preventable Drivers of Claim Denials and Prior Authorization Delays
What You Should Know
An Inovalon national survey of over 400 revenue cycle management (RCM) leaders by Inovalon reveals that healthcare's most costly billing problems begin before a claim is ever submitted.Front-end workflow breakdowns drive 78% of denied claims, led by insurance eligibility verification, patient registration, and prior authorization delays.Prior authorization remains heavily manual: 93% of provider organizations rely on phone, fax, or payer portals, with only 7% utilizing
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Cedar Launches Purpose-Built AI Agents for Patient Revenue Recovery
What You Should Know
Cedar officially announced the Kora Platform, evolving its single AI billing agent into an integrated suite of purpose-built, autonomous AI agents designed for healthcare revenue recovery.Built on a foundation of 1.5 billion+ patient interactions, $13.6 billion in processed payments, and 63 million+ patients served, Kora integrates directly into existing EHR, telephony, and contact center environments.The platform features Autonomous Inbound Voice, Autonomous Outbound
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M&A: EnableComp Acquires Helix Advisory to Advance Complex Revenue Recovery Platform
What You Should Know
Complex RCM leader EnableComp announced its acquisition of Cincinnati-based revenue recovery firm Helix Advisory.The acquisition expands EnableComp's Zero Balance Review capabilities, integrating underpayment recovery directly into the same platform used for complex claims and denials.Helix Advisory's technology adds three specific capabilities: detecting underpayments outside traditional rules-based audit logic, clinical signal detection to flag reimbursement
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XiFin and Notable Systems Form Strategic Alliance and Announce Series B Investment
What You Should Know
XiFin, Inc. and Notable Systems announced a multi-year strategic alliance to develop and embed purpose-built agentic AI capabilities across the XiFin Empower AI RCM ecosystem.As part of the multi-year alliance, XiFin made a strategic investment in Notable Systems during Notable's Series B financing round.The partnership targets complex billing domains—including diagnostics, outpatient laboratories, specialty pharmacies, and durable medical equipment (DME)—by automating
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M&A: Health Catalyst Closes $147M Sale of Vitalware to Med-Metrix
What You Should Know
Healthcare intelligence leader Health Catalyst, Inc. completed the sale of its mid-revenue cycle business, Vitalware, LLC, to Med-Metrix, LLC on July 31, 2026.The divestiture generated $147M in total cash consideration, subject to customary adjustments.Health Catalyst combined the net proceeds with cash on hand to fully repay and retire its credit facility, eliminating approximately $19M in annual GAAP interest expense.Capital and operational focus will pivot toward
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The Growing Disconnect Between Clinical Documentation and Reimbursement
Most documentation problems I have reviewed over the years were never really about documentation itself. They were workflow problems that showed up later as denials, CDI overruns, and revenue that quietly disappeared.
That is the honest truth the industry keeps avoiding. We keep buying tools to fix a problem that is not about tools. The gap between clinical documentation and reimbursement is not growing because technology is failing. It is growing because we keep ignoring how misaligned our
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Solventum Announces Intent to Separate Health Information Systems Business
What You Should Know
Solventum announced its intent to separate its Health Information Systems (HIS) business to sharpen focus as a pure-play MedTech provider centered on MedSurg and Dental Solutions.The Health Information Systems division generates $1.4B in annual sales, is deployed across 30+ countries, serves over 75% of U.S. hospitals, and processes roughly 660 million clinical documents monthly.Management operates within a ~$10 billion addressable market growing at 5–6% annually,
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AMS Solutions Releases 2026 Benchmark Report on The State of Medical Billing
What You Should Know
Physician-founded revenue cycle vendor AMS Solutions published its State of Medical Billing 2026 benchmark report, detailing a rise in industry-wide claim denial rates to 9% (up from 7.5% in 2023).Increased Medicare Advantage penetration and automated machine-learning claim reviews by commercial payers are driving higher denial rates, extended days in accounts receivable (averaging 42 days, up from 38), and stricter documentation requirements.Neurology exhibits the
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