Tackling the Denials Challenge: Smarter Strategies, Stronger Defenses

Hospitals aren’t just reacting to denials anymore—they’re redesigning the playbook. As commercial and Medicare Advantage (MA) denials grow more complex, organizations are taking strategic, cross-functional approaches to manage them. Revenue integrity teams are leveraging analytics to detect payer-specific trends and working hand in hand with CDI, contracting, compliance, and legal to prevent denials. It’s no longer just about working the denials—it’s about designing systems that minimize them at the source.
To better understand the scope of the challenge and the strategies gaining traction, the NAHRI Leadership Council conducted the 2025 spring membership survey on Denials Management and Prevention. The research, sponsored by Solventum, formerly 3M Health Care, highlights denial amounts, payer impact, and how hospitals are staffing their denials teams.