Revenue Cycle Optimized: Staying Ahead in the AI Arms Race with Payors

Ep 130- Value-Based Shift: Inside the CMS TEAM Transformation On this episode Dan explores the newly introduced the CMS Transforming Episode Accountability Model (TEAM)—a mandatory five-year, episode-based pricing model, informed by earlier initiatives from the CMS Innovation Center. Designed to cover high-volume, high-cost surgical procedures, TEAM represents a significant shift in how hospitals and providers approach bundled payments. Join Dan and special guest Lucy Zielinski, an expert in value-based programs and HCC coding, as they unpack what the TEAM model entails and what participating hospitals must do to prepare for the January 1, 2026 implementation. Gain insights how this model influences financial performance, drives care coordination redesign, and introduces new incentives and penalties. Whether you are a healthcare leader, provider, or payer, don’t miss this overview of one of CMS’s initiatives shaping the future of value-based care. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

On this episode Justin invites back John Halamka, MD, MS and Paul Cerrato, MA to discuss their latest book Transform. This is part 1 of a 2 episodes. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

Host Matt Fisher talks Adam Russo, Esq., CEO, The Phia Group, about the definition of self-funded health plans; need for better education and knowledge in plan administration; impediments to cost containment; impact of awareness and understanding in building plans. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

Threats to healthcare facilities and staff are ocurring with increasing frequency. The types of threats continue to expand. On this episode host Jim Tate sits down with Travis Leonardi, CEO & Founder of SOS Technologies to explore a novel approach from SOS Technologies which has developed a SmartSOS, a fully integrated threat management platform. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

Six Shifts Shaping RCM Influenced by AI Agents In 2025, revenue cycle management is being reshaped by the rapid advancement of automation and the emergence of intelligent AI agents. This session explores six major shifts that are redefining how healthcare providers manage claims, denials, eligibility, and financial performance — all through the lens of AI-enabled transformation. Built from real conversations with revenue cycle leaders, clinical teams, and healthcare finance professionals, this session offers a strategic breakdown of where RCM is headed and what’s holding organizations back. From the transition to platform-first strategies, to the increasing need for secure and resilient infrastructure, to the rethinking of workforce models around digital assistance — we’ll dive into the practical realities shaping today’s automation landscape. With AI agents now acting as collaborators, not just tools, healthcare organizations are beginning to realize new efficiencies, enhanced compliance, and measurable ROI. This session goes beyond hype and gets into how automation is truly impacting day-to-day revenue operations. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

Episode 71 When Communities Lead: Little Manila Rising's Blueprint for Health and Healing On this episode they explore the powerful story of Little Manila Rising, an organization founded to preserve the Filipino American legacy in Stockton, California, and uplift the South Stockton community. Hear how founders rallied local residents to prevent the destruction of historic neighborhoods and created a movement rooted in ancestral legacy, heart-centered activism, and holistic care. Learn about programs tackling health inequities, environmental justice, mental health, and youth development, all shaped by listening to community needs. Through initiatives like the Healing PUSO project and ECHO, we witness how blending Western and traditional Filipino healing practices, offering free clinics, and providing culturally responsive mental health support have made a tangible impact. Centering community voices and advocating for policy change, Little Manila Rising exemplifies the importance of accessible, culturally anchored healthcare that truly cares for the whole person. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

On this episode host Justin Barnes recorded live at HIMSS25 in Las Vegas. Stay tuned for the next few weeks to hear all his guests.This week his guests are Carl Brown, General Manager Business Development at Supermicro and Tony Black, Global Director, Healthcare, Privacy & Digital Transformation at Kyndryl. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

On this inaugural episode, host Adam Russo welcomes Jeffrey S. Gold MD, owner and physician of Gold Direct Care PC to discuss Direct Primary Care (DPC). Dr. Gold explains what DPC is along with sharing his insights on why he transitioned to DPC and how it has allowed him to engage with his patients in a way that traditional insurance-based primary care did not and never could. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

From Vision to Reality: Building Smart Hospitals That Actually Work Healthcare expert Lorren Pettit shares insights on how hospitals are transforming from basic digital systems to AI-powered smart healthcare environments, covering real-world applications and implementation challenges. Key Takeaways: • Beyond basic digitization - Hospitals are progressing toward predictive, AI-driven care using new maturity models that guide smart technology adoption. • Southeast Asia leads adoption - Indonesia, Malaysia, and the Philippines are pioneering smart hospital development, often outpacing traditional markets. • AI shows real results - Successful applications include medical imaging, radiology diagnostics, and automated revenue cycle management. • Culture drives success - Technology implementation requires addressing staff resistance and cultural change, not just new systems. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

Staying Ahead In The AI Arms Race With Payors As artificial intelligence takes a front seat in revenue cycle operations, providers are confronting a fast-changing landscape shaped by payor-driven automation. Denials are being issued in seconds. Post-payment reviews are ramping up. And compliance, once a back-office function, is now a strategic necessity. In this special Office Hours session, Stuart Newsome distills the most important insights from his AAPC HEALTHCON presentation and a prior HFMA segment—delivering a clear-eyed look at the AI arms race between payors and providers. The session will examine how payors are deploying AI to control costs, how providers can avoid costly compliance missteps, and what governance structures are needed to keep automation accountable. Attendees will leave with a practical understanding of the risks and remedies surrounding AI in healthcare RCM, plus actionable steps to build resilient compliance programs that evolve with the technology. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen/