IMHO , you are missing what made the costs so high. It starts with the insurance plan. These are the costs providers take risk on and shouldn’t : 1. The credit risk of the deductible 2. The float for Pre Auth denials/delays 3. The doctor/admin cost to appeal PA 4. The underpayments by carriers of contracted rates. 5. The admin costs of processing, that changes ever year. 6. All the consultants they pay re the above 7. (Excluding networks that are so dominant they see the rules ) In response the hospitals try to compensate for the above by : 1. Inventing Facilities Fees 2. Overcharging patients they will negotiate 3. 340b abuses 4. Site neutrality arbitrages 5. Underpaying doctors and nurses The question is what would happen for hospitals that didn’t have the above issues with carriers ? Could they be profitable at hospital (as opposed to Indy physician rates ) I think the answer is yes. Multiple hospitals make money on Medicare and Medicaid rates. But they make sure their expenses fall in line with expected revenue. Curious what everyone here thinks

2⃣ Games, 2⃣ Scores for 8⃣1⃣ ! Hutch Crow makes an incredible grab on the scramble drill and keeps his feet in bounds, putting the Lions in front early! #RoarLionRoar🦁 // #OnlyHere🗽

Already happening. A significant portion of trend uptick is AI-enabled coding. Case intensity up

Adherence =/= compliance. This is measuring proportion of days covered (cadence of refills). Obviously when you only have to fill a med once instead of three times PDC goes up. PDC drives stars and other quality metrics but has a very loose relationship, at best, with taking the med.

This is a great piece on how a nonprofit hospital system, Parkview, amassed 69% market share in Fort Wayne, IN through acquisitions and now abuses that power at the expense of the community. It details many of the worst practices of the industry and is worthy of a thread. 1/12

Congratulations to @DrCCrow, this year’s Robert Graham Award (@TheGrahamCenter) recipient! 🎉 Dr. Crow has spent more than 20 years helping communities thrive by improving the delivery of primary care, including as co-founder and CEO of @catalysthg: bit.ly/4evO56y

RANKED WIN FOR THE LIONS. The Jon Poppe era started off on a high note as @CULionsFB earned its first win against a top 15 opponent since 1995. Bryson Canty had a pair of TD receptions as the Lions topped No. 14 Lafayette 31-20 🌿🏈

No better feeling! @WillFurniss