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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. These changes will impact how hospitals approach their contracts and denial strategies.

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

Sensible Medicine

The worry I have about medical science is that a lot of our experiments produce little to no knowledge. The Trial STRONG-HF studied two treatment strategies after a patient was discharged from the hospital after treatment for heart failure. The primary endpoint (of hospital readmission for HF or death) occurred in 15.2%

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Closed Hospital Owes Former Employees $2 Million in Alleged Wage Theft

Scrubs

The Madera Community Hospital in California closed its doors in January after struggling to pay its bills. But a member of the board recently confirmed that the hospital still owes some $2 million to former employees in the form of unused vacation time, sick time, and other compensation time based on the facility’s records.

Hospital 244
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The Craziest Medical Bills

Scrubs

trillion, was spent on hospital services. Patients around the country are getting stuck with enormous medical bills as hospitals continue to mark up the cost of their services, including those for routine medical procedures and advanced surgeries. For many patients and families, rising medical bills can be a nightmare.

Billing 245
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Mental Health Crisis in Miscarriage–an Unrepresented Patient Population

The Healthcare Blog

I handed them the same box of single ply tissues I was now sobbing into, as I handed them a pen to sign their discharge paperwork. Two weeks after my emergency room discharge, I continued to live life as if nothing happened, returning to work without any healthcare follow-up to address my emotional burden.

Follow-Up 109
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What I Read This Week

Sensible Medicine

We discuss in Ending Medical Reversal why we should be suspicious of single center studies. Safety, tolerability and efficacy of up-titration of guideline-directed medical therapies for acute heart failure (STRONG-HF): a multinational, open-label, randomised, trial I’ve come out pretty strongly against GDMT.

Follow-Up 286
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Choosing a Control Group

Sensible Medicine

Patients may develop a disease that requires admission to the hospital, mostly because of lung problems, such as the need for oxygen. Indirect organ damage is common in medical conditions that are severe enough to warrant admission to the hospital. The disease might affect other organs—either directly or indirectly.