Before You Plan 2026: Why a Year-End Revenue Cycle Assessment Is No Longer Optional
Author:
Tim Fuchs, Chief Growth Officer at nimble
Most years, ASCs and surgical practices review financial performance after the new year begins. They wait until January or February to analyze cash flow, denials, productivity, and coding accuracy.
That worked in the past. It does not work anymore.
Because what’s coming in 2026 — reimbursement shifts, deductible resets, updated prior auth rules, heightened payer scrutiny, rising case complexity — will reward centers that enter the year prepared, and quietly punish those who don’t.
And the truth is simple: If you wait until January to diagnose revenue cycle risk, you’ll spend Q1 fixing problems instead of capitalizing on opportunities.
A year-end assessment is no longer a “nice to have.” It’s your financial insurance policy going into 2026.
Why Now — Not January
1. Deductibles reset means cash flow risk
January brings slower collections, more patient collection friction, and tighter payer review windows.
If your clean claim rate or days-to-bill is off by even 5–10%, you’re going to feel it in Q1.
January isn’t the time to discover revenue leakage — it’s the time to already be correcting it.
2. Policy & reimbursement changes hit fast
Every cycle, payers evolve documentation rules and prior auth requirements. In 2026, expect:
- Stricter medical necessity documentation
- Higher coding specificity standards
- More automated denials
- Contract complexity increases
If your workflows and coding accuracy aren’t tuned before January 1, you’ll pay for it — quickly.
3. Case volume is at its peak right now
Your team is busy. Which is exactly why this matters.
A low-lift assessment now = high-confidence planning later.
When the first quarter hits, you don’t want to be playing catch-up. You want to be operating with clarity, confidence, and clean data.
What We’re Seeing in 2025 Assessments
Even strong ASCs — groups that consider themselves best-in-class — are discovering avoidable gaps:
| KPI | Benchmark | What We’re Finding |
| Coding accuracy | 95%+ | ~80% avg (lower in ortho) |
| Days-to-bill | ≤3 days | 10-25 days |
| Claims paid in 20 days | 90%+ | 60-80% |
| Revenue cycle accuracy | 95% | Misses in follow up & payment posting |
These aren’t minor issues. They’re silent profit leaks — compounding every month.
And in one recent assessment? A surgical center uncovered 30% in lost revenue — simply due to coding, process timing, and payer contract oversight.
Start 2026 Strong — Not Uncertain
If you’re expanding, adding specialties, renegotiating payer contracts, or simply aiming to protect margin in 2026, this step is non-negotiable. The ASCs that win in 2026 will be the ones acting now — not reacting later.
