How payers are reshaping reimbursement, especially via Medicare Advantage plans — and what providers can do about it
Ensemble’s Payer Trendscape 2025 draws on national payer data from nearly 300 facilities across 30+ health systems to reveal how payers, including Medicare Advantage plans, are increasingly denying inpatient claims, resisting compliance with the Two-Midnight Rule and delaying payments through unnecessary requests for information.
You’ll learn:
- Why the majority of RFI denials ultimately end up paid, but reimbursements are delayed by 100+ days
- Which KPIs to monitor to hold payers accountable and improve payment timelines
- How strengthening contracts limits payer discretion and enforces prompt pay provisions
- Why payer strategy must be part of a full revenue cycle partnership, rather than a standalone fix
