Overall, MA companies generated an estimated $9.2 billion in risk-adjusted payments for diagnoses listed only on chart reviews and health risk assessments, with the top 20 companies receiving more than half of the payments. OIG is urging CMS to provide more oversight.
Along with daily surveys, a research team from Mount Sinai used Apple Watches to measure how stress impacted healthcare workers' bodies and pinpointed the characteristics that were associated with lower stress levels over time.
When it comes to managing inbound phone calls, underperformance has devastating cost implications.
In a new study, researchers suggest ACOs are not helping CMS save substantial amounts of money as they were expected to do, so the model should be eliminated. But other experts in the industry disagree, taking issue with the study's methods and conclusions.
Partnering with private consulting firms can spur greater hospital participation in the Bundled Payments for Care Improvement initiative Advanced Model, in which hospitals earn rewards for spending less than CMS-set benchmarks on an episode of care or pay penalties if they spend more.
Called the Covid Hotspotting Score, the tool brings together 10 indicators that can help health systems predict the possibility of a Covid-19 surge up to six weeks ahead of time.
Though medical debt climbed high over the past decade, it appears that Medicaid expansion can help. States that expanded Medicaid saw average debt drop by 44% as opposed to a 10% reduction in non-expansion states.
The progress in artificial intelligence (AI) is reshaping patient care, across various dimensions, from facilitating faster discharge to curating treatment plans and suggesting lifestyle changes.
Enrollment in Medicare Advantage plans grew rapidly between 2009 and 2018, with the largest increases seen among Black, Hispanic and dual enrollee — that is enrolled in both Medicare and Medicaid — populations. This indicates that payers will need to play a key role in addressing health inequities.
People with private insurance report poorer access to care, higher costs and lower satisfaction as compared to those with public insurance plans, a new study shows. As the debate over health insurance reform continues, policymakers should consider efforts that expand Medicare and increase protections for those with private insurance.
Hospitals acquired by PE firms tend to have higher operating margins than those that are not acquired — and that gap widens over time, a new study shows. But it is too early to say whether these glowing financial figures equate to better support for clinical care.
According to a national survey of health information exchanges, EHR vendors and health systems commonly engage in information blocking. Insights from the survey can help the HHS enforce its soon-to-be implemented information blocking rules, researchers say.
Closing cancer health equity gaps require medical breakthroughs made possible by new funding approaches.
The Veterans Health Administration and health technology company Ontrak will conduct a three-year study examining a new intervention to improve care for veterans at high risk for suicide after they have been discharged from psychiatric hospitals.
Amid the Covid-19 pandemic and a growing interest in at-home care, DispatchHealth has published new data showing that its hospital-at-home program did not result in unexpected deaths, serious adverse events or patients being subsequently admitted to a skilled nursing facility.