Whitepapers

The line between inpatient admission and observation care is one of the most consequential decisions in hospital medicine. For payers, it sits at the center of medical necessity disputes, length-of-stay variability and post-payment audit risk. This white paper walks through…

Few hospital decisions carry more downstream impact than the ED disposition call: discharge, observation or inpatient admission. The wrong determination can trigger denials, audits and revenue loss long after the patient has gone home. This new white paper from a…

Cancer outcomes have improved but delays and fragmentation still define much of the care journey. Patients wait an average of 156 days between screening and diagnosis, and every four-week delay can increase mortality risk by 6 to 8 percent. For…

Tens of millions of average-risk adults remain overdue for colorectal cancer screening, even as colorectal cancer has become the leading cause of cancer death among Americans under 50. Traditional mailed FIT programs often struggle to sustain engagement, complete follow-up colonoscopy…

Most payer organizations agree AI will reshape underwriting, claims and operations. But many initiatives still struggle to move beyond isolated pilots. The challenge is no longer whether AI matters. It’s how to operationalize it responsibly. This new white paper examines…

EMS reimbursement pressures are rising as audits, denials and documentation scrutiny intensify across the industry. As payer analytics become more sophisticated, EMS organizations are facing growing pressure to justify every transport, document every modifier accurately and prevent revenue leakage before…

For small and rural hospitals, today’s interoperability requirements are reshaping where revenue cycle pressure lands first: at the front end. Real-time eligibility verification, advance explanations of benefits and faster prior authorization aren’t just technology updates, they are operational shifts that…

Members with serious illness often experience fragmented care, avoidable hospitalizations and repeated emergency department visits before receiving meaningful support. For health plans, the result is rising utilization, higher costs and growing pressure to improve quality performance across Medicare, Medicaid and…

2026 marks an unprecedented convergence of forces that will reshape the market landscape: This executive brief reveals why traditional gap closure programs are failing and how diagnostic intelligence enables the shift from retrospective campaigns to continuous, real-time quality management. Healthcare…

Most health systems have built programs that deliver results for specific populations: cancer patients, high-risk cardiology cases, post-discharge transitions. The harder question: what happens to everyone else? Rising-risk patients with one or two chronic conditions often cycle through primary care…