David M. Cyganowski

The article on Becker's Healthcare explores predictions from 32 payer executives about the future of healthcare over the next decade. Key themes include the integration of artificial intelligence (AI) in diagnostics and personalized treatment, the rise of home-based and remote care, and the emphasis on interoperability and data sharing to improve patient outcomes. Executives also foresee a shift towards value-based care and personalized insurance models, with technology playing a crucial role in managing chronic conditions and enhancing overall healthcare delivery. For more details, you can read the full article [here](https://lnkd.in/eg2Qyhre).

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Top 10 Things we need to do to Fix health care in the US. #6 PE and Financial institutions and the corporate practice of medicine. Ok, now this one is tricky. Right off the bat people are going to think that I'm going to say that PE firms are evil and should never be called to be involved in health care. Not so. Hear me out. Private Equity is a financing mechanism. It is a tool just like any tool. Narcotics used in the right situation and under the right supervision of a doctor are an incredibly powerful tool. They can also do incredible damage in the wrong hands. PE is much the same. So, here is my recommendation. We need to have more oversight into the management and business practices whenever an external financial entity owns some part of heath care delivery. We need to make sure they are doing the right thing and not just putting profits before patients. That means PE and to be honest that means UHC's ownership of physicians, ASCs etc. UHC is a financial entity just like PE. Part of these rules should be physicians in decision making positions to make sure that patients come first. These physicians need to be more than a King or Queen that comes out on parade days but doesn't have any real power but rather a critical part of the senior management team. There needs to be other controls put in place but you get the drift. https://lnkd.in/eFNekyum

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🌟 Exciting Insights from the Q1 2024 Home-Based Care M&A Report 🌟 The home-based care sector continues to evolve rapidly, and the latest M&A report for Q1 2024 is out, shedding light on the trends and figures that are shaping the industry. 🔍 Key Takeaways: - A notable increase in transaction volumes, indicating robust industry growth and investor confidence. - Strategic shifts as companies adapt to changing healthcare demands and demographic shifts. - Emerging opportunities for businesses looking to innovate and expand their services. 📈 This report is a must-read for industry professionals, investors, and anyone interested in the future of healthcare. Understanding these trends will help us better prepare and adapt to the ongoing changes in the market. 👉 Check out the full report here for detailed insights and analysis: https://hubs.li/Q02wZ-FS0 Let's discuss! What are your thoughts on these trends? How do you see them impacting the industry in the long run? #HomeCare #HealthcareIndustry #MergersAndAcquisitions #BusinessGrowth #MarketTrends

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The Reintroduction of the Stop Wall Street Looting Act The recent bankruptcy of Steward Health Care has reignited discussions around the Stop Wall Street Looting Act. This legislation, championed by Senator Warren, aims to curb the detrimental practices of private equity firms. These takeovers often lead to job losses, company closures, and significant harm to essential sectors like healthcare. The bill represents a renewed effort to bring regulation to the private equity industry. #PrivateEquity #Healthcare #Legislation #EconomicReform https://lnkd.in/gieuYQS4

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S&P: Medicare Advantage's growth a bad omen for hospitals - n8: and Many Health Systems Continue to Participate Under the Terms Dictated by the MA plans, Enabling this Abuse “Even beyond rates, MA adds more administrative and liquidity hurdles for providers. S&P pointed to MA plans’ “key strategy” of prior authorization requirements, which force providers to absorb associated refiling costs and sometimes keep patients locked in a longer hospital stay. That burden is exacerbated by insurers’ generally “high” denial rates, S&P wrote, which have led to instances where smaller providers without the resources to fight claim denials terminate their MA plan contracts and become more vulnerable to closure…. The report also notes that many MA plans have longer pay cycles than traditional Medicare. Combined with claims denials and payment uncertainty, the delayed reimbursement “can hurt cash flow and liquidity,” according to the report.” https://lnkd.in/g3-drT-S So it goes n8 #healthsystems #hospitals #valuebasedcare #medicareadvantage #valuebasedscam

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Looking for a quick recap of the healthcare trends from Q2 2024? Check out our Q2 2024 Healthcare Quarter in Review! Once a quarter we deliver healthcare trends, risks, opportunities, and regulatory updates directly to your inbox. Sign up if you haven’t already: https://lnkd.in/gj58RP59

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Important work from Massachusetts Health Quality Partners (MHQP). Our health system must adopt financial incentives that prioritize primary care and consumer directed technologies that ultimately empower people to make informed decisions about their health and wellness. While hospitals play an important role in healthcare, we must transition away from sick care and invest in primary care, as well as services that advance health, wellness and lower the cost of care. #health #primarycare #healthnotsickcare #healthcare #wellness #affordability #lowercosts

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The concept of "health insurance" can be viewed as a contradiction. In reality, it appears to function more like "income assurance" for the insurance companies themselves. The system seems to shift a significant amount of wealth from those of us who need health insurance, often leading to bankruptcy for many American families, and even causing some healthcare providers to leave the profession altogether. It is estimated that only 30% of what we spend on healthcare goes to direct patient care, while the remaining 70% is absorbed by administration and margins for all the intermediaries involved (such as insurers, PBMs, large consolidated health systems, etc.). Oor healthcare as compared to other industrialized questions is the lowest for quality and costs 2x to 3x more per capita. We can and should do better. Larry BeckerMichelle T. HayesChris DeaconGe BaiScott Conard, MDTrevor P.Liam LaFountainStacey RichterJeffrey Hogan

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McKinsey & Company Report: The healthcare industry is anticipated to undergo significant shifts, with government segments expected to outgrow commercial segments by 65% by 2027. This shift, driven by rising Medicare Advantage penetration and growth in duals segments, will impact payer profit pools. Health systems are facing substantial pressure due to inflation and labor shortages, but transformation efforts and cost containment, particularly in labor, are expected to help EBITDA margins recover. Healthcare technology is also predicted to experience rapid growth, with an estimated 12% compound annual growth rate (CAGR) from 2022 to 2027. https://lnkd.in/g4MfPH99

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Really interesting article. ASC operations are proving crucial for the successful adoption of value-based payment systems and evolving healthcare as we know it. Strong operational foundations inherently lead to economic success and greater flexibility in adopting new care models, which in turn improves patient outcomes. #ASCs #Healthcare #PatientCare

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Looking for a quick recap of the healthcare trends from Q3 2024? Check out our Q3 2024 Healthcare Quarter in Review! Once a quarter we deliver healthcare trends, risks, opportunities, and regulatory updates directly to your inbox. Sign up if you haven’t already: https://lnkd.in/g6xNtMwC

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Looking for a quick recap of the healthcare trends from Q3 2024? Check out our Q3 2024 Healthcare Quarter in Review! Once a quarter we deliver healthcare trends, risks, opportunities, and regulatory updates directly to your inbox. Sign up if you haven’t already: https://lnkd.in/g3vBTeSz

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One of the most vexing topics in today's care environment is how to follow up on incidental findings. There has never been more information in the eco-system, but it is not easy to manage. Hats off to David Facchini of Yale New Haven Health for your 40 under 40 nomination by Radiology Business and recognition for your innovative work in expanding care and building sustainable business. https://lnkd.in/e-e3wiKi Intelerad

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2 hospital systems have widely been reported to take these positions: HHC and NYPHS. With the large impact to employer healthcare costs and the push toward transparency, not sure why these stories have not gotten more traction and attention. Plans have also said yes to this. Hopefully this changes moving forward. "HHC purportedly engaged in antitrust violations through their “all-or-nothing” contracts with insurers. A 2021 presentation to the Connecticut legislature’s Insurance and Real Estate Committee defined “all-or-nothing” contracts as contracts that require insurers to include the entirety of a network’s facilities in its coverage plan, regardless of price. Another alleged anticompetitive strategy HHC enacted was the use of “anti-steering” and “anti-tiering” provisions in their contracts with insurers.  According to the Department of Justice, steering is “a method used by insurers to offer consumers options to reduce some of their health care expenses.” Anti-steering provisions prohibit health insurers from including anything that may steer patients to more cost-effective hospitals and facilities. According to the National Academy for State Health Policy, a nonprofit dedicated to analyzing national health policy, tiered networks are when insurers “place providers into tiers based on price and quality and then offer patients financial incentives, typically through lower cost-sharing, to choose providers from a higher-value tier.” Under anti-tiering provisions, insurers are barred from offering tiered networks to patients, which encourage patients to pursue more affordable care.  The lawsuit goes on to say that HHC’s conduct has “forced patients and employers in Connecticut to pay higher prices for routine services that are often available at other hospitals only minutes away for substantially less.”

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Nice sum up on the #privateequity investments in #healthcareservices “healthcare services are increasingly integrating technology into workflows and becoming more attractive to tech investors” - Dan Shoenholz Private Equity Leader at EY-Parthenon. Technology has immense potential to amp up the quality of care, access and bridge gaps created by labor shortages through AI, automation and richer data science prediction tools.

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Transforming Health and Wealth Management: A Holistic Approach for Family Offices Imagine a world where your health and wealth are seamlessly managed with the utmost care and precision. John Samuels founder and CEO of Wellworth, is making this vision a reality. In this article, he explores how health care advisers and financial advisers can unite to offer comprehensive, personalized solutions for family offices. From expertly navigating chronic health conditions to ensuring peace of mind with end-of-life planning, Samuels’ insights resonate deeply with our mission at TrustHouse to redefine home health care through unparalleled, bespoke services and meaningful partnerships. Join us in discovering how the powerful synergy between health and wealth can enrich the lives of ultra high net worth families.

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We know that private equity (PE) in healthcare is increasingly coming under fire, and with good reason. But vilifying PE in healthcare for the sake of villifying PE, without actually backing up criticisms with real data and concrete examples of the harm caused, is not necessarily valuable. So, here is some data as well as concrete examples. In 2023 alone, a shocking 21% of healthcare company bankruptcies were tied to these financial predators. PE bankruptcies in healthcare have exploded 112% in five years. PE firms buy healthcare companies, saddle them with unsustainable debt, strip their assets, and when these companies inevitably collapse under financial strain, they leave chaos in their wake—job losses, diminished care, and shuttered facilities. These are not victimless crimes. Envision Healthcare, owned by KKR, crumbled into bankruptcy, displacing thousands of employees and compromising crucial medical services. The Center for Autism and Related Disorders, swallowed up by Blackstone, went bankrupt, abruptly cutting off services for countless vulnerable patients. PE ownership was linked to 20,000 premature deaths in nursing homes over 12 years, according to the National Bureau of Economic Research. These are not isolated incidents but patterns of a systematic onslaught on healthcare by PEs relentless rapacity. The infuriating reality is that while healthcare companies buckle under excessive debt, PE moguls make billions by exploiting various financial strategies to maximize their profits. Dividend recapitalizations (loading companies with debt to fund dividends back to the PE firm), increases returns but also company debt. They also exploit interest deductibility to lower taxable income by deducting interest on borrowed funds. Management and monitoring fees are extracted as additional revenue streams, often prioritizing them over other company needs. PE firms asset strip, often leasing back valuable assets in order to extract cash while saddling the company with ongoing lease payments. Lastly, they use the step-up in basis tax provision to reduce capital gains taxes on assets sold, by resetting their tax value at the time of purchase. These maneuvers illustrate how PE firms legally manipulate financial and tax rules, often to the detriment of the companies they acquire. Abuse of the bankruptcy system isa the final exploit, a calculated escape hatch that allows them to walk away unscathed while the companies, employees, and patients they've burdened suffer the consequences. In many cases, and in increasing frequency, PE firms profit from their financial engineering while leaving behind a trail of human and economic devastation.

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Last but not least at Becker's Healthcare CEO/CFO conference - terrific panel led by my ECG Management Consultants colleague Steve McMillen, including Andrew Chang from UChicago Medicine, Patrick Cockey from Jefferson Health, and Maura Buxton from CVS Health. Topic: The Digital Patient Experience. Fascinating discussion in which the panelists agreed on many things, but productively disagreed on some topics. These are my favorite panel discussions, where constructive disagreement fosters truly engaging dialogue. Some of my takeaways (not attributed to any individual member of the panel): (1) The term "digital front door" can imply that we want everyone to begin their journey with us on a device or through an app; we really should be talking about making every channel accessible and seamless. (2) Improving patient experience is necessary but not sufficient; any solution should also simplify provider workflow. (3) We have a lot to learn from our existing patients and consumers, but also much to learn from those who choose NOT to engage with us digitally. #patientexperience #leadership #healthcare

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In the last 4 years, we've seen dramatic surges and falls in healthcare private equity deals and volumes. PE investments can revitalize existing healthcare organizations and breathe life into new, innovative approaches. Read more from my colleague Troy Keach on the top PE trends emerging in 2024.

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