Healthcare

A new research in the INFORMS journal Manufacturing & Service Operations Management finds that Medicare Advantage (MA), the largest healthcare capitation program in the U.S., unintentionally incentivises health plans to cherry-pick profitable patients from traditional Medicare (TM). The study, “Can Big Data Cure Risk Selection in Healthcare Capitation Program? A Game Theoretical Analysis,” shows that even if the current MA risk adjustment design became informationally perfect through increased availability of big data, incentives would continue to persist for risk selection, primarily because of the way the current risk adjustment model is designed. Co-author SMU Assistant Professor of Operations Management Zhaowei She said, “No generic risk adjustment algorithm can solve the strategic prediction problem in risk adjustment without explicitly taking into account the underlying mechanism in healthcare capitation programs.” The study calls for practitioners and policymakers to change their views of seeing risk adjustment as a pure statistical and machine learning problem and to look more comprehensively at the human impact.

New research in the INFORMS journal Manufacturing & Service Operations Management finds that Medicare Advantage (MA), the largest healthcare capitation program in the U.S., unintentionally incentivizes health plans to cherry-pick profitable patients from traditional Medicare (TM). “Capitation” is the annual fee paid to a healthcare practice by each participant in a health plan.

People 65 and older now account for nine of out 10 COVID-19 deaths, a higher proportion than at any other time in the pandemic.

Amid return-to-office debates, 82% of U.S. hiring managers at companies that worked remotely during the pandemic said their organizations planned to continue to allow staff to perform their duties offsite, according to the results of a Harris Poll survey commissioned by Express Employment Professionals.

New COVID-19 cases in Clark County and statewide continued to increase this week but at a slower rate, while hospitalizations dipped, new state data shows.

In October, the Chinese government declared its zero-Covid policy to be the best and most cost-effective. That has made the strict policy’s sudden end in the past several days a surprise to many, even the policy’s fiercest critics. The rapid change has also sparked concerns about how potential new public health risks will further disrupt supply chains. Will this mark the beginning of the end of China’s dominant role in global supply chains? 

Sue Laridis recently tried to buy cough medicine for her grandson. “I just couldn’t find it,” she said. “Nobody has anything. It’s like even at the grocery stores. It’s getting ridiculous.”

Consumers are at the mercy of drug companies when it comes to learning about what is causing the shortages, and how and when they might be resolved.

A new type of antibiotic for treating urinary tract infections (UTIs) may be available sooner than expected.

The life expectancy of Americans has dropped for two consecutive years. The first year, attributed to the COVID-19 pandemic, was consistent with other countries. The second year was not.