1) Revenue Cycle Watch
Medical necessity denials continue trending upward in imaging and infusion services, largely driven by inconsistent clinical documentation tied to prior authorizations.
E/M and infusion add-on down coding remains a material leakage point; payer edits are increasingly automated.
Patient-responsibility balances are climbing early in the year, increasing AR days when front-end collections are weak.
2) Physician & APP Compensation Watch
wRVU productivity pressure is intensifying as reimbursement growth lags cost inflation.
Growing compliance sensitivity around FMV defensibility, especially for oncology, hospital-based specialists, and APP-heavy service lines.
Early interest in non-wRVU incentives tied to access, throughput, and quality metrics.
3) 340B & Pharmacy Watch
Manufacturer contract-pharmacy restrictions continue to create revenue volatility and operational complexity.
Audit exposure remains highest around:
Eligible patient definition
Child-site alignment with cost reports
Carve-in / carve-out configuration consistency
Increased board-level demand to quantify community benefit tied directly to 340B savings.

4) Compliance & Governance Watch
Heightened scrutiny around physician arrangements, medical directorships, and incentive plans.
Compliance leaders want operationally usable policies, not legal-only documents.
Boards increasingly expect quantified compliance risk reporting.

Victor Esan MPM,MBA