Shifting from reducing MA capitation by an across-the-board coding intensity adjustment factor to Medicare Advantage ...

Private equity (PE) acquisitions of health care providers are often framed as a monolithic intervention, but firms’ strategies for generating returns for investors may vary. In a ...

Consolidation of physician practices, largely driven by health systems, has motivated policy efforts to move care toward lower-price, non–health system settings. At the same time, however, private ...

While evidence-based decisions are essential, they must be paired with effective public messaging that builds trust and ...

This article does not attempt to predict the potential policies that the new administration and Congress might pursue or how ...

Given the prevalence of managed care, it’s incumbent upon the industry to ensure that there is a robust supplier pool.

Oklahoma and South Carolina are among nine states that use some form of provider-based reference pricing to contain spending ...

Transforming physical design. Hospitals are also dangerous; patients are exposed to infection and injuries that could be prevented if hospitals had better designs. 16 An analysis of more than 600 ...

In 2016, ahead of the US presidential election, the National Academy of Medicine launched the strategic initiative Vital Directions for Health and Health Care—a series of papers on critical areas of ...

Transparency in the program is more than just a mechanism for fair pricing—it is a driving force that diminishes the returns ...

The FDA’s framework for AI regulation, while robust for premarket evaluation, would benefit from more specific mechanisms for continuous monitoring of AI performance in diverse real-world settings.

Rates Of Care Use Exhibit 1 shows the use of health care services at different sites based on insurance status. There are two key results. First, the uninsured do not use the ED substantially more ...