Healthcare coding has fundamentally transformed from volume-driven revenue capture to compliance-first, defensible documentation standards.

Inspired by examples in other fields like NASA’s Mission Control, a number of multi-hospital health systems have launched ...

Background and aims Chronic inflammation induced by chronic hepatitis B virus (HBV) infection increases the risk of hepatocellular carcinoma (HCC). However, little is known about the immune landscape ...

Molina Healthcare faces a 2025 margin collapse due to elevated medical costs, but sector-wide premium hikes are expected to restore profitability in 2026. MOH is structurally insulated from Medicare ...

Within the same physician groups, 2-sided risk in Medicare Advantage (MA) was associated with higher quality and lower utilization for dually eligible beneficiaries compared with fee-for-service MA ...

Artificial intelligence (AI)-enabled tools such as natural language processing (NLP) have been integrated into a wide range of applications, including risk adjustment coding tools, for greater ...

Dr. James Barr, vice president of physician value-based programs at Atlantic Health System and chief medical officer at Optimus Healthcare Partners, an accountable care organization within that health ...

There is widespread agreement that taxpayers pay more when Medicare beneficiaries are enrolled in Medicare Advantage (MA) plans than if those beneficiaries were enrolled in traditional Medicare. MA ...