Coverage of our peer-reviewed research and news reporting in the healthcare and mainstream press.
An article by Skilled Nursing News, titled “Researchers Find ‘Perverse Incentives’ for Skilled Nursing Operators Under PDPM,” cited a study published in the April 2020 issue of The American Journal of Managed Care® (AJMC®) titled “The Patient-Driven Payment Model: Addressing Perverse Incentives, Creating New Ones.” In the study, researchers indicated that although the Patient-Driven Payment Model (PDPM) addresses perverse incentives in Medicare’s previous payment system for skilled nursing facilities (SNFs), it includes new incentives that may be problematic. The study authors recommended that regulators should maintain close oversight of billing by SNFs and patient outcomes as the PDPM takes effect to mitigate potential unintended consequences.
A piece reported by Healio referenced a study published in the November 2019 issue of AJMC®, “CKD Quality Improvement Intervention With PCMH Integration: Health Plan Results.” The study results supported innovation in chronic kidney disease (CKD) by commercial health plans, as a scalable CKD quality improvement intervention demonstrated feasibility, decreased hospitalization, and reduced costs.
AI in Health Care: Balancing Governance, Innovation, and Trust
September 2nd 2025In this conversation with Reuben Daniel, associate vice president of artificial intelligence at UPMC Health Plan, we dive into how UPMC Health Plan builds trust with providers and members, discuss challenges of scaling AI effectively, and hear about concrete examples of AI's positive impact.
Listen
Team Coordination, Data Sharing Help Prioritize Value in Cardio-Renal-Metabolic Care
September 12th 2025Cardiologists, nephrologists, and payers met in Scottsdale, Arizona, on August 26, 2025, to share insights on how team members can work together, empowered by data, to achieve value-based management of cardio-renal-metabolic syndrome.
Read More