Medicare has become more of a private marketplace — and it’s costly
Medicare Advantage is fundamentally altering Medicare's structure. More
Evaluation of the Merit-Based Incentive Payment System and Surgeons Caring for Patients at High Social Risk
This cohort study evaluates the Merit-Based Incentive Payment System scoring of surgeons caring for patients at high social risk to assess whether this implementation is associated with patient access to surgical care. More
Private Equity and Health Care Delivery: Value-Based Payment as a Guardrail?
This Viewpoint considers how payment models may dictate the nature of private equity investment in health care delivery and how these investments may affect health care access, quality, equity, and affordability. More
Transforming Health Care to Address Value and Equity
This Viewpoint explains the national Vital Signs initiative—developed by the National Academy of Medicine to track improvements in health, health care costs, engagement of the public in its health, and health care and quality. More
UnitedHealthcare delays ER claims policy following backlash
UnitedHealthcare's new policy, which could reject as many as 1 in 10 claims, was labeled as "dangerous" by the American Hospital Association. More
Can a Subscription Model Fix Primary Care in the US?
Medical subscriptions, a $199 million CEO payday and the race to fix primary care in the U.S. One Medical is betting big that a subscription model can fix primary care. More
Viewpoint: A Path Forward for Alternative Payment
This Viewpoint explores existing payment models and waste elimination incentives and proposes a new approach to addressing waste in health care. More
Employers Cut Health Costs With Incentives for Patients, Doctors
Employers can cut their health-care expenses by paying top medical providers a flat rate for a bundle of related services while offering incentives to the patients who use them, a study suggests. More
Hospital Revenue Under Maryland’s Total Cost of Care Model During the COVID-19 Pandemic, March-July 2020
This study compares revenue of Maryland hospitals in March-July 2020 vs historical trends and assesses whether rate increases for inpatient and outpatient services that were permitted to offset pandemic-related decines in revenues were associated with changes to state hospital revenue. More
Challenges of a Supplemental Private Option Under National Health Insurance—Observations From Australia
This Viewpoint describes the role of private hospital insurance in Australia, a country with universal government-sponsored insurance. More