Static credentialing can no longer keep up with regulatory complexity. As workforce and vendor access expand, periodic checks are no longer enough and hospitals are increasingly exposed. In 2026, credentialing won’t be a checkbox. It will be a board-level issue,…
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New Mexico’s health insurance marketplace has reached record enrollment, despite the expiration of enhanced federal subsidies at the end of 2025, the Albuquerque Journal reported. More than 80,400 people have enrolled for medical or dental coverage through BeWell, the state’s…
For ASCs and ambulatory providers, recoupments can be devastating. A single payer takeback can wipe out weeks of margin, strain small billing teams and trigger rework that outpatient workflows aren’t built to handle. Yet recoupments — also called takebacks or…
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AI is no longer theoretical in revenue cycle operations. Healthcare organizations are already seeing measurable gains: faster payer payments, fewer denials and improved workforce efficiency. The challenge is knowing how to measure success. This whitepaper outlines the specific KPIs healthcare…
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An Arkansas law has expanded coverage for bariatric surgery, but not weight-loss drugs. Under Act 628, the state’s Medicaid program and commercial plans must cover bariatric surgery — along with its preoperative and post-operative care — for individuals with “severe…
Health insurance marketplace Access Health CT is extending its enrollment window until Jan. 31 for coverage that starts in February, according to an update on its website. The open enrollment period for qualified health plans and stand-alone dental plans began…
Public safety retirees in Arizona can access broader cancer insurance benefits through a new state law clarifying eligibility. Eligible retirees include former firefighters, law enforcement officers and corrections officers. The legislation passed in the spring, but the changes were effective…
Medi-Cal no longer covers GLP-1s for weight loss as of Jan. 1. Wegovy, Zepbound and Saxenda have been removed from the Medi-Cal Rx Contract Drugs List and are no longer eligible for coverage for weight loss or weight-loss indications. The…
Enhanced ACA premium tax credits expired Dec. 31, with congressional efforts to extend them stalled and no resolution in sight. The enhanced subsidies, introduced under the 2021 American Rescue Plan Act, increased subsidy amounts and expanded marketplace eligibility to households…
Ambulatory organizations face tightening margins, staffing volatility and increasing regulatory scrutiny — all while patient expectations rise. Just staying compliant isn’t enough anymore. To grow sustainably, ASC leaders must build systems that drive engagement, elevate care and free up bandwidth…
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