Editor's Note According to a Healthcare Financial Management Association (HFMA) analysis, the US healthcare system is in “serious condition,” with affordability collapsing and provider financial risk escalating, HealthLeaders September 19 reports. The group’s new Healthcare Vitals Tracker scored the industry just 35.9 out of 100, compared to a peak of…

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Editor's Note The American Medical Association (AMA) has released the 2026 Current Procedural Terminology (CPT) code set, introducing 288 new codes that capture emerging technologies and modern care delivery models, the association announced on September 11. In total, the update includes 418 changes: 84 deletions, 46 revisions, and the newly…

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Editor's Note: This page is a companion page to the main article, "Survey: Staffing problems increase as surgical volume continues to rise."   Most OR leaders (81%) report having a business manager. Historically, fewer than half had this position (42% in 2024, 37% in 2023, and 43% in 2022). The…

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Editor's Note Healthcare providers, payers, and analytics teams face sweeping ICD-10 changes this fall, with the 2026 code updates taking effect October 1, 2025, Wolters Kluwer July 14 reports. The release includes 614 new codes, 12 invalidations, 642 billability changes, 88 terminology revisions, and the creation of an entirely new…

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Editor's Note The US Department of Justice (DOJ) has conducted the largest healthcare fraud takedown in US history, charging 324 individuals, including 96 licensed medical professionals, in schemes totaling more than $14.6 billion, HealthCare Business News July 8 reports. The nationwide crackdown involved 50 federal districts and 12 state attorneys…

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Editor's Note Medicare Advantage (MA) patients undergoing elective surgery incurred lower costs than comparable patients in traditional Medicare (TM) without higher readmission rates and with no significant difference in mortality rates, according to a study published August 1 in JAMA Health Forum. The findings suggest that MA plans reduce surgical…

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Editor's Note A “quiet transformation” in how Medicare pays doctors could reduce payments for specialty care, including rates for billing codes associated with surgery, diagnostic imaging, outpatient care, pain management, and orthopedics, Modern Healthcare July 22 reports. According to the article, The Centers for Medicare and Medicaid Services (CMS) 2026…

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Editor's Note The American Hospital Association (AHA) has called on the Department of Health and Human Services (HHS) to eliminate or ease a variety of federal regulations, arguing that excessive administrative rules drive up costs, reduce patient access, and hinder innovation, Modern Healthcare reported May 13. According to the article,…

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Editor's Note Nonprofit hospitals, which are legally required to provide free or discounted care to qualifying patients, attempt to collect hundreds of millions of dollars from low-income patients annually while receiving significant tax breaks meant to ensure affordable care, according to a May 12 article from CBS News.   As…

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Editor's Note Terry A. Bohlke, MSHA, CPA, CMA, CASC, emphasized that Rocky Mountain High Surgery Center is a pseudonym “to protect the innocent,” but the numbers he presented at the 2025 Ambulatory Surgery Center Association (ASCA) Conference & Expo in Denver last week were real enough. Based on actual scenarios…

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