By Beth Friedman, FACHDM, Sr. Partner, FINN Partners
LinkedIn: Beth Friedman
LinkedIn: FINN Partners
Host of FINN Voices
The park where I walk my dog is near a lake, so I often see dragonflies along my path. Dragonflies signify transformation, adaptation, and new beginnings. Folklore also suggests that dragonflies represent change ahead and remind us to think differently.
The HFMA 2026 Annual Conference was recently held in National Harbor, Maryland. National Harbor is a waterfront area just south of Washington, D.C. And yes, there were dragonflies.
Here are my top three dragonfly moments from HFMA AC’26 to help you, your revenue cycle leadership team, and your hospital or health system begin to think differently and dare to solve some of healthcare’s most complex financial management challenges.
Moment #1: Healthcare affordability is a shared responsibility of providers, payers, and the government
The HFMA AC’26 event celebrated 80 years of a healthcare financial management community that has historically shown up for one another. As a member, I can attest to the group’s commitment to leave no healthcare professional behind and support members throughout major industry changes.
For Chief Financial Officers (CFOs), Chief Information Officers (CIOs), and senior revenue cycle leaders who were unable to attend, the overarching message of the conference was clear: incremental adjustments to fix healthcare costs and affordability problems are no longer sufficient. Furthermore, finger-pointing among healthcare stakeholders is counterproductive to achieving our shared goals: healthcare affordability, financial stability, and better community health. The time to think differently is now.
HFMA President and CEO, C. Ann Jordan, reiterated this point during the opening session. She introduced Vitalic Health, a collaborative movement aimed at tackling the affordability and sustainability crisis in healthcare. Panelists during the session shared their own perspectives on making healthcare affordable:
- We are experiencing a healthcare affordability paradox where technology innovation and rising expenditures fail to yield proportional outcomes in costs, quality, or health span.
- Confronting this paradox requires honest, transparent conversations regarding the true underlying costs of healthcare delivery.
- Affordability can no longer be viewed strictly as a patient relations problem or a consumer compliance obligation. It will take all of us, working collaboratively, to fix healthcare’s most-complex problems.
- Revenue cycle tasks such as pre-bill review, charge capture optimization, chargemaster management, clinical documentation integrity (CDI), clinical coding, and medical necessity validation, can no longer be siloed. Instead, functions should be centralized and integrated to prevent revenue leakage, improve first-pass acceptance rate (FPAR), defend against payer audits, and detect underpayments.
All agreed that healthcare organizations must share in the collective responsibility of making U.S. healthcare more affordable and returning cost savings to patients. Several concrete actions were recommended for hospital finance and IT teams:
- Update infrastructure and improve interoperability: The technology framework that claims processing runs on is decades old. Likewise, many hospitals find themselves burdened by technical debt and legacy systems. Modern infrastructure, alongside updated standards for integrating financial and clinical data, is needed to reset the conversation. Payers recognize this reality and are actively joining efforts around standards, data exchange, and information-sharing rules.
- Seek out comprehensive solutions: The “balloon squeeze” metaphor is omnipresent in healthcare. When one side of the balloon is squeezed (or fixed), it simply displaces the pressure, causing problems on the opposite side. Healthcare financial management and payment system reimbursement issues are deeply interconnected; therefore, we must pursue holistic, comprehensive solutions that keep the whole balloon in tact.
- Build paths to care: One in five American citizens is opting out of healthcare due to cost. The financial burden stemming from non- or under-insured populations will remain substantial. As an industry, we must establish the right pathways for patients to access care despite ongoing reimbursement shifts.
Much of the conversation at HFMA’s AC’26 also centered on the overwhelming volume of transactions in healthcare and how modern technology can be strategically leveraged to reduce them.
Moment #2: AI Brings New Opportunity to Reimagine Revenue Cycle Transactions and Processes
The use of AI in the revenue cycle has moved from potential to proof. AI capabilities are now considered table stakes for RCM vendors and were included in every exhibit hall conversation. Among the many use cases discussed at AC’26 is AI’s ability to automate complex healthcare transactions.
The extreme volume of healthcare transactions is a shared challenge across all stakeholders: providers, payers, government, and patients. Recent reductions by health plans in cases requiring prior authorization reflect a growing industry sentiment to re-evaluate transactions and legacy processes.
Beyond prior authorizations, one speaker suggested that observation status and the two-midnight rule may also be prime candidates for transaction trimming, especially since most of these cases are ultimately approved by the payer. HFMA’s surprise special session speaker, Dr. Mehmet Oz, Administrator of CMS, offered up quality reporting as another target area for reducing administrative burden in healthcare. He noted that “not everything we measure today in quality programs really matters,” adding that the administration actively seeks to remove elements of measurement and quality complexity.
Today’s AI solutions can automatically read medical records, abstract information, and reduce administrative steps, relying on humans in the loop to supervise AI outputs. Dr. Oz suggested that much of the time required to collect and report quality data could be mitigated using AI tools, and perhaps some legacy quality metrics could be eliminated entirely.
According to Ryan Dice, Vice President at TruBridge, AC’26 attendees were highly focused on the holistic application of AI in the revenue cycle: “Attendees are looking for partners that can literally take over the whole revenue cycle with AI working in the background to achieve greater efficiency and better reimbursement outcomes. Preventing denials before claims go out the door is a common conversation here at AC’26.”
To address this, vendor FinThrive announced an AI-powered solution to proactively identify claims likely to be denied before they are ever submitted. The tool helps providers prevent avoidable denials and protect core revenue.
Darin Ryder, Chief Revenue Officer at e4health, provided further insights into the operational dependencies of these technologies. “There is a direct relationship between AI success, reimbursement outcomes, and data quality,” Ryder mentioned. “Every duplicate medical record or erroneous piece of patient information is a denial waiting to happen.”
Ryder emphasized that data integrity issues can get particularly troublesome during major IT updates, such as EHR optimization or system replacement. While it is tempting for IT departments to put off rigorous data cleansing during system transitions, clean data is the ultimate prerequisite for downstream AI success.
Providers and payers that can have collaborative, meaningful conversations about data sharing, data accuracy, and the use of AI to remove red tape in the healthcare revenue cycle will be winners in cost reduction and financial sustainability. This includes during payer negotiations.
Moment #3: Price Transparency Law Delivers New Value to Hospitals and Health Systems
Immediately following the event, CMS announced new penalties for 500 hospitals that failed to provide price transparency data. However, the news isn’t entirely negative as it relates to this 2021 hospital (and payer) requirement.
The Transparency in Coverage (TiC) data produced from the law effectively balances the scales for hospitals and health systems during payer contract negotiations. While early implementations of price transparency rules suffered from a lack of data formatting standards, time has vastly improved TiC data quality and utility—steadily tipping the scales in favor of provider organizations.
Several tips for hospitals to optimize TiC data were provided by Ryan Kelly, Senior Director at Trek Health:
- Vet pricing data internally to verify its overall quality and accuracy.
- Share data often, as end-users derive immense operational value from this information.
- Tap AI technology to navigate complex, ever-changing payer policies.
- Partner with payer intelligence vendors now to properly prepare for 2027 contracting cycles.
Moments that Mattered at HFMA AC’26
Just as dragonflies inspire me to think differently in my personal life, my three days at HFMA AC’26 sparked new insights into age-old revenue cycle conundrums.
The overriding message for this member and attendee is clear: the revenue cycle’s status quo has officially reached its operational limit. The industry is rapidly accelerating toward a critical tipping point that links patient healthcare affordability with hospital financial sustainability.
To survive, we must collectively move past isolated operational silos and unshared data. By re-examining legacy transactions, processes, and requirements through the powerful lens of modern AI capabilities, healthcare leaders can guide their organizations away from impending vulnerability and toward a sustainable, affordable future.