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Navigating Medicare Advantage: Strategies for Hospitals to Tackle Growing Challenges

EvidenceCare

Written by Carol Howard, VP of Clinical Strategy As Medicare Advantage (MA) continues to grow, hospitals have faced growing challenges in navigating complex policies, payer friction, and financial pressures. “Many of our health systems that have at-risk contracts are expecting headwinds in revenue of up to 20%.”

Hospital 130
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STRONG HF – A Positive Trial that Does Not Help Clinical Medicine

Sensible Medicine

The Trial STRONG-HF studied two treatment strategies after a patient was discharged from the hospital after treatment for heart failure. Actual cardiologists performed these visits, which included up-titration of meds, but, also, as Adam correctly notes, patients had MD-level assessments. Here were the results. A: It does not.

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Can We Select “Better” Residents?

Sensible Medicine

If applicants are more impressive on paper, but no more impressive in the clinics and hospitals, aren’t we doing something wrong? To some extent, I think this is mostly what we already do in admission/selection committees. [ii] One could also follow the lead of the tech industry and invest in the selection process.

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Most Important

Sensible Medicine

She meets her existing patients and picks up a new one, Bill. He was a direct admission after an electrophysiologic (EP) study. They found a medication that made it harder to induce VT and sent him up to the medical floor for admission and monitoring with instructions to initiate that medication.

Billing 339
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A Strong Critical Appraisal of the CHAGASICS Trial in patients with Chagas Cardiomyopathy

Sensible Medicine

JMM The CHAGASICS Trial: A Disturbing Failure of Peer Review at a Leading Cardiology Journal By Anis Rassi Jr, MD, PhD, FAHA, FACP, FACP, Scientific Director, Anis Rassi Hospital, Goiânia, Brazil I submitted a letter to the editor regarding the CHAGASICS trial, which was recently published in JAMA Cardiology (October 2024).

Follow-Up 246
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A Surprising Look at the Evidence for Beta-Blockers After MI

Sensible Medicine

Doctors and hospitals incur penalties if a patient with an MI is not on a beta-blocker—unless there is a darn good reason put down in the chart. A place where a learner can go to look up the seminal trials that established modern day cardiology practice. About 16,000 patients were randomized from more than 200 hospitals.

Hospital 342
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Almost the AI Article I Want

Sensible Medicine

The idea was that the software would examine patients’ medical records – the entire medical record: clinical notes; labs; radiology; and their admission histories – and learn to stratify people in terms of their risk for readmission. I admit that I do not follow the Medical AI literature closely.

Follow-Up 253