Why It’s Time to Bring HCC Coding In-House
Recent advances in generative AI have made it a lot easier and safer to bring HCC coding in-house, lowering costs, and strengthening audit readiness.
Employing AI in Coding and Risk Adjustment: 4 Key Recommendations
As CMS ramps up its RADV initiatives in the months ahead, plans should ensure their risk adjustment programs meet the highest standards of accuracy and compliance. Prospective and retrospective analytics enhanced by AI can help plans work with providers to optimize documentation at the point of care and identify coding errors during audit preparation.
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Esperion Sets Its Sights on New Areas While Maintaining Commitment to Cardiovascular Health
In a recent interview, Esperion president and CEO, Sheldon Koenig talks about the reality of statin intolerance and his company’s expansion into new diseases
The AI Advantage: Navigating the 2026 Medicare Advantage Rate Bump
The 2026 Medicare Advantage Rate Announcement is more than just funds allocation — it signals a policy shift. It’s the next phase of value-based care and encourages every stakeholder in the MA ecosystem to rise to the occasion.
How One Health System Drove Revenue Gains with Ambient Listening
Riverside Health is reporting an increase in revenue and net margins as a result of adopting Abridge’s ambient AI technology. The tool listens to doctor-patient interactions and generates clinical notes — which not only alleviates physicians’ burnout, but also improves their documentation accuracy. The Virginia-based health system saw a 14% increase in HCC diagnoses documented per encounter.