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Happy Tuesday Hospitalogists,
Today we’re hearing from Hospitalogists about getting the revenue cycle on track, I’m breaking down the “2026 Rural Health State of the State,” plus spicy takes from ep of the pod (featuring the OG himself: my dad), and an upcoming executive briefing on the state of healthcare finance.
Whew. That’s a lot.
Enjoy! |
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What do you see is the biggest problem in getting your revenue cycle on track? |
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Anonymous
“The biggest problem isn't the revenue cycle systems themselves. It's that we've got clinical, financial, and administrative teams operating in separate worlds. Our doctors don't understand how their documentation affects billing. Our billing staff doesn't understand the clinical pressures. And leadership isn't talking to the people doing the work.
Buying new software or hiring consultants to ‘fix’ things is treating symptoms. The real issue is we've lost sight of the fact that healthcare is fundamentally about relationships… between caregivers and patients, yes, but also between departments. Until we break down these silos and get everyone understanding how their piece affects the whole, we're just rearranging deck chairs.”
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Nathan Kaufman - Managing Director
“The biggest problem is internal silos, and focus on process vs results in large hospitals and lack of resources to deal with the complexity of the system for smaller hospitals and physicians offices. Select for-profit health systems have amazing RCMs because they are focused.”
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Anonymous
“The biggest problem in getting the revenue cycle on track is that no one actually owns the end-to-end economic outcome.
RCM is still managed in silos: front-end access, HIM, coding, billing, denials, managed care, finance. Everyone optimizes their slice, but very few leaders are accountable for how decisions upstream show up as cash downstream. So we keep fixing symptoms — faster coding, better work queues, more automation — without addressing the structural handoffs that create leakage in the first place.
What is working right now is targeted automation tied to very specific pain points: eligibility, charge capture, denial prevention, and follow-up where ROI is measurable and accountability is clear. Ambient documentation, selective AI in coding and CDI, and denial analytics actually move the needle when they’re embedded into operations, not bolted on.
What’s not working is the belief that a new platform or outsourcing partner will fix RCM without changing incentives, workflows, or leadership models. RCM problems are operating model failures. And until health systems treat revenue like a system instead of a department, progress will stay incremental.”
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Anonymous
“We need to view revenue cycle challenges less as a billing problem and more as a systems thinking and communication problem. The real issues are cultural and interpersonal. We need to be focusing on fixing systemic communication breakdowns and siloed thinking rather than just technical or process issues.”
Hospitalogy members can join this discussion here. Not a member yet? Apply to join here.
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Chartis’s annual assessment of the U.S. rural health safety net focuses on the current financial and operational stability of rural hospitals and trends in access to critical care services in rural communities.
Also included in this year’s edition is a look at the potential impact of the $50B RHT funding initiative and a summary of the tech and innovation priorities listed in state RHT applications.
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Over 40% of rural hospitals operate at a loss; that number rises to over 50% in states that have not expanded Medicaid.
- 417 rural hospitals are considered vulnerable to closure.
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300+ rural hospitals have eliminated obstetrics services, 300+ have stopped offering general surgery, and 450+ no longer provide chemotherapy.
- 89% of rural census tracts are designated Behavioral Health Professional Shortage Areas (HPSAs), and in 13 states, that figure is 100%.
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States’ RHT plans emphasize telehealth, AI, interoperability, and clinically integrated care models. Eight RHT applications mentioned CON reform.
Read the full report here.
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Episode 3 of my new podcast featured a real cast of characters… my dad, Clete Madden, and the JTaylor Podcast Crew, including Herd Midkiff, Kyle Kirkpatrick, and Anna Brewer.
If it feels like healthcare keeps “solving” the same problems with shinier tools, this is the conversation that gets right to the why.
The 5 of us break down what’s actually changing (AI adoption getting real, consumer expectations rising, the deal market re-accelerating), and what’s about to get messier (Medicaid/ACA changes, 340B economics, Medicare Advantage’s growing gravitational pull).
It’s part year-end reckoning, part 2026 forecast, with a few spicy detours on GLP-1s, cash-pay “parallel” systems, and who really controls innovation: the people or the payors.
Check out the episode and subscribe to the podcast here.
I also encourage you to subscribe to the JTaylor Healthcare Podcast.
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On March 27, 2026 at 12:00 PM CDT, join Herd Midkiff and Kyle Kirkpatrick from JTaylor for an executive-level review of the current state of healthcare finance, hosted by yours truly.
We’ll be examining the key factors influencing financial performance across hospitals and health systems, covering:
- Healthcare spending and utilization trends
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Reimbursement dynamics and cost pressures
- Federal price transparency regulations and how this data can inform decision-making
- Legislative considerations and potential revenue impact
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Key takeaways for navigating today’s healthcare finance environment
This is a can’t-miss event for leaders shaping financial strategy across hospitals and health systems. Register here.
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*This read is brought to you by one of my brand partners who help make this newsletter possible!
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That’s it for today. I would love to know your thoughts!
– Blake |
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The conversation doesn't have to stop here
Keep learning and connecting in the Hospitalogy Network
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