Higher Thinking

Quick, timely blog posts. Thought-provoking trends. How-to guides and in-depth case studies. Use this page to explore all of our best thinking on US healthcare delivery, plus the occasional news from our firm. Find something that inspires or troubles you? Contact us any time – we’d love to be your thought partner in delivering more accessible, sustainable, and equitable healthcare. >>

Securing the Future of a County-Owned Hospital

Here’s how we helped elected leaders in one rural county secure a brighter future for the county-owned hospital.
A woman lies alone in a hospital bed

Medicare (Dis)Advantage: Hospital Observation Downgrades

Research shows that observation status is much more common under Medicare Advantage – bad news for patients and hospitals alike.
A Wall Street street sign, in black and white, illustrates the idea that hospital operating margins are tenuous, while investment income provides some cushion.

Hospital Operating Margins in Limbo as Investments Drive Profitability

Hospital operating margins are highly uncertain, even as investment income provides an illusion of financial wellbeing.
Patricia Dowbiggin and her husband at Niagara Falls

Meet the Team: Patricia Dowbiggin

Our strategy consultant discusses her background in EMS, her burden for rural healthcare ... and her love of the outdoors.

Celebrating Another Year of Impact

Here's what happened when our far-flung team gathered in NC for a 2023 holiday party.
A down arrow in pink neon against a black background illustrates the idea of DRG downgrades. Photo by Ussama Azam on Unsplash.

Medicare (Dis)Advantage: DRG Downgrades

MA plans are using millions of DRG downgrades as a "backdoor" tool for cutting hospital payments. Here are 3 ways to fight back.
A NYC pedestrian "stop" sign illustrates the idea of delayed care for Medicare Advantage patients with prior authorization requirements. Unsplash photo by Kai Pilgerl

Medicare (Dis)Advantage: 35 Million Prior Authorizations

Prior authorizations have become the norm in Medicare Advantage, causing treatment delays for patients and financial headaches for providers.
A group of doctors and nurses in blue scrubs walking away from the camera. Photo by Luis Melendez on Unsplaush.

Medicare (Dis)Advantage: Hospitals Count the Cost

Medicare Advantage now covers more than half of U.S. seniors, putting huge new strains on healthcare delivery.
Dollars and healthcare items scattered on a light blue background. Photo by Anastasiia Gudantova.

Total Cost of Care: Lessons from the Maryland Model

A Maryland expert shares her experience with total cost of care as CMS pushes other states to consider the approach.
A document reading "last will and testament" illustrates the idea that private equity is a last choice for dying hospitals. Photo by Melinda Gimpel via Unsplash.

Why Private Equity Is No Strategy for Struggling Hospitals

For providers in imminent danger of closing their doors and stopping all service, private equity might be better than nothing. But only just.
A woman and two caregivers in a post-acute facility/SNF

Why the Post-Acute Crisis Is Acutely Troubling for Hospitals

Nursing homes are facing unprecedented staffing challenges in 2023 – with big implications for hospitals.
Signs on the front door informing patients that rural Martin General Hospital is closed

Ascendient Aids County After Hospital Closure (Video)

When a rural hospital was closed unexpectedly, Ascendient stepped in to find a more sustainable option for local healthcare.
Crumpled paper next to a paper airplane illustrates the concept of CMS's new AHEAD model.

Can a New CMS Model Move Healthcare Transformation AHEAD?

Thoughts on the newest CMS model, based on our deep expertise with Maryland's TCOC model.
abstract lighthouse watercolor

Ascendient’s Guide to the Maryland Model and the Path AHEAD

Maryland's experiment with Total Cost of Care offers a glimpse of the future for states considering the new AHEAD model from CMS.
abstract lighthouse watercolor

Public Health Strategic Planning: the Ascendient Guide

Where are we? Who are we? Where are we going? Those three questions are the key to public health strategic planning in a time of turmoil.
Research Roundup November header

Introducing the New Healthcare Research e-Brief from Ascendient

Each month, the Ascendient Research Team curates and analyzes the most pressing, most actionable healthcare research.
Greg Flicek, wearing a white golf hat, smiles with his infant son in a blue bucket hat

Meet the Team: Greg Flicek

Our resident CPA discusses where he came from, what drives him, and what he'd like to fix in healthcare.
A building crane in silhouette against a yellow sky. Photo by Shivendu Shukla on Unsplash.

Hospital Finance: Capital Expenditure Costs Are Up Nearly 2x

Rising interest rates + building costs have nearly doubled the price of capital projects. What happens now?
3 volunteers offering food & medicine illustrate the idea of hospital community benefit guidelines

Hospital Community Benefit Rules: Changes Ahead

From state capitals to Washington DC, hospitals face mounting pressure to justify their tax exemption. Here are 3 things to do right now.
An abstract watercolor painting of the sun is the symbol of Ascendient's Healthcare Horizons series, including this installment on health equity strategy

Smart Health Devices: A Smart Business for Hospitals?

Why a hospital-based tech boutique might be a viable strategy for building enduring patient relationships and new revenue streams.