News
News releases
A new risk management approach for today’s healthcare
Kodiak’s Dan Yunker shares his insights for healthcare boards and senior leaders in the April 2026 issue of The Governance Institute’s BoardRoom Press.
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Kodiak Solutions announces winners of Revenue Cycle Awards
Kodiak Solutions is excited to reveal the winners of Kodiak's fifth-annual Revenue Cycle Awards. The awards recognize excellence in healthcare revenue cycle operations and are based on an organization's performance on eight of Kodiak's Revenue Cycle KPI metrics.
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Kodiak Solutions Acquires BESLER
Kodiak Solutions acquires BESLER to enhance revenue integrity and reimbursement services for hospitals, health systems, and medical practices.
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Kodiak recognized as one of Modern Healthcare’s Best in Business
Kodiak Solutions is proud to announce that we were recognized by Modern Healthcare as one of the Best in Business of 2025.
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Kodiak Solutions hires Victoria Dames to lead product development
Kodiak Solutions has hired Victoria Dames to lead product development as Kodiak continues to build out its next-generation platform serving healthcare finance and revenue cycle departments.
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Kodiak Solutions to provide data for Indiana State Payor Scorecard
Kodiak Solutions, an IHA Endorsed Business Partner, will produce the quarterly payor scorecard based on claims and collections data from more than 70 participating Indiana hospitals.
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Kodiak Solutions hires Sarah Haines as Chief Financial Officer
Haines brings finance leadership experience from enterprise software and healthcare sectors as Kodiak's chief financial officer.
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Kodiak helps hospitals with price transparency compliance
Kodiak strategic pricing helps hospitals create a pricing strategy that boosts net revenue and aids with price transparency.
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Technology executive Haiyan Song joins Kodiak Solutions board
Song brings more than 25 years of enterprise software experience and extensive board experience for software companies
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Effective enterprise risk management in IT: Dan Yunker
Published by The Governance Institute, Kodiak’s Dan Yunker takes a deep dive into one of healthcare organizations’ biggest risk areas—IT and cybersecurity—outlining specific risks and strategies for governing boards to effectively manage them.
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Kodiak Solutions recognizes its 4th Annual Revenue Cycle Awards
Kodiak Solutions is excited to announce our fourth-annual Revenue Cycle Awards winners.
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Ankit Sharma joins Kodiak Solutions as first Chief Technology Officer
Sharma brings deep experience leading development teams for revenue cycle management platforms as Kodiak continues to innovate and grow
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Kodiak's products achieve AICPA's SOC certifications
Compliance achievement underscores the company’s commitment to data protection measures for our customer data.
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Healthcare providers facing stiff headwinds on revenue cycle performance
Revenue cycle leaders need creative, data-driven solutions to counteract lower payment rates by patients and higher denial rates from payors as trends from 2024 expected to continue.
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Kodiak promotes Eric Busch to lead finance and reimbursement team
Kodiak Solutions has promoted Eric Busch to lead its finance and reimbursement business unit. Busch, a senior vice president, takes over leadership of the unit from Derek Bang.
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Healthcare finance leader Michael Coggin joins Kodiak Solutions board
INDIANAPOLIS—(January 15, 2025)—Former Lifepoint Health CFO Michael S. Coggin has joined the board of Kodiak Solutions, the company announced.
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Kodiak Solutions and Cyber Security Solutions
Kodiak Solutions bolsters cybersecurity risk assessment and incident response in new relationship with Cyber Security Solutions.
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Generative AI, Cybersecurity Among Top Risks for Healthcare
Overseeing the use of generative artificial intelligence, enhancing cybersecurity and ensuring compliance with a host of federal healthcare regulations headline the Top Risks health systems face in 2025, according to an annual study by Kodiak Solutions.
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Kodiak Solutions selected for IHA Endorsed Business Partner Program
IHA members gain preferred access to Kodiak Solutions’ technology and tech-enabled services for measuring and managing finance department performance.
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Medicare Advantage Plans vs Traditional Medicare data analysis
Observation rates for MA beneficiaries in 2024 remain elevated despite a federal regulation that went into effect in January requiring MA plans to cover the same services as traditional Medicare
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Final Denial Rate for Inpatient Claims Over 50% more in 2023
Hospitals are seeing a sharp increase in the value of claims that insurers are refusing to pay even after appeals, according to data collected by Kodiak Solutions.
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Cyberattack costs hospitals $2 billion a week in cash flow
The cash flow impact of a recent cyberattack on a healthcare claims processor is illustrated by Kodiak RCA data.
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Kodiak Solutions Presents 2023 Revenue Cycle Performance Awards
Six health systems receive awards during 2024 Kodiak Solutions Healthcare Virtual Symposium
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On our radar
Preferences for Infection Prevention in Hospital-Acquired Infections
SOURCE: JAMA Network Open
VARIATIONS EXPLAINED
Price Transparency by Hospitals Caring for the Disadvantaged
SOURCE: JAMA Network Open
COMPLIANCE CHALLENGES
Health Insurance Exchanges 2026 Open Enrollment Report
SOURCE: Centers for Medicare and Medicaid Services
CHANGES IN ACA ENROLLMENT
State of AI in Medicine
SOURCE: Doximity
ARE YOUR DOCS USING?
Key Facts about the Uninsured Population
SOURCE: KFF (Kaiser Family Foundation)
EXPECTED INCREASES
Flu and COVID Vaccine Coverage Among Health Care Personnel
SOURCE: Centers for Disease Control and Prevention
ARE YOU COVERED?
Administrative AI: Current Use and Potential Impact
SOURCE: Peterson Health Technology Institute
MEDICAL BILLING IMPACT
Hospital Nutrition Service Obligations
SOURCE: Centers for Medicare and Medicaid Services
CONDITIONS OF PREPARATION?
Claims Denials and Appeals in ACA Marketplace Plans in 2024
SOURCE: KFF (Kaiser Family Foundation)
ACA PLAN DENIAL RATE
Outpatient Coding Intensity After Adoption of AI Scribing
SOURCE: Trilliant Health
AI AND CODING
ACA Cost Concerns and Coverage Changes
SOURCE: KFF (Kaiser Family Foundation)
ACA DISENROLLMENT IMPACT
State of Healthcare Safety 2026
SOURCE: Press Ganey
WHAT'S YOUR SAFETY STATE?
Top 10 Patient Safety Concerns 2026
SOURCE: ECRI
KNOW THE EMERGING RISKS
AI agent in healthcare: applications, evaluations, and future directions
SOURCE: npj Artificial Intelligence
AGENTIC AI GOVERNANCE
National Survey of Workers with ESI Key Findings
SOURCE: AHIP
IMPACT ON REVENUE CYCLE
Patterns of AI Use in Clinical Work by Hospitalists
SOURCE: Journal of Medical Internet Research
WHERE'S AI GOVERNANCE?
Study suggests AI is boosting hospital billing
SOURCE: Blue Cross Blue Shield Association
AI AND CODING
2026 Physician Survey on Augmented Intelligence
SOURCE: American Medical Association
WHERE'S AI GOVERNANCE?
Report to the Congress: Medicare Payment Policy
SOURCE: Medicare Payment Advisory Commission
IMPACT OF RECOMMENDATIONS
The Big Ugly Threat to Safety Net Hospitals
SOURCE: Public Citizen
OBBBA MEDICAID IMPACT
Costs of Caring: Challenges Facing America’s Hospitals
SOURCE: American Hospital Association
ADMINISTRATIVE BURDEN
Competition in Health Insurance Markets
SOURCE: National Bureau of Economic Research
IMPACT ON REVENUE CYCLE
State-Level Impacts of Key Medicaid Provisions in the OBBA
SOURCE: Rand Corp.
DISENROLLMENT CHALLENGE
2025 CAQH Index
SOURCE: Council for Affordable Quality Healthcare
AUTOMATED CLAIM SAVINGS
Longitudinal Care Code for Traditional Medicare Patients
SOURCE: Journal of the American Medical Association
ARE YOU ADDING ON?
Forced Disenrollments Among Medicare Advantage Beneficiaries
SOURCE: Journal of the American Medical Association
DISENROLLMENT CHALLENGE
Medicare Advantage Disenrollments After Plan Exits
SOURCE: Journal of the American Medical Association
BENEFITS VERIFICATION IMPACT
Gov. Announces Over $1 Billion in Medical Debt Relief
SOURCE: State of Illinois Newsroom
BAD DEBT IMPACT
Request for Information: 340B Rebate Model Pilot Program
SOURCE: Department of Health and Human Services
COMMENTS DUE BY MARCH 19
Break Up Big Medicine Act
SOURCE: Congress.gov
INTEGRATION AND PRICES
2026 Medicare Accountable Care Organization Initiatives
SOURCE: Centers for Medicare & Medicaid Services
ACO PERFORMANCE BENCHMARKS
Prior Authorizations Rank as Public’s Biggest Burden
SOURCE: KFF (Kaiser Family Foundation)
ALLEVIATING THE BURDEN?
2025 Alternative Payment Model Measurement
SOURCE: AHIP
APM REVENUE BENCHMARKS
Shadow AI: A hidden risk to healthcare
SOURCE: Wolters Kluwer Health
WHERE'S YOUR AI RISK LURKING?
December 2025 Healthcare Data Breach Report
SOURCE: The HIPAA Journal
DON'T BECOME A STATISTIC
Top Management and Performance Challenges Facing HHS
SOURCE: HHS Office of Inspector General
WHAT'S ROLLING YOUR WAY
Simplifying Data Access for Better Patient Experience
SOURCE: The Sequoia Project
LEARN THE RISKS AND REWARDS
Health Care Provider Consolidation
SOURCE: Bipartisan Policy Center
CONSOLIDATION AND PRICES
MA Plan Prior Authorization Determinations in 2024
SOURCE: KFF (Kaiser Family Foundation)
HOW MANY DID YOU FACE?
Financial Assistance, Charity Care, and Medical Debt
SOURCE: JAMA Network Open
LESS DEBT BUT MORE CHARITY?
Prior Authorization Requirements and Prescription Fills
SOURCE: Journal of the American College of Cardiology
ADHERENCE INTERFERENCE
Ambient AI Tool Adoption in Hospitals and Associated Factors
SOURCE: American Journal of Managed Care
WHY USER ADOPTION VARIES
Governor's Plan to Ban Medical Debt from Credit Reports
SOURCE: Mass.gov
PLANNING A BAN
Misuse of AI chatbots tops list of health tech hazards
SOURCE: ECRI
ARE THESE RISKS ON YOUR RADAR?
Transparency, Repricing, and Price Convergence
SOURCE: Value in Health Journal
TRANSPARENCY AND PRICES
False Claims Act Settlements Exceed $6.8B in Fiscal 2025
SOURCE: U.S. Department of Justice
MEDICARE CLAIM SCRUTINY
Fiscal Year 2025 Improper Payments Fact Sheet
SOURCE: Centers for Medicare & Medicaid Services
UNDERPAID OR OVERPAID?
AI could help health plans simplify prior auth
SOURCE: Deloitte
WHAT'S PROVIDER IMPACT?
What to expect in US healthcare in 2026 and beyond
SOURCE: McKinsey & Company
KNOW WHAT'S COMING
2025 year-end digital health funding overview
SOURCE: Rock Health
COMPARE DIGITAL DOLLARS
Housing Instability Following Medical Debt Exposure
SOURCE: JAMA Network Open
DEBT AND SOCIAL DETERMINANTS
Agentic AI and the race to a touchless revenue cycle
SOURCE: McKinsey & Company
ARE YOU IN THE RACE?
Ambient AI Scribes and Physician Financial Productivity
SOURCE: JAMA Network Open
HOW AI AFFECTS RVUs
Hospital Prices Post-COVID-19: Troubling Trends From Calif.
SOURCE: Health Affairs
CHECK YOUR PRICES
Healthcare CFOs caught between AI pressure, governance risk
SOURCE: Fortune
DO YOU FEEL CAUGHT?
What Hospital Payment Classifications Mean For Policy
SOURCE: Health Affairs
MEDICARE CLASSIFICATION
2026 Environmental Scan
SOURCE: American Hospital Association
KNOW YOUR LANDSCAPE
Risk of Burdensome healthcare spending over time in the U.S.
SOURCE: JAMA Internal Medicine
BURDEN ON YOUR PATIENTS?
Hospitals’ Expanding Pursuit Of Nonclinical Revenue
SOURCE: Health Affairs
ARE YOU IN THE RACE?
Adoption of Machine Learning in US Hospital EHR Systems
SOURCE: Journal of Medical Internet Research
A LITTLE ML IN YOUR EHR?
U.S. NFP Hospitals’ Outlook Neutral as Margins Rebound
SOURCE: Fitch Ratings
REBOUND OR RETREAT?
Letter to withdraw proposed HIPAA Security Rule
SOURCE: Healthcare IT News
DO YOU FEEL CYBER SECURE?
ACCESS Model
SOURCE: Centers for Medicare & Medicaid Services
TECH MEETS CHRONIC CARE
U.S. Not-For-Profit Acute Health Care 2026 Outlook
SOURCE: S&P Global Ratings
RESILIENT FOR NOW?
AHA Letter to FDA on AI-enabled Medical Devices
SOURCE: American Hospital Association
RIGHT DOSE OF REGULATION?
CMS Relief Funding After Cyberattack On Change Healthcare
SOURCE: Health Affairs
OVERPAID OR UNDERPAID?
Health system CFO tenure and turnover
SOURCE: Furst Group
HOW DO YOU COMPARE?
The Responsible Use of AI in Healthcare
SOURCE: The Joint Commission and the Coalition for Health AI
DO YOU CHECK THE BOXES?
Request for Investigation into Health Plan Downcoding
SOURCE: American Academy of Family Physicians
READ REQUEST TO THE FTC
Staff–Reported Workplace Violence in Patient Safety Reports
SOURCE: JAMA Network Open
MONITOR YOUR RISK
Essential Data 2025: Our Hospitals, Our Patients
SOURCE: America's Essential Hospitals
CHARITY CARE REPORTING
Tech-Enabled Health Plan Offers Transparent Prices
SOURCE: Cigna
IMPACT ON COLLECTIONS
AI-Enabled Care Is on the Rise for Medicare Beneficiaries
SOURCE: Manatt Health
IMPACT ON CLAIMS?
How Do Americans Experience Healthcare in Their State?
SOURCE: West Health-Gallup Center on Healthcare
AFFORDABILITY BY STATE
AI Governance Helps Hospitals Fast Track Pilots' ROI
SOURCE: Black Book Research
TEST YOUR AI GOVERNANCE
State Medicaid Officials Project Flat Enrollment
SOURCE: Kaiser Family Foundation
PAYMENT RATE IMPACT
Prevalence of ghost rates in transparency in coverage data
SOURCE: Health Affairs Scholar
DO YOU SEE GHOSTS?
National Performance Goals™ Effective January 2026
SOURCE: The Joint Commission
MEET THE STANDARDS
Dangerous illusion of ‘peer-to-peer’ review for PA
SOURCE: Stat
CAN YOU SEE CLEARLY?
Community Benefits Provided by U.S. Nonprofit Hospitals
SOURCE: American Hospital Association
LEARN WHAT'S INCLUDED
Healthcare Affordability and Medical Debt
SOURCE: Undue Medical Debt
LEARN WHO CONSUMERS BLAME
2026 Medicare Physician Fee Schedule Final Rule
SOURCE: Centers for Medicare & Medicaid Services
FOLLOW THE FINAL RULE
Calif. Health Care Quality and Affordability Act
SOURCE: California Legislative Information
COMING TO YOUR STATE?
Fair Credit Reporting Act; Preemption of State Laws
SOURCE: Consumer Financial Protection Bureau
NEW MEDICAL DEBT RULE
SB-351 Calif. Health Facilities
SOURCE: California Legislative Information
NEW PE LIMITS ON PRACTICES
Patient Experience Top C-Suite Priority
SOURCE: Sage Growth Partners
DIGITAL IMPACT ON REVENUE
Medicare Advantage Enrollee Access to Physicians
SOURCE: KFF
KNOW YOUR NETWORK
2025 Employer Health Benefits Survey
SOURCE: Kaiser Family Foundation
GET LATEST BENEFIT TRENDS
The State of AI in healthcare
SOURCE: Menlo Ventures
WHAT'S YOUR AI STATE?
Reforming Hospital Price Transparency Enforcement
SOURCE: Health Affairs
ARE YOU PREPARED?
State Scorecard on Medicare Performance
SOURCE: The Commonwealth Fund
YOUR STATE RANKING
2025 Trends Shaping the Health Economy
SOURCE: Trilliant Health
KNOW THESE MARKET FORCES
Healthcare IT Investment: AI Moves from Pilot to Production
SOURCE: Bain & Company
WHERE RCM RANKS
2025 Ponemon Healthcare Cybersecurity Report
SOURCE: Ponemon Institute
CARE DISRUPTION DATA
Affiliated Versus Independent Specialty Physician Prices
SOURCE: Health Affairs
ACCESS THE STUDY
Systematically Identify and Evaluate Health Disparities
SOURCE: Institute for Healthcare Improvement
DOWNLOAD FRAMEWORK
State Scorecard on Climate, Health, and Health Care
SOURCE: The Commonwealth Fund
CALCULATE YOUR RISK
Hospital Price Markup and Outcomes of Major Elective Surgery
SOURCE: JAMA Surgery
JUICE WORTH THE SQUEEZE?
288 new CPT codes cover digital health, AI and more
SOURCE: American Medical Association
Get the codes
Hospitals Provided Nearly $150 Billion in Total Benefits
SOURCE: American Hospital Association
Read the report
Colorado Public Health Order: COVID-19 vaccine access
SOURCE: Colorado Department of Public Health & Environment
Read more
Health Insurance Coverage in the United States: 2024
SOURCE: U.S. Census Bureau
Read the study
Debt, Bankruptcy, and Credit Scores After Cancer Diagnosis
SOURCE: JAMA Oncology
Read the study
Substantial Costs Of No Surprises Act Arbitration Process
SOURCE: Health Affairs
Read the study
Eliminating bad debt reimbursement to hospitals
SOURCE: JAMA Network Open
Read more
Patient Repayment of US Hospital Bills From 2018 to 2024
SOURCE: JAMA Health Forum
Read the study
House bill on Medicare reimbursement
SOURCE: Healthexec.com
Read More
Proposed Fair Pricing Act caps hospital bills at 150% of Medicare
SOURCE: ABC News 10 (Albany, N.Y.)
READ THE ARTICLE
AHA fact sheet on site-neutral Medicare payment policy
SOURCE: AHA.org
READ MORE
Health Infrastructure Security and Accountability Act
SOURCE: Congress.gov
read more
Idaho mandates 340B reporting from covered entities
SOURCE: hfma.org
read more
HHS proposed HIPAA Security Rule targets cybersecurity threats
SOURCE: hhs.gov
read more
Health Care Cybersecurity and Resiliency Act
SOURCE: Congress.gov
read more
Media coverage
Clinical Denials: ‘Not a Human-Addressable Problem Anymore at This Scale’
Rising clinical denial rates are driven by a deliberate, structural shift in payer operations that has outpaced human-led workflow capabilities.
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The Revenue Cycle of the Future: AI boom and workflow redesigns accelerate rev cycle transformation
Intelligent revenue infrastructure and AI adoption are crucial for managing complex, evolving healthcare reimbursement landscapes amidst labor constraints and rising transparency expectations.
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Funding cuts push many hospitals toward breaking point
An opinion piece in the San Diego Union-Tribune argues that federal funding cuts, particularly from the One Big Beautiful Bill Act (OBBBA), threaten to push hospitals toward a breaking point, potentially reducing annual revenue by up to $25 billion.
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Healthcare’s $200 Billion Translation Problem
According to a WSJ Paid Program, nearly 12% of insurance claims are initially denied, with only 2.5% ultimately upheld, resulting in $200 billion in annual administrative friction.
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Hoosiers face rising health insurance premiums
A new Payor Scorecard, analyzing data from 70 Indiana hospitals, shows hospitals delivered more than $717 million in care in 2025 that went unpaid as insurers delayed or denied payments—while continuing to raise premiums and out-of-pocket costs for Hoosiers.
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Rising claims denials dent provider revenue: report
According to a Modern Healthcare report citing data from consultancy Kodiak Solutions, providers saw revenue losses from claims denials and unpaid bills increase by nearly $10 billion between 2024 and 2025.
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Despite better cash flow, providers missed out on more revenue in 2025
Providers managed to secure claims payments from insurers more quickly in 2025, but ultimately missed out on substantially more revenue due to a rise in clinical denial activity that was already elevated in 2024, according to a full-year look at more than 2,300 hospitals’ and 350,000 physicians’ revenue cycle data.
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Hospitals lost over $48B from claims denials, uncollected bills
Hospitals are losing an exorbitant amount of revenue from final claim denials and uncollected medical bills from patients, according to a new report from Kodiak Solutions.
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Hospitals' net revenue leakage increases 25% due to denied claims
Insurers denied more claims on clinical grounds in 2025 compared with 2024, leading to a 25% increase in net revenue leakage at hospitals, according to a new report by Kodiak Solutions.
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Battle of the Bots intensifies over denials
Will AI-powered tech give providers an edge in the denials fight? Here's what first movers are learning from AI use cases.
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Kodiak Solutions Acquires BESLER to Close the “Revenue Leakage” Gap
Kodiak completed its acquisition of BESLER & Company, a market leader in hospital reimbursement. By absorbing BESLER’s specialized recovery tools into its massive analytics engine, Kodiak is signaling that the future of the hospital business office isn’t about having more vendors—it’s about having a smarter platform.
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Kodiak acquires revenue integrity and reimbursement services company
Kodiak Solutions has completed its acquisition of revenue integrity and reimbursement services firm Besler & Company.
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Why Healthcare CFOs Are Prioritizing Underpayment Analysis and Claims Workflow
Underpayment analysis and intelligent claims aging workflow management have become essential investments for healthcare organizations facing mounting revenue pressure.
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The latest worry at hospitals—rising payment backlogs
Payments owed to nonprofit health systems are rising despite efforts to improve collections ahead of federal funding cuts.
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Infographic: Rev Cycle Guide to Preparing for CPT Updates
New CPT code changes for invasive cardiology and interventional radiology will take effect on January 1, 2026, with a potential impact on the revenue cycle that demands immediate, system-wide. preparation.
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New CPT Code Changes Put Hospital Revenue at Risk
New CPT code changes for invasive cardiology and interventional radiology will take effect on January 1, 2026, impacting a significant portion of hospital net revenue and threatening to exacerbate denial rates.
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OBBBA Impact on Medicaid Disenrollment
OBBBA Impact on Medicaid Disenrollment
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Health Plan Price Transparency Report
Trilliant Health
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How Expiration of ACA Tax Credits Will Affect Healthcare Spending
Robert Wood Johnson Foundation
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2025 State of Claims Survey Report
Experian
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Hospital Trends in the Use of Predictive AI, 2023-2024
Assistant (HHS) Secretary for Technology Policy
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AHA Supports Medicare Advantage Prompt Pay Act (S. 2879)
American Hospital Association
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Hospital Price Transparency Report
PatientRightsAdvocate.org
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Medicaid disenrollments to reduce hospital revenue
Large-scale Medicaid disenrollments under President Trump's new spending law would reduce hospital revenue by $1 million to $4 million in a single year, according to new analysis.
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Impact of Medicaid Work Requirements on Hospital Revenues
The Commonwealth Fund
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Infographic: 4 CFO Strategies to Mitigate Medicaid Fallout
A new study by Kodiak Solutions spells out exactly how the One Big Beautiful Bill Act could majorly disrupt hospital finances. A potential $25 billion annual drop in net revenue, according to a benchmarking analysis.
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OBBBA impact could cost hospitals $25B a year: Report
Hospitals nationwide could see annual revenue losses of up to $25 billion through Medicaid losses stemming from the One Big Beautiful Bill Act, according to a new analysis from Kodiak Solutions.
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$25B in Hospital Revenue Losses from Medicaid Disenrollment
A new Kodiak Solutions analysis warns that Medicaid cuts under the OBBBA could cost hospitals up to $25 billion a year, hitting net revenue hard and reshaping payer mix and uncompensated care.
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Changes in Medicare Part D Plan Designs After the IRA
JAMA Internal Medicine
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Infographic: How top performers compare in the revenue cycle
The numbers are in, revealing a clear performance gap between providers on eight KPIs. See the metrics that separate top-performing revenue cycles from the rest and benchmark your own success.
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Quick Tips to Improve Rev Cycle Performance Against 8 KPIs
The latest data from Kodiak Solutions shows significant variation among provider organizations in their performance against key performance indicators (KPIs), offering insight into opportunities for improvement.
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Why hospitals are seeing an increase in bad debt
Bad debt is rising among some hospitals, largely driven by an increased burden on patients to cover the costs of care.
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Insurers, patients pay less of their bills
Healthcare providers faced growing challenges last year in getting paid for care among patients covered by insurance, according to new benchmark data from Kodiak Solutions.
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What transformed Intermountain’s Peaks Region’s revenue cycle
Intermountain Health’s Peaks Region is a regular winner of the Healthcare Financial Management Association’s MAP Award and Kodiak Solutions’ Top Performing Revenue Cycle Award.
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Initial claim denial rates put revenue cycle in tough spot
New data shows an increase in initial claim denial rates, which are putting pressure on patient collections and the overall healthcare revenue cycle.
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Claim denials grew as prior authorization rejections fell in 2024
Health insurance companies initially declined to pay more than one dollar for every $10 providers submitted in claims last year, an increase from 2023.
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The Evolving Patient Payment Landscape: Strategies for RCM Success
Patients are taking on greater responsibility for their healthcare costs. Trends toward high-deductible health plans (HDHPs) and rising overall costs seem likely to continue in the foreseeable future.
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Claims denial rates up, prior auth denials down in 2024: Report
Hospitals and medical practices faced slower payment processing from insurers in 2024 compared to 2023 even as prior authorization denial rates fell, according to new revenue cycle data from Kodiak Solutions.
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3 revenue cycle trends to watch in 2025
Denial rates and patient collection rates are both trending in the wrong direction, according to data from Kodiak Solutions.
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Patient collection rates declined in 2024
The collection rate from commercially insured patients dropped 3 percentage points between 2023 and 2024, according to recent findings.
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Patient collection rate falls by over 3 percentage points
Patient collection rates for commercially insured patients fell in 2024, worsening revenue cycle challenges and requiring providers to adapt their tech and data-driven strategies.
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The headwinds revenue cycle leaders are facing in 2025
Healthcare revenue cycle leaders are facing three headwinds "whipped up" by payers' claims-paying behaviors, according to a Feb. 27 report from Kodiak Solutions.
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Revenue cycle challenged by low collection rates
Providers have partially offset a lower patient collection rate by improving POS collections and collection on bad debt.
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Plummeting patient collection rates
For community hospitals, it’s a sign of the need for a different approach to patient financial communication and payment — one that meets patients where they are and protects their dignity while avoiding undue stress on the organization’s bottom line.
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Michael Coggin, Board member at Kodiak Solutions
Michael S. Coggin has joined the board of Kodiak Solutions. Coggin is a deeply experienced financial leader for healthcare provider organizations. Most recently, Coggin served as CFO of Lifepoint Health and previously served as Lifepoint’s SVP and chief accounting officer. “Mike brings an invaluable mix of perspectives to the Kodiak board,” Kodiak Founder and CEO Derek Bang said. “Over his career, he has encountered just about every challenge a healthcare finance leader can face."
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Generative AI and cybersecurity are top risks for healthcare in 2025
Overseeing the use of generative artificial intelligence (AI), enhancing cybersecurity and ensuring compliance with a host of federal healthcare regulations are some of the top risks health systems face in 2025.
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Some payers are 'hitting the snooze button' on 2-midnight rule: Report
Our analysis of hospital claims data suggests that payers are "continuing to apply their own criteria"
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Impacts of delayed payments after No Surprises Act rulings
Discover the impact on hospitals of payors delaying reimbursements after a No Surprises Act dependent dispute resolution (IDR) ruling.
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Hospital lobbyists leveraging revenue cycle data
Access to revenue cycle data streams makes the difference for hospital lobbyists petitioning Washington on healthcare policy.
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Provider surveys, vendor benchmarking, rising claims denials
Recent survey and system data are again suggesting that payers’ increasing claims denials are a pain point for healthcare providers.
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Why Hospitals Now Require Patients to Prepay for Treatment
More hospitals and surgery centers are calling for patients to pay their full deductible before treatment begins. Wall Street Journal reporter Melanie Evans joins host J.R. Whalen to discuss questions you should ask as well as financial aid programs available.
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Payers increasingly using information requests to deny care: Report
Payers are delaying billions of dollars in payments by increasingly using requests for more information to initially deny claims from health systems.
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Report: Payer requests for information are slowing reimbursement
Payers are increasingly rejecting claims through requests for informatio that serve no purpose other than to delay reimbursement.
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Claim denials becoming more of a headache for providers: report
Insurance claim denials continue to be a vexing problem for healthcare providers, forcing them to expend more resources to reverse payers' decisions.
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The profound shift ahead for health system C-suites
Hospital leaders are bracing for another wave of consolidation that could eclipse the sweeping changes spurred by the Affordable Care Act more than a decade ago.
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