UnitedHealth (UNH) and peers face significant margin risk after the CMS's 2027 Medicare Advantage rate proposal fell short of ...

Policymakers are exploring reforms to address shortcomings of risk adjustment that inflate Medicare Advantage payments and ...

As CMS-HCC V28 fully takes effect in 2026, healthcare organizations face a structural reset in risk scoring. Planning ...

For example, the No UPCODE Act, introduced by Senators Bill Cassidy (R-LA) and Jeff Merkley (D-OR), would eliminate the use of health risk assessments used to boost coding intensity and utilize two ...

Accuity, an AI-driven clinical intelligence and revenue integrity partner for leading health systems, today announced its ...

RAAPID Inc. is proud to announce that the company was recognized by Modern Healthcare as one of the Best in Business of 2025 ...

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AI-generated code requires stepped-up human oversight. Experts advise keeping AI-generated code in a sandbox. At best, AI may do about 80% of the work in building software. We've been hearing ...

The Swedish company is now valued at $6.6 billion, more than triple its $1.8 billion valuation set by investors in July. By Niko Gallogly From a young age, Anton Osika wanted to build things. That ...

Open-source development platform builder Coder Technologies Inc. today is unveiling a suite of governance and execution capabilities designed to help enterprises integrate artificial intelligence ...

Google and Replit are expanding their partnership to bring vibe coding to more companies. Replit projects $1 billion in revenue by the end of 2026, its CEO told Business Insider. Sundar Pichai says ...

Most health plans obsess over HCCs. They build entire departments around maximizing hierarchical condition categories. They invest in retrospective coding, prospective review, and audit prep. But ...