Reimbursement
While shorter-term fixes like renegotiating payer contracts can help, Wipfli's Kelly Arduino recommends that hospitals heavily dependent on Medicaid rebuild community philanthropy and endowments.
Matt Koehler, VP of product innovation at Surescripts, describes a scenario, which was presented at AHIP 2025, where prior auth can be completed in 30 seconds using coordination between the physician, PBM and EHR.
John Yount, chief innovation officer at FinThrive, discusses ways AI can eliminate inefficiencies and better reduce revenue leakage that typically stem from errors, delays and missed opportunities for reimbursement.
Today, 60% of all healthcare payments are in some form of value-based care if you include fee for service with quality metrics for upside bonuses, says Dave Snow, CEO of Cedar Gate Technologies.
Data reveals that the people who are enrolling in Medicare Advantage have 50% more chronic conditions than people who are enrolling in Medicare fee-for-service, says Christie Teigland, Inovalon's VP of research science and advanced analytics.
Mark Newman, founder and CEO of Nomi Health, recommends driving accountability on fully automating payments for primary care visits to providers. He says there is no reason why they should be delayed or slow.
Different types of artificial intelligence help mirror clinical judgement and deliver real-time insights across the areas of the mid-revenue cycle, specifically utilization management, clinical documentation and coding, says William Chan, cofounder and CEO of Iodine Software.
Millie founder and CEO Anu Sharma discusses reasons why one-third of the U.S. is considered a "maternity care desert" and what can be done.
HIMSS25
As AI technology continues to evolve, Abhinav Shashank, Innovaccer CEO, says IT leaders must stay focused on ensuring that all AI tools are ethically trained, tested and deployed and that their desired outcomes are clearly defined.
When it comes to claims review, AI allows things to be done much faster than humans with less errors, says Christine Stetler, AVP of Solution Engineering at MedeAnalytics.