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Anticipated Healthcare Cost Growth for 2027
Healthcare research released in mid-2026 projects that commercial medical cost trend will remain elevated heading into 2027. In its annual Behind the Numbers study, the professional services firm PwC projects a 2027 medical cost trend of 9.0% for the employer-sponsored group market and 8.5% for the individual Affordable Care Act (ACA) market, based on surveys and interviews with actuaries at 27 U.S. health plans covering over 103 million employer-sponsored members and 8 million individual marketplace members. The projected commercial trend would be the highest in almost 20 years. (Read more...)
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OhioHealth Settles DOJ Antitrust Claims Over Insurer Contracts
On June 16, 2026, the U.S. Department of Justice (DOJ) and the State of Ohio filed a proposed consent judgment in the U.S. District Court for the Southern District of Ohio to resolve their civil antitrust suit against OhioHealth Corporation, a nonprofit system that owns or manages 16 hospitals in the Columbus area. The proposed judgment would void contract provisions the government alleged OhioHealth used to keep commercial insurers from steering patients toward lower-cost competitors; bar the system from seeking such terms again; and install an independent monitor, all without any admission of wrongdoing or payment of penalties. (Read more...)
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The 2026 National Health Care Fraud Takedown
On June 23, 2026, the U.S. Department of Justice (DOJ) announced the 2026 National Health Care Fraud Takedown, charging 455 defendants, including 90 physicians and other licensed medical professionals, in schemes involving over $6.5 billion in false claims and, in several instances, patient harm that included death. The coordinated action reached 56 federal districts and 45 states and territories, with 50 state Medicaid Fraud Control Units (MFCUs) participating, the most in DOJ history. This Health Capital Topics article reviews the scope of the 2026 Takedown and the expanding role of data analytics in moving federal healthcare fraud enforcement toward prevention before payment. (Read more...)
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Valuation of Neurological Services: Overview & Competitive Environment
Neurological services encompass the diagnosis, treatment, and long-term management of disorders of the brain, spinal cord, and nervous system, a category of conditions that together represent some of the most prevalent and disabling in the U.S. As the population ages and the incidence of chronic and acute neurological conditions continues to rise, demand for neurological services is growing at a pace that increasingly outstrips the available supply of specialists, with significant implications for the valuation of physician services and related healthcare entities. This first installment in a four-part series examining the valuation of neurological services begins with an overview of the specialty and an analysis of the competitive environment. (Read more...)
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"Urgent Care Centers: Finding Value in the Continuum of Care - Part I of II" authored by HCC President, Todd A. Zigrang, MBA, MHA, FACHE, CVA, ASA, ABV, and, HCC Senior Vice President and General Counsel, Jessica Bailey-Wheaton, Esq., was featured in the recent issue of The Value Examiner, published by the National Association of Certified Valuators and Analysts (NACVA) .
For more recently published material written by HCC, please visit www.healthcapital.com
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OIG Clarifies AKS Liability Beyond FMV and Stark Law: Additional Guidance Provided on Physician Remuneration authored by HCC's Todd A. Zigrang, MBA, MHA, FACHE, CVA, ASA, ABV, and Jessica Bailey-Wheaton, Esq., was published in the recent issue of QuckRead published by the National Association of Certified Valuators and Analysts (NACVA).
For more recently published material written by HCC, please visit www.healthcapital.com
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