Background: Poor coordination between hospital and outpatient care worsens health outcomes, and increases preventable hospitalization and health care expenditures, especially for socioeconomically disadvantaged populations. Evidence of the effects of current programs to improve care coordination is mixed, and there is little data on how their impact may differ for hospitalizations for ambulatory care-sensitive conditions (ACSCs) [...]

Background: Poor coordination between hospital and outpatient care worsens health outcomes, and increases preventable hospitalization and health care expenditures, especially for socioeconomically disadvantaged populations. Evidence of the effects of current programs to improve care coordination is mixed, and there is little data on how their impact may differ for hospitalizations for ambulatory care-sensitive conditions (ACSCs) [...]

Background: In 2022, healthcare spending in the US accounted for 17.3% of its GDP(1), yet the US ranked near the bottom among high-income nations for key health outcomes. It is unclear if a similar relationship exists between spending and health outcomes across US Hospitals. Centers for Medicare and Medicaid Services (CMS) reports a standardized risk-adjusted [...]

Background: At the time of hospitalization, a physician must place an admission status order designating inpatient, outpatient, or observation care. If a patient requires medically necessary hospital care for at least 2 midnights, an inpatient admission order is appropriate. If care is expected to last fewer than 2 midnights or if there is uncertainty about [...]

Background: Insurance companies are issuing more denials and causing financial instability for hospitals. On average, hospitals are paid $6,000 less for a patient in outpatient observation status as compared to inpatient status. According to Kaiser Family Foundation Health, the average expense in 2022 for a hospital per inpatient day was $3,025 and is only increasing. [...]