Hospitals and health systems are entering 2026 under intensifying financial pressure. Slowed reimbursement, rising patient acuity, workforce strain, and increasingly complex payer requirements are converging. While many of these forces remain outside an organization’s control, one lever continues to have an outsized impact: the accuracy and quality of clinical documentation.
That theme anchored the webinar Rethinking revenue strategies in 2026 for faster cash flow, a fireside chat exploring how healthcare organizations can manage denials and protect revenue by shifting from reactive fixes to proactive, point-of-care strategies.
Click below to watch the full webinar, or keep reading for a recap, featuring IMO Health’s Meg Broom, Sr. Product Sales Director, and Sri Talluri, Product Sales Director.
Revenue pressure isn’t new – but the margin for error is shrinking
As moderator Megan Hillgard framed it early in the session, organizations are being asked to “do more with less” as new reimbursement models and policies evolve. Against that backdrop, denials and under-captured risk adjustment pose direct threats to financial stability.
“If you don’t really understand where and what is causing your denials, it’s hard to come up with a real articulate and impactful strategy to help reduce them,” said Broom.
Denials management has traditionally lived downstream, focused on appeals and rework after claims are already at risk. But as Broom emphasized, that approach often creates additional administrative burden that erodes the very reimbursement it’s meant to recover.
Preventing medical necessity denials
Medical necessity denials remain among the most frustrating and costly. Rules vary by service, payer, and even individual plans, making them difficult to manage with one-size-fits-all approaches.
“There are a lot of differences in medical necessity rules based off of what sort of service is being provided and then based off of the payer down to even the plan,” Broom said.
The panel highlighted the growing need to surface payer-specific guidance earlier – when orders are placed and procedures scheduled – rather than after care is delivered. This upstream shift helps avoid revenue loss, patient delays, and avoidable rework.
Small documentation gaps can add up to major losses
Several real-world examples illustrated how seemingly minor documentation issues, like unspecified laterality or non-primary diagnoses, can snowball into significant financial impact.
One organization, Broom said, had about a million dollars in perioperative cases hitting a work queue every day that didn’t include laterality on the diagnosis and/or procedure side.
“[IMO Health] leveraged the unspecified ICD-10 content, as well as the unspecified laterality CPT content to build triggers into that workflow,” she said. “…and they were able to significantly reduce that $800,000-to-a-million that was hitting that queue and have been thrilled with the results.”
Another example involved the orthopedics department of a New York health system:
Risk adjustment accuracy and revenue
Denial prevention and risk adjustment are tightly linked. As Talluri explained, nearly every value-based care model depends on accurately reflecting patient acuity.
“The premise of everything that is value-based care, really, is that higher acuity patients… need more resources,” he said. “That’s the entire chassis on which the US healthcare system is really built upon.”
When chronic conditions go undocumented, organizations still incur the cost of care – but without receiving appropriate reimbursement. Accurate, defensible documentation ensures that health systems are resourced in line with the populations they serve.
Why point-of-care strategies succeed – or fail
Moving revenue protection upstream only works if clinicians trust and adopt the guidance they see.
“First off, [upstream alerts] have to be accurate,” Broom said. “If you have a high false-positive rate… that’s going to very quickly become something that providers are going to lose trust in and therefore not utilize.”
Equally important, alerts must be actionable. Simply telling clinicians something is wrong without showing how to fix it introduces frustration instead of value.
Looking ahead to 2026
As reimbursement pressure intensifies, the webinar made one thing clear: faster cash flow doesn’t come from working denials harder after the fact. It comes from getting documentation right the first time – accurately, defensibly, and in ways that support clinicians rather than slow them down.
For healthcare leaders preparing for 2026, revenue strategy and clinical documentation strategy are no longer separate conversations. They’re the same one.
