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

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 ...

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 ...

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

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 ...

In a “rapid response” to the changing administration, authors write: “The current moment in American health care and politics presents new challenges but also new opportunities to advance the goals of ...

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 ...

Artificial intelligence (AI) and machine learning (ML) have already demonstrated tremendous potential to transform medicine, with almost 1,000 AI-enabled medical devices approved as of 2024 ...