Machine learning algorithm improved risk adjustment models, study finds
- A Diagnostic Cost Group (DCG) machine learning algorithm succeeded in generating risk adjustment models and predicted healthcare spending better than the current HHS hierarchical condition category (HCC) model, a study found. Medicare Advantage, Affordable Care Act (ACA) marketplaces, Medicare Part D benefit programs, and state Medicaid managed...
Articles
Market consolidation worse among payers than health systems
There has been a large focus on how market consolidation among hospitals and health systems, including physician practice acquisitions, affects competition, pricing, and access to care. However, new...Breaking down the new CMS proposed bundled payment model: TEAM
CMS has proposed a new mandatory bundled payment model to test if episode-based payments for select surgical procedures would lower Medicare spending and improve care quality. The Transforming Episode...Study: Lax antitrust enforcement boosting hospital prices
A recent study in the journal American Economic Review: Insights found that lax antitrust enforcement contributed to less competition and higher prices for hospital care. The study, conducted by...Sponsored by Greenway Health
Understanding Revenue Cycle Metrics for Healthcare Financial Success
The financial success of a healthcare practice correlates directly with its ability to provide quality patient care, sustain operational efficiency, and support ongoing growth and development. By...Sponsored by CareCredit
Easing Administrative Burdens: Staffing and Burnout Challenges
There continues to be an acknowledgment of the significant levels of burnout experienced by medical personnel. Burnout is also being cited as the primary reason for healthcare workers leaving the...CMS sets minimum staffing standards for nursing homes
A new final rule from CMS establishes minimum staffing standards for nursing homes at a national level for the first time in history. The rule states that nursing homes participating in Medicare and...Portal allows public reporting of anti-competitive behaviors
A new online portal allows the public to report any anti-competitive behaviors they see in the healthcare sector that may be impacting quality of care and affordability. The Federal Trade Commission...HHS finalizes 340B Administrative Dispute Resolution process
A new rule from HHS finalizes a revised Administrative Dispute Resolution (ADR) process under the 340B Drug Pricing Program (340B), which will allow covered entities to address disputes with...Half of private equity-owned physician practices are resold within 3 years
More than half of private equity-acquired physician practices underwent an exit within three years of acquisition, with most practices being resold to other private equity firms, according to a study...About 1 in 5 healthcare bankruptcies in 2023 owned by PE firms
A new report reveals a record year for healthcare bankruptcies as more private equity-owned companies filed for bankruptcy in 2023. There were approximately 80 healthcare bankruptcies last year,...Hospital merger and acquisition activity generated $12B in Q1 2024
Hospital merger and acquisition activity in quarter one of 2024 hit a first-quarter high since 2020, with 20 announced transactions generating $12 billion, a Kaufman Hall report found. The number of...Sponsored by Practice Fusion, a Veradigm Network solution
