Publications
– Health Services ResearchMedicare Advantage Plan Bid Risk Underestimates and Corresponding Insurer Revenuesbrary
From 2008 to 2020, Medicare Advantage plans systematically underestimated plan risk by approximately 1% and the frequency and magnitude of the underestimates increased with plan size.
– JAMA Network OpenAn Electronic Health Record-Integrated, LLM-Powered Tool to Triage Surgical Patients
This quality improvement study evaluates whether an electronic health record (EHR)–based large language model (LLM) can accurately identify surgical patients who would be good candidates for comanagement.
– NatureToward a test of medical AI superintelligence - Nature Medicine
Researchers urgently need a rigorous, task-based framework to define and measure medical AI ‘superintelligence’, because existing benchmarks are misleading and insufficient.
– HMPIThe Growth in Healthcare Administrators since 2004 in the United States - HMPI
The changes in the healthcare market since the passage of the Affordable Care Act has led to a significant growth in the number of administrators and in the ratio of the number of administrators per physician.
– HMPIThe State of Payer and Provider Contracting: Challenges and Opportunities - HMPI
Modernizing contracting with standardized, structured, and more digital approaches could reduce administrative burden and better support value-based care.
– HMPIThe Emerging Risk of AI-Enabled Healthcare Fraud - HMPI
The structural complexity of U.S. healthcare and the lack of market governance have led to significant lags in the response to emerging AI-enabled fraud. The authors propose a new technical framework that could lead to proactive fraud prevention.
CERC Development Brochure
Major New Study:
Medical Debt Ecosystems: The Mechanized Wealth Extraction from America's Patients
For millions of patients, essential medical care often means a lifetime of debt or bankruptcy. This in-depth study of medical lawsuits in Virginia reveals the web of players behind a exploitative collection system.
In the report by CERC, GW Law and PatientRightsAdvocate.org, hospitals are far from the only actors in a medical debt ecosystem that disproportionately impacts lower-income Americans.