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. >>

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.
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.
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?
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.
To illustrate the idea of health system profits, a pink piggy bank wearing a blue surgical mask is surrounded by piles of coins. Photo by Konstantin Evdokimov via Unsplash.

Health System Profits Are Widespread Despite Operating Losses

Big health systems are turning profitable again, but investment income may be masking deep – and unsustainable – operational woes.
A healthcare provider types on a laptop with a stethoscope in the foreground

Chronic Care Management Reimbursement: Pitfalls & Potential

Struggling physician practices may be missing a lucrative opportunity that's also a key to healthcare transformation.
abstract lighthouse watercolor

Look-Alike Health Centers: the Ascendient Guide

Learn why this obscure provider type can offer financial and strategic benefits while improving care for underserved communities.
Karla Dechavez

Healthcare Consulting Partnerships: 3 Executive Testimonials

Three healthcare leaders in a variety of roles discuss Ascendient's value as a long-term partner.
A blurred image of an ambulance suggests the theme of a Rural Emergency Hospital

Rural Emergency Hospital Questions: Just the FAQs

We have answers to the 9 biggest questions we've been hearing about Medicare's new Rural Emergency Hospital model.
A man in a sportcoat examines financial charts on a tablet device

Analysis: 88% of Large Health Systems Are Losing Money in 2022

Healthcare financial planning is tougher than ever. In 2022, even the largest health systems are losing money on both operations & investments.
A young boy with a Jenga tower illustrates the concept of strategic planning for hospitals

Strategic Planning for Hospitals: Why Worry About the Surge

Lately we've seen record interest in our strategic planning services for hospitals – and that could be a bad sign for the U.S. healthcare system.

Steering Two Competing Systems Toward a Population Health Center

In one rural market, we created a blueprint for cooperation rather than unsustainable competition between failing providers.
A lone orange chair in an empty room illustrates the issue faced by rural hospitals with too many unused inpatient rooms

3 Ways to “Upcycle” Those Unused Inpatient Hospital Rooms

There's likely to be a glut of unused inpatient hospital rooms when REH status picks up steam. Here are 3 ways to put those rooms to use.
A yellow warning light symbolizes the financial hazards ahead for Critical Access Hospitals

Critical Access Hospitals: 5 Troubling Financial Signals for 2022

Days cash on hand, the quickest metric for judging financial health at Critical Access Hospitals, is poised to plunge in 2022. Here's why.
A crumbling cookie illustrates that cookies are going off the menu in healthcare marketing

Healthcare Marketing: Why “Cookies” Are Off the Menu

Third-party cookies are commonly used in healthcare marketing, but they're going away in 2022. Here's what you need to know.
Walgreens is investing billions of dollars to expand VillageMD value-based care

Corporations Are Betting Big on Value-Based Care

Companies are investing billions in value-based care – a good sign for healthcare transformation but a potential problem for traditional providers.