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Preparing for generations of Medicare growth

by Gist Healthcare, Sep 24, 2021

The healthcare industry is now at the peak of the long-awaited transition of the Baby Boom generation into Medicare. The “greying” of the Boomers will…

Preparing for generations of Medicare growth

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Providers threaten to leave MA networks amid contentious negotiations  

This week’s graphic highlights increasing tensions between health systems and Medicare Advantage (MA) plans as they battle over what providers see as unsatisfactory payment rates and insurer business practices. On…

Health systems risk being reduced to their core

This week’s graphic features our assessment of the many emerging competitive challenges to traditional health systems. Beyond inflation and high labor costs, health systems are struggling because competitors—ranging from vertically integrated…

Taking stock of a decade of Medicare ACOs 

In this week’s graphic, we showcase recent data from Health Affairs highlighting the progress made by the Centers for Medicare and Medicaid Services’ (CMS) flagship value-based payment initiative, the Medicare Shared Savings…

CMMI increased Medicare spending in its first decade

In this week’s graphic, we highlight the recent Congressional Budget Office (CBO) analysis of the budgetary impact of the Center for Medicare and Medicaid Innovation (CMMI), which has gotten off to a…

Increased expenses, especially labor, impacting hospital margins 

Workforce shortages, supply chain disruptions, expensive new drugs, and high inflation have all greatly increased hospitals’ expenses. These rising costs are the top cause of the tenuous state of hospital margins today.…

Uneven operating margin recovery for national health systems

Using data from Kaufman Hall’s latest National Hospital Flash Report and publicly available investor reports for some of the nation’s largest health systems, the graphic below takes stock of the state of…

Health “insurtechs” struggling to stay relevant

“Insurtechs” Clover Health, Oscar Health, and Bright Health all went public in the midst of the hot equity market of 2021. Investors were excited by the fast growth of these health insurer startups, and…

Epic expanding its lead on EHR competitors

Two large nonprofit health systems made headlines earlier this month announcing that they plan to transition, enterprise-wide, from Oracle Cerner to Epic for their electronic health record (EHR) system. Using data from KLAS…

Behavioral health utilization driven by fast-growing telehealth use

The pandemic worsened the existing mental health crisis in the United States, greatly increasing demand for care. In this week’s graphic, we highlight new data from JAMA Health Forum on mental healthcare trends from…

Private equity-backed practices flexing market share muscle 

This week we showcase data from a recent American Antitrust Institute study on the growth of private equity (PE)-backed physician practices, and the impact of this growth on market competition and healthcare prices. From…