Financial Recovery Group

Financial Recovery Group FRG is a leading provider of healthcare analytical tools, enabling organizations to identify opportun

FRG is a leading provider of healthcare analytical tools, enabling organizations to identify opportunities that drive financial and quality performance.

Balancing financial health and patient outcomes requires a structural shift from volume to value. Sustainable healthcare...
06/02/2026

Balancing financial health and patient outcomes requires a structural shift from volume to value. Sustainable healthcare systems achieve this balance by connecting clinical results directly to financial metrics, a strategy that reduces expensive medical utilization, identifies cost drivers, and protects the core medical mission.

Read the full analysis from Forbes: https://bit.ly/3SbTxWn

AccuReports empowers health plans, MSOs, IPAs, ACOs, and consultants to navigate this transition seamlessly. FRG’s secure, customizable platform uses a unified platform to track quality metrics, providing the clear financial intelligence needed to make confident decisions.

To learn more about FRG, email [email protected] or call 888-466-1025.

Healthcare organizations need both the resources to invest in staff, technology and care delivery and the ability to prove investments lead to positive patient outcomes.

Is your revenue aligned to your members' risk profiles?FRG’s RAMP helps Medicare Advantage plans and provider groups ide...
05/28/2026

Is your revenue aligned to your members' risk profiles?

FRG’s RAMP helps Medicare Advantage plans and provider groups identify gaps, track chronic condition recapture, and build accurate accruals.

Stop leaving revenue on the table. Read: https://frgsystems.com/healthcare-finance-news/risk-bearing-contracts-with-ramp-by-frg

Learn how RAMP by FRG helps Medicare Advantage plans and risk-bearing organizations identify revenue gaps, improve HCC recapture, and more.

CenterWell’s value-based cardiovascular care model demonstrated rapid success in its first year, achieving a 20% reducti...
05/26/2026

CenterWell’s value-based cardiovascular care model demonstrated rapid success in its first year, achieving a 20% reduction in avoidable heart failure hospitalizations and a 15% decrease in overall admissions. By shifting from volume to outcomes and enhancing collaboration with primary care, the program also lowered the cost of care by approximately 20%.

Read the full success story at

At CenterWell, early data shows 20% fewer avoidable heart failure hospitalizations, 15% fewer admissions and 20% lower total cost of care.

The Centers for Medicare and Medicaid Services (CMS) is seeking industry feedback on its Comprehensive Regulations to Un...
05/22/2026

The Centers for Medicare and Medicaid Services (CMS) is seeking industry feedback on its Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH) project, which aims to combat fraud through stronger supplier verification and AI oversight. While healthcare groups offer cautious support, they urge federal regulators to establish strict guardrails and warn against empowering private insurers to disrupt patient care.

Read the full story at

The Centers for Medicare and Medicaid Services asked the healthcare industry for guidance on its anti-fraud efforts.

“Radical payer-provider collaboration" and full-risk arrangements are vital for success in value-based care, said speake...
05/20/2026

“Radical payer-provider collaboration" and full-risk arrangements are vital for success in value-based care, said speakers at the Spring 2026 NAACOS conference.

🙌 Kevin Spencer, chief medical officer of Millennium Physician Group, told attendees that organizations that can identify high-performing physician behaviors and replicate them at scale will survive CMS’s continued revenue pressures.

🫵 He highlighted guideline-directed medical therapy as an underutilized tool. While it can reduce admissions by 60%, fewer than 20% of patients with conditions like heart failure are currently on these regimens.

🤝 Robert Millette, senior vice president at Astrana Health, called for the delegation of care and utilization management, alongside real-time claims data-sharing, so teams can act proactively rather than reactively.

To read the full article, visit https://www.ajmc.com/view/building-payer-provider-partnerships-for-a-stronger-health-ecosystem.

Led by data science and client pain points in contract performance, revenue capture, cost containment, and margin growth, AccuReports’ analytics highlight members at risk and avoidable high-cost utilization for prioritized member outreach and condition monitoring.

For more information about FRG’s healthcare financial intelligence solutions, email [email protected] or call 888-466-1025.

At NAACOS 2026, value-based care leaders make the case for treating payers as partners and explain what providers must see in return.

Mastering modifiers is the secret to reducing claim denials and ensuring fair reimbursement. Financial Recovery Group cr...
05/19/2026

Mastering modifiers is the secret to reducing claim denials and ensuring fair reimbursement. Financial Recovery Group created a Modifier Cheat Sheet that puts essential guidance at your fingertips.

Stop revenue leakage and bill smarter. Download our Modifier Cheat Sheet here: https://frgsystems.com/healthcare-finance-news/medical-coders-billing-guide

FRG provides a Modifier Cheat Sheet that can help coders provide a more accurate picture of what occurred during a patient encounter.

The Centers for Medicare and Medicaid Services temporarily paused new home health and hospice enrollment into Medicare. ...
05/15/2026

The Centers for Medicare and Medicaid Services temporarily paused new home health and hospice enrollment into Medicare. The pause applies to applications for initial Medicare enrollment and follows a fraud prevention proposal to score facilities on inappropriate utilization, care quality, and compliance concerns.

For more details, visit

CMS said the six-month pause will help the administration crack down on fraud.

How do risk contracts actually work?In the shift to value-based care, providers are taking on more financial accountabil...
05/14/2026

How do risk contracts actually work?

In the shift to value-based care, providers are taking on more financial accountability for patient outcomes. Our latest article breaks down:
✅ Shared savings vs. global capitation
✅ Benchmarking & attribution
✅ Quality gates

Catch up on the essentials of healthcare risk contracts: https://frgsystems.com/healthcare-finance-news/what-is-risk-contract-in-healthcare

Risk contracts connect provider payment to cost and performance. Here’s how they work and what that means in practice.

What will make payers, providers, and technology companies trust AI models in healthcare? Purpose-built AI functionality...
05/12/2026

What will make payers, providers, and technology companies trust AI models in healthcare?

Purpose-built AI functionality, fed by relevant, validated data and aligned to client workflows, can make adoption intuitive and add value for multiple stakeholders.

Healthcare Innovation notes:

✅ Scalability requires attentive governance, inclusive of global learnings but sensitive to single-site criteria.
✅ High-quality, contextual data — including about constraints and access issues — drives trustworthy outputs.
✅ AI models should help clinicians identify blind spots and missing considerations in high-stakes decisions.

Read the full story:

As adoption accelerates, leaders across payer, provider, and tech sectors say success will depend on aligning AI with outcomes, incentives, and accountability.

Major U.S. health insurers reported improved Q1 2026 financial performance due to cost control and positive reserve deve...
05/11/2026

Major U.S. health insurers reported improved Q1 2026 financial performance due to cost control and positive reserve development. But still they face significant challenges from the ACA subsidy expiration, high utilization trends, and potentially higher acuity in the Medicaid risk pool.

Read the full story here:

Health insurance companies including UnitedHealthcare, CVS Health’s Aetna and Blue Cross and Blue Shield plans are seeing lower costs. But there’s trouble ahead.

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