RESEARCH & PUBLICATIONS

Research & publications

Reports, issue briefs, and white papers translating evidence into practical guidance.

Issue Brief Jul 2026

Behavioral Health: The Blind Spot and the Expired Excuse

Only 17% of hospitals send records to most or all behavioral health providers, the thinnest link in hospital data exchange. For decades the reason was a federal privacy rule. That rule was rewritten, and compliance came due February 16, 2026. The harder problem remains: where accountability has reached behavioral health, studies measured whether spending fell and mostly did not ask whether patients got better.

Issue Brief Jul 2026

Prior Authorization: Faster Is Not the Same as Right

A federal rule now requires payers to decide prior authorization requests within 72 hours or seven days, explain denials, and publish their numbers. These are real improvements. But the evidence suggests much of prior authorization delays care it goes on to approve: in one study, 58 of 61 denied imaging requests (95.1%) were approved once reviewed. The rule speeds the process without changing its standard, and it excludes drugs.

Issue Brief Jul 2026

Post-Acute Care: The Unclaimed Prize

Accountable care organizations have cut post-acute spending by about 9% (roughly $106 per beneficiary) without harming patients, one of the clearest wins in value-based care. But the savings come from clinicians managing individual attributed patients inside facilities they do not own, and that is exactly where the data does not travel: hospitals get records back from post-acute providers only 8% of the time.

Issue Brief Jul 2026

Interoperability Reached 70% of Hospitals by 2023, but the Data Often Goes Unused

Hospital data exchange rose from 46% of hospitals in 2018 to 70% in 2023. Payment reform did not drive that gain. And most of the data that now moves is not used: 71% of hospitals have outside records available at the point of care, but only 42% of clinicians routinely use them.

Issue Brief Jul 2026

Hospital at Home Is Linked to Fewer Emergency Department Visits

In a national study of 15,871 matched Medicare admissions, hospital-at-home patients made fewer emergency department visits within 30 days of discharge (8.8% versus 10.0%) and had lower in-hospital mortality, with no increase in readmissions. The signal is encouraging, though who is treated this way, and where, matters as much as the headline.

Report Jun 2026

Research & publications

Behavioral Health: The Blind Spot and the Expired Excuse

Prior Authorization: Faster Is Not the Same as Right

Post-Acute Care: The Unclaimed Prize

Interoperability Reached 70% of Hospitals by 2023, but the Data Often Goes Unused

Hospital at Home Is Linked to Fewer Emergency Department Visits

MassHealth's 2028-2032 Medicaid Waiver: Continuity Under Pressure

Measuring What Matters: State Priorities in Medicaid Procurement

From Fee-for-Service to Value-Based Payment: A Roadmap

Risk Adjustment: The Foundation of Fair Value-Based Payment

Designing Value Into State Medicaid Reform

Utilization Management in a Value-Based World

Primary Care as the Foundation of Value

Value-Based Care Across Medicare and Medicaid

Measuring Equity in Value-Based Care