Accountable care organizations in the Medicare Shared Savings Program that have higher financial risk and have participated longer than others have achieved better outcomes, according to an issue brief from the Health Care Transformation Task Force. The task force found that participation in two-sided risk models is associated with greater savings and quality improvements than participation in one-sided risk models.

~ Health Care Transformation Task Force

Prior authorization has evolved into a major cost-containment tool in health care, with machine learning and AI tools that can deny a request in seconds. Payers are not denying care as much as they are denying documentation, and high-quality, comprehensive documentation of medical necessity at the point of care is a must for avoiding denials, writes registered health information administrator Angela Comfort. Health care organizations should integrate clinical documentation integrity upfront, align coding and utilization management, and use data to reduce denials.

Some patients in North Carolina have received unexpected bills for self-administered questionnaires assessing mental health and social drivers of health needs. Novant Health began charging for these surveys in 2024 and connecting patients to resources if needed, but patients say they were not informed of the charges before completing the questionnaires. Some commercial insurers expect such screenings to be included in the total visit charge and will not pay a separate fee.

A new American Hospital Association report based on data from Vizient shows that survival rates in US hospitals have increased 30% since 2019, central line-associated bloodstream infections have decreased 24%, and urinary tract infections linked to catheters decreased 25%, as of mid-2025. Breast and colon cancer screenings increased 95% over the study period, according to the report.

Virtual nursing programs have not reduced workloads for 56% of bedside nurses responding to a survey, researchers reported in JAMA Network Open. Although 53% of respondents said virtual nursing programs have improved the quality of care, only 11% reported significant improvements. Bedside nurses said virtual nursing works best for handling patient monitoring and documentation, mitigating staffing gaps, easing patient distrust and improving workflow efficiency.

Join the health information community at the AHIMA Advocacy Summit, March 16-17, 2026, in Washington, D.C. and make your voice heard. Together, we can make a difference!

"AHIMA members will have the unique opportunity to meet with representatives face-to-face on Capitol Hill and advocate for the issues we're passionate about. How often do you get a chance to do something like that?" - Maria Caban Alizondo, AHIMA President/Chair

Hurry, seats are limited. Learn more and sign up today.

Rush Health is consolidating its revenue cycle functions across its campuses and has implemented more than 1,000 process changes in its Epic system to standardize revenue cycle roles and workflows. Clinicians are embedded in revenue cycle teams, assisting with prior authorization requests, revenue integrity projects and appeals of denials. Rush is among the first health systems to implement Epic's AI-based billing tool that allows patients to ask questions about itemized bills and financial assistance through MyChart.