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False Health Claims Abound, but Physicians Are Still the Most Trusted Source for Health Information

The COVID-19 pandemic spotlighted a growing problem: the pervasiveness of false claims about health. To better understand how people in the US view health inaccuracies and learn about them through media use, KFF (formerly Kaiser Family Foundation), a nonprofit organization focused on health policy, tracked exposure to and beliefs about certain claims. For their Health […]

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Physician groups are private equity’s next big growth target. Here’s why

Around 63% of physician transactions in 2023 were attributable to a PE firm or their portfolio companies, according to VMG Health’s 2024 Healthcare M&A Report published May 7. Here are five major trends involving private equity and physician medical group transactions, according to the report.

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Provider Compensation: Five Key Challenges Health Systems Face, and Strategies to Overcome Them

Physicians and Advanced Practice Providers (APPs) are the foundation of a health system’s ability to deliver quality patient care. Provider compensation models that 1) attract and retain high-quality providers while 2) meeting an organization’s operational, strategic, and financial targets are the goal of any health system.

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APG’s Susan Dentzer: We’ve Got to Inspire PCPs Forward Into Value-Based Care

The press release published jointly by the offices of the two senators began thus: “As part of their ongoing work to address primary care challenges and reform physician payment models, U.S. Senators Sheldon Whitehouse (D-RI) and Bill Cassidy, M.D. (R-LA) released a Request for Information (RFI) to accompany the introduction of the senators’ bipartisan Pay […]

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As a primary care physician, here’s how I hope to partner with AI

AI’s enormous potential to help clinicians become more focused on patients, available, diagnostically accurate, and efficient feels like a dream. Yet memories of the nightmarish introduction of the electronic heath record into clinicians’ work lives looms like a dark cloud. Since EHRs swept into clinical life with passage of the American Recovery and Reinvestment Act […]

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Measuring Primary Care Spending in the US by State

Accurately measuring primary care spending is essential to improving health care delivery and outcomes. This case series identifies states’ estimates of primary care spending and recommends steps policymakers can take toward standardizing these estimates.

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Cleveland Clinic will pay $7.6M to resolve false claims case

The Cleveland Clinic Foundation has agreed to pay the U.S. $7.6 million to resolve allegations that it violated the False Claims Act, the Justice Department announced May 17. The settlement resolves allegations of undisclosed foreign sources of funding on National Institutes of Health grant applications and reports

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Investigations Newsletter: Testing Facility Settles $2.5 Million Anti-Kickback Lawsuit

On May 15, the US Attorneys for the Southern District of New York announced that they had settled their civil fraud lawsuit against Balance Diagnostics USA, LLC, a diagnostic testing facility based in Cedarhurst, New York, for paying kickbacks to physicians and their medical practices in violation of the Anti-Kickback Statute.

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Senate Paper Mulls Options for Fixing Physician Pay in Fee-for-Service Medicare

Healthcare organizations seemed pleased with a Senate Finance Committee white paperopens in a new tab or window on problems with physician payment under the Medicare fee-for-service program, even though the paper was vague on some plans for addressing the issues presented.

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CMS makes it easier to report hospital EDs violating emergency care requirement

The Biden administration continues to dig its heels in on emergency care requirements, announcing Tuesday the launch of a new web portal for individuals to report potential violations. The Emergency Medical Treatment and Active Labor Act (EMTALA) was enacted by Congress in 1986 to prevent hospitals from turning away patients with life-threatening health emergencies but […]

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Audio-Only Telehealth Use Among Traditional Medicare Beneficiaries

This cross-sectional study analyzes how use of audio-only telehealth services by Medicare beneficiaries changed from 2020 to 2022 and assesses which patients would be most affected by policy reforms.

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Nurse Practitioner Care, Scope of Practice, and End-of-Life Outcomes for Nursing Home Residents With Dementia

This cohort study examines whether there is an association between nurse practitioner care and end-of-life outcomes for nursing home residents with Alzheimer disease and related dementias and whether these associations differ by state-level nurse practitioner scope of practice regulations.

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Legacy physicians, PAs, NPs consider unionization ahead of possible OHSU purchase

Physicians, physician associates and nurse practitioners at Portland, Ore.-based Legacy Health’s primary care clinics announced May 7 their efforts to unionize with the Pacific Northwest Hospital Medicine Association. The providers submitted union authorization cards to the National Labor Relations Board on May 8, according to a union news release.

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Illinois hospital, OSF HealthCare enter into merger negotiations

Peoria, Ill.-based OSF HealthCare and Dixon, Ill.-based Katherine Shaw Bethea Hospital have shared plans to merge after entering into exclusive negotiations. The two parties have signed a term sheet and plan to spend the next few months finalizing agreements and securing the required regulatory approvals, according to a May 10 news release.

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Healthcare’s Next Void to Fill: Digital Primary Care

Digital care is becoming mainstream — more than 90 percent of health systems have telehealth programs in place, and 71 percent have expanded their offerings in the past year. Yet, as the number of digital health programs available to patients grows, the major challenge has become how to facilitate trust and navigation of virtual care, […]

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How Can the Looming Physician Shortage Be Addressed?

On March 21, the Association of American Medical Colleges (AAMC) published a report concluding that the U.S. is expected to face a physician shortage of between 13,500 and 86,000 by the year 2036. The report states that the continued need for more physicians is related to population growth and aging.

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Healthcare Fraud: A World Beyond the Anti-Kickback Statute

Americans spend more than $3 trillion per-year on healthcare-related expenses. Of that, the National Health Care Anti-Fraud Association estimates that between $60-250 billion is lost to fraud every year. Not all of those losses, however, relate to taxpayer-funded health insurance programs—such as state and federal Medicaid/Medicare—but involve losses to private payers and other non-traditional funding […]

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OIG Issues Favorable Advisory Opinion Regarding Patient Assistance Funds

Recently, the Department of Health and Human Services Office of Inspector General (“OIG”) released Advisory Opinion (“Opinion”) 24-02 regarding patient assistance funds provided by a non-profit charitable organization (“Requestor”). This opinion marks the latest in a string of advisory opinions which have approved similar patient assistance programs (“PAPs”). As highlighted in previous advisory opinions, OIG […]

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University of Pittsburgh Medical Center Settles Whistleblower Lawsuit for $38m

The University of Pittsburgh Medical Center has agreed to pay $38 million to settle a longstanding whistleblower lawsuit that claimed some of its surgeons were ordering unnecessary and overly-complex procedures to increase their earnings. The agreement will allow the hospital system to deny and any all allegations of wrongdoing.

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Trends in telehealth: Integrating physicians into virtual care

Across the board, physicians are interested in working in telehealth — whether they’re young, close to retirement, or simply feeling overloaded and looking for a less stressful alternative. Some providers are even willing to jump to organizations that offer telehealth opportunities, whether it’s part-time, full-time or gig work. Patient access, lower cost of care, and physician burnout are […]

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Early-career physicians working temp roles to ‘test drive’ practice settings, survey finds

Physicians and advanced practice providers are opting for the flexibility of temporary, locum tenens work in seek of improved job conditions and to relieve burnout, according to an April 23 survey conducted by AMN Healthcare. AMN, the largest provider of healthcare interim leadership and executive search services in the U.S., asked physicians, physician assistants and […]

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Health systems phase out common type of anesthesia

A growing number of health systems are moving to end the use of desflurane — a common anesthesia gas that lingers in the atmosphere for more than a decade. Already, Children’s Hospital of Philadelphia and Marlton, N.J.-based Virtua Health have stopped using the gas, according to a May 7 report from The Philadelphia Inquirer. Virtua […]

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Hallmark Publishes 2024 Healthcare Outlook Reports on the Future of Contingent Labor Management and Provider Compensation

Hallmark Health Care Solutions, a leading healthcare workforce management technology company, announced the release of their 2024 Outlook Reports, The Future of Contingent Labor Management in Healthcare and The Future of Provider Compensation in Healthcare. The reports provide healthcare leaders with an analysis of the current and emerging trends impacting the labor and compensation landscape, […]

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Steward Health Care files for Chapter 11 bankruptcy

Dallas-based Steward Health Care, the largest physician-led hospital operator in the country, filed for Chapter 11 bankruptcy this morning in the U.S. Bankruptcy Court for the Southern District of Texas, following months of financial struggles including missed payments to its landlord and vendors. Steward operates more than 30 hospitals across eight states, according to a […]

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Recommendations to support clinician well-being

Clinician well-being has often focused solely on the individual through “burnout” or “resiliency” training because participation and completion can be tracked. While these programs can be helpful, they often ring false or incomplete when not accompanied by systemic changes. Clinician professional well-being initiatives should encompass personal wellness techniques and tie organizational, systemwide and policy improvements […]

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CareFirst, Children’s National Hospital Develop Value-Based Care Alliance

CareFirst BlueCross BlueShield and Children’s National Hospital in Washington, D.C., have entered into a value-based care alliance to address three key priority health conditions: behavioral and mental health, diabetes, and infant mortality.

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Flexible scheduling: smoother workflow, happier doctors?

Several hospitalist groups have moved to create flexible scheduling for their staff given the heightened need to reduce physician burnout and improve retention. These changes reflect studies including a literature review posted this year by Global Advances in Integrative Medicine and Health that looked at the prevalence of burnout among women clinicians.

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Making the most of scheduling software

For the hospitalists at the University of New Mexico Hospital in Albuquerque, scheduling software has helped them achieve targeted flexibility with different kinds of shifts. Christopher Smith, MD, section chief of hospital medicine, says that historically, the academic hospitalists rounded with residents seven-on/seven-off. But “over time, the hospital has asked more and more of us, […]

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When PTO stands for ‘pretend time off’: Doctors struggle to take real breaks

Researchers surveyed 3,024 doctors, part of an American Medical Association cohort designed to represent the American physician workforce. They found that 59.6% of American physicians took 15 days of vacation or less per year. That’s a little more than the average American: Most workers who have been at a job for a year or more […]

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4 Things Hospitalists Can Do to Reduce Nursing Turnover

Hospitalists and hospital administrators know the greatest challenge to providing safe, high-quality healthcare day in and day out in the U.S. is adequate nurse staff. Already a problem before the pandemic, the nursing shortage continues to worsen. By 2025, less than a year from now, the U.S. will have a shortage of 200,000 to 450,000 […]

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Will Generative AI Tools Improve Access to Reliable Health Information?

Could generative AI tools help extend access to reliable medical information and public health messaging—and, in turn, address health disparities? And what types of benefits should be demonstrated before AI technologies are introduced in the clinical setting? Virologist Davey Smith, MD, MAS, head of the Division of Infectious Diseases and Global Public Health at the […]

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Continued Medicare reimbursement declines could threaten access to physicians

These reimbursement trends varied widely by physician specialty (-57.6% for cardiac surgery to +189.1% for pain management). In comparison, non-physician practitioners’ reimbursement per Medicare patient increased more than 3-fold over the same period. The research, published today in INQUIRY: The Journal of Health Care Organization, Provision, and Financing evaluated changes in payments for Part B […]

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False Health Claims Abound, but Physicians Are Still the Most Trusted Source for Health Information

The COVID-19 pandemic spotlighted a growing problem: the pervasiveness of false claims about health. To better understand how people in the US view health inaccuracies and learn about them through media use, KFF (formerly Kaiser Family Foundation), a nonprofit organization focused on health policy, tracked exposure to and beliefs about certain claims. For their Health […]

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Reconsidering and Measuring Patient Access in Medicaid

Recent Medicaid policy discussions have focused on coverage issues because millions of beneficiaries have been disenrolled during the unwinding of COVID-19 pandemic–era eligibility protections. But access to care during a person’s enrollment in Medicaid is an equally important issue, and one that is particularly thorny to measure and address.

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OIG Issues Favorable Advisory Opinion Regarding Patient Assistance Funds

Recently, the Department of Health and Human Services Office of Inspector General (“OIG”) released Advisory Opinion (“Opinion”) 24-02 regarding patient assistance funds provided by a non-profit charitable organization (“Requestor”). This opinion marks the latest in a string of advisory opinions which have approved similar patient assistance programs (“PAPs”). As highlighted in previous advisory opinions, OIG […]

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Cedars-Sinai expands virtual primary care app

Los Angeles-based Cedars-Sinai expanded its virtual primary care app April 10. Cedars-Sinai Connect will now be available to children aged 3 to 17 (via their parents) as well as Spanish-speaking patients.

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Steward Health Care Plans to Sell Physician Network to Optum

Financially troubled Steward Health Care has announced plans to sell its physician network to Optum Care, a division of UnitedHealth Group, for an undisclosed sum. Dallas-based Steward has faced significant financial trouble in Massachusetts, where it operates nine healthcare facilities. It will permanently close New England Sinai Acute Long-Term Care And Rehabilitation Hospital in Stoughton […]

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Q&A: Physician discusses unintended consequences of patients having immediate access to test results

In a fast-paced digital age where patients can open their test results as soon as they are available, what happens when a patient reads through complicated results without a physician there to help them understand what it all means? And what happens when a patient misinterprets bad news as good news, or vice versa? It’s […]

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Insurer “Delay and Deny” Practices Continue to Threaten Patients’ Timely Access to Gastrointestinal Care – It’s Time for Reform

When a patient is struggling with gastrointestinal (GI) health issues, such as rectal bleeding, inflammatory bowel disease (IBD), or the possibility of colorectal cancer, they must immediately seek medical care. Receiving a timely colonoscopy or endoscopy is essential to developing an individually tailored treatment plan to help the patient recover.

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New ACGME Peds Program Requirements Present Challenges and Opportunities

Although updates to the Accreditation Council for Graduate Medical Education (ACGME) program requirements for pediatric graduate medical education will present financial challenges to some hospitals and planning challenges for some resident programs, the changes may provide a more balanced and tailored education. It may also impact long-term training needs for residents planning to become pediatric […]

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Revolutionizing Medicare with ACO Primary Care Flex Model: Enhancing Access and Equity

Every primary care physician (PCP) in the United States should be integrated into an accountable care model. The primary objective of accountable care models is to provide all participating healthcare providers with the necessary incentives and resources to deliver top-notch, coordinated, team-based care that prioritizes health promotion. By doing so, it aims to minimize fragmentation […]

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Physicians accuse Legacy Health of unilaterally reducing shifts

The Pacific Northwest Hospital Medicine Association, a physician and advanced practice provider union represented by the American Federation of Teachers and staffed by the Oregon Nurses Association, is accusing Portland, Ore.-based Legacy Health of reducing hours worked by hospitalists without sufficient bargaining.

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Report: Gap Widens in Patient Perceptions of Inpatient vs. Outpatient Safety

While patient perceptions in outpatient settings are rising, nearly half of all staff and almost one-third of inpatients report low perceptions of safety, according to Press Ganey data. Reports of violence against nurses are also rising.

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What’s Behind Slow Uptake of Rural Emergency Hospital Designation?

A recent webinar at Penn Medicine Leonard Davis Institute (LDI) of Health Economics focused on the growing set of challenges facing rural hospitals. One issue the panelists zeroed in on is why the Rural Emergency Hospital designation doesn’t seem to be catching on with rural hospitals.

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Why don’t physicians accept Medicaid patients?

One reason is that reimbursement rates for Medicaid are lower than for Medicare or commercial insurance. Another (often overlooked) factor, however, is physician’s risk of payment denials and the administrative hassle they face trying to get reimbursed by Medicaid. A paper by Dunn et al. (2024)–cleverly named “A Denial a Day Keeps the Doctor Away“–shows […]

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AAMC Predicts Significant Physician Shortage by 2036

A new report published on March 21 by the Association of American Medical Colleges (AAMC) concludes that the U.S. is expected to face a physician shortage of between 13,500 and 86,000 by 2036. According to the study, The Complexities of Physician Supply and Demand: Projections from 2021 to 2036, many physicians will reach retirement age within the next decade.

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Flexible scheduling: smoother workflow, happier doctors?

Several hospitalist groups have moved to create flexible scheduling for their staff given the heightened need to reduce physician burnout and improve retention. These changes reflect studies including a literature review posted this year by Global Advances in Integrative Medicine and Health that looked at the prevalence of burnout among women clinicians.

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AI Adoption Essential for Healthcare Providers Amid Rising Challenges and Patient Options

Eli Lilly’s decision to sell weight-loss drugs and other medications directly to patients reflects the growing competition in the healthcare industry as consumers gain more options. If you’re not addressing core challenges and improving healthcare experiences to meet people’s needs, you risk losing your competitive edge. Traditional healthcare providers often struggle to innovate and compete due […]

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Intravascular Microaxial Left Ventricular Assist Device Manufacturer Payments to Cardiologists and Use of Devices

Mechanical circulatory support devices are increasingly used by physicians for patients receiving percutaneous coronary intervention (PCI). Use of intra-aortic balloon pumps (IABPs) has decreased, whereas use of intravascular microaxial left ventricular assist devices (LVADs) grew from 4.1% to 9.8% of all PCIs for acute myocardial infarction complicated by cardiogenic shock from 2015 to 2017, despite […]

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How AI can be a catalyst for building a change-ready culture

Generative artificial intelligence (AI) offers significant promise as healthcare organizations seek innovative solutions to meet evolving consumer preferences, lower costs and address workforce shortages. While organizations are eager to realize the potential benefits of tech investments, prioritizing speed over other outcomes during an implementation can prevent long-term success and poorly affect culture. Huron’s research shows […]

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Apple Vision Pro Could Reduce Surgeon Training Time 40% To 200%

Apple Vision Pro is perhaps the best virtual tool yet for training surgeons, says a company that builds virtual experiences to medical training, adding that its gesture control system is “phenomenal.” Using Apple Vision Pro in training-similar to other VR systems-can reduce surgical training time by 40% to 200%.

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Healthcare’s Next Void to Fill: Digital Primary Care

Digital care is becoming mainstream — more than 90 percent of health systems have telehealth programs in place, and 71 percent have expanded their offerings in the past year. Yet, as the number of digital health programs available to patients grows, the major challenge has become how to facilitate trust and navigation of virtual care, […]

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Free med school tuition won’t solve the shortage of primary care physicians

Last month, nearly 40,000 medical students were accepted into residency programs on “Match Day.” Surrounded by family and friends, these soon-to-be-physicians opened envelopes revealing where they would begin their careers. This moment marked the culmination of a residency match process that requires medical students to make a series of choices and rankings about which medical […]

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Experts Aren’t Surprised About Optum Closing Its Virtual Care Business

Healthcare leaders agree that this closure reflects broader trends in the telehealth market, in which saturation and differentiation challenges are leading some providers to struggle. In the future, experts believe the most successful virtual care companies will be those that provide personalized patient experiences and focus on niche community needs — as well as those […]

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Contracted ED clinicians at Ascension hospital vote to strike

Members of the Greater Detroit Association of Emergency Physicians, who work at Ascension St. John’s emergency department but are employed by TeamHealth, said that long wait times, reportedly up to 17 hours in the ED, have become normal. They also allege that TeamHealth, which is owned by a private equity firm and handles emergency room […]

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Investigations Newsletter: Testing Facility Settles $2.5 Million Anti-Kickback Lawsuit

On May 15, the US Attorneys for the Southern District of New York announced that they had settled their civil fraud lawsuit against Balance Diagnostics USA, LLC, a diagnostic testing facility based in Cedarhurst, New York, for paying kickbacks to physicians and their medical practices in violation of the Anti-Kickback Statute.

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“Stark” Differences: DOJ’s Renewed Focus on Stand-Alone Stark Law Violations

The Department of Justice (DOJ) is breathing new life into False Claims Act (FCA) enforcement based on the Stark Law (Stark), 42 U.S.C. § 1395nn, also known as the Physician Self-Referral Law. Over the past few months, DOJ has filed two FCA complaints-in-intervention focusing on Stark violations and announced at least two multimillion-dollar Stark-related settlements. […]

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Stark Integrity Podcast: wRVUs Physician Compensation, Volume or Value, and Telehealth Compliance and Use Issues Episodes

Check out the latest episode on the Stark Integrity podcast hosted by Nelson Mullins Riley & Scarborough LLP’s Nashville partner Bob Wade, featuring professionals in the healthcare industry including Christine Hall with Stirling Global Solutions.

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How Can Healthcare Ensure Responsible AI Use?

Over the past decade or so, leaders across the globe have debated how to responsibly integrate AI into clinical care. Though there have been many discussions on the topic, the healthcare field still lacks a comprehensive, shared framework to govern the development and deployment of AI. Now that healthcare organizations have become entangled in the […]

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Indiana health system to automate chart reviews with AI

Indianapolis-based Community Health Network plans to expand an artificial intelligence tool that automates chart reviews across the enterprise. The AI platform from Notable also identifies patient care gaps and helps with pre-visit planning. The AI scans charts for unstructured data, assists patients in self-scheduling, then automatically adds appointments to EHRs.

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Latest Posts

HCA provided $3.7B in 2023 charity care

Nashville, Tenn.-based HCA Healthcare provided around $3.7 billion in charity care, uninsured discounts and other uncompensated care in 2023, according to its annual impact report. 

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Mercy taps chief legal officer, senior vice president

St. Louis-based Mercy has tapped Jennifer Brown as chief legal officer and senior vice president, effective April 1.

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UnitedHealth pays $3.3B to providers following Change hack

UnitedHealth Group said it has paid out more than $3.3 billion to providers affected by the Feb. 21 cyberattack on its subsidiary Change Healthcare, CNBC reported March 28.

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Provider Strategy reports on market developments and insights related to the healthcare provider workforce. Our publication is committed to improving the healthcare professional workforce, utilization of providers, and ultimately supporting thought leadership in workforce innovation.

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