In my early career as a health economist, I struggled a lot with clinician researchers who just *loved* Mr. Winsor's methods... Me: "No, we can't just trim patients with total costs over $1m." Them: "Why not?" Me: "Because I'm pretty sure accounts receivable doesn't stop expecting payment."

Even relatively modest out-of-pocket costs can be unaffordable when they are concentrated in time. #ASHEcon2026 Photo credit: Paul Shafer

Outsourcing revenue cycle management to private-equity-backed companies is associated with upcoding (increased proportion of higher-complexity DRGs). -Cal Feng of the University of Chicago #ARM26

“Don’t put medical debt on a credit card. Once you do, it’s no longer medical debt—it’s consumer debt, which has different regulations, different (much harsher) sets of rules.” -Eva Stahl of @unduemeddebt.bsky.social #ARM26

“Some patients have no medical debt. Or any other debt. $0. … because they sold their house.” -Rebekah Angove on why measuring #medicaldebt is hard. #ARM26

Do you have a comorbidity and would like to look up a price of a health care service? Or would you like to know what to expect financially if complications occur? Well, too bad. Those prices are harder to find. Janet Akinde presents our research at #ARM26 @umassamherst.bsky.social

Come see me at poster session A (today at 8:00-9:15 am), poster board A-154 #ARM26

A colleague had meeting with an NIH PO last week telling them exactly this. (Second person I’ve heard this from.) Astonishing.

So proud of my amazing students, presenting research posters at SPHHS Research Day! Janet Akinde shows that prices for services provided to patients with comorbidities or who experience complications are harder to find. This implies disparities in the benefits of price transparency.

My god. Not even the first part is right. (If a drug was $100 and its price increased to $600, that would be a 500% increase.)

Kakistocracy

"Subpoenas could show how AI is being applied [in medical billing] or lead to a deescalation where the standard of care is to over-bill and under-reimburse" said @alexhoagland.bsky.social news.bloomberglaw.com/bankruptcy-l...

"A patient does not shop for CPT 27447. They shop for a successful knee replacement. Listing the price of a single code is useless if the patient does not know they also need a specialist consultation, anesthesia, and facility fees." academyhealth.org/blog/2026-03...

Brutal.

“Shocking” that a mean is higher than a median for a right skewed distribution. (for the record, I don’t dispute the point the chart is hoping to make)

A new explainer in @theconversation.com of the most common (and yet confusing) health insurance jargon that US consumers must regularly navigate: theconversation.com/health-insur... With a great addition of a health insurance quiz by @kff.org 😍

🚨🚨🚨 NEW PAPER ALERT 🚨🚨🚨 In this @journalgim.bsky.social brief report, @alexhoagland.bsky.social, our clinical co-authors, and I lay out ancillary services to screening mammography and colonoscopy, for which patients receive medical bills. link.springer.com/article/10.1... cc: @acscan.bsky.social

🚨🚨🚨 NEW PAPER ALERT 🚨🚨🚨 In this @journalgim.bsky.social brief report, @alexhoagland.bsky.social, our clinical co-authors, and I lay out ancillary services to screening mammography and colonoscopy, for which patients receive medical bills. link.springer.com/article/10.1... cc: @acscan.bsky.social

I’m so excited to announce that I’m joining the Tufts School of Medicine as an Assistant Professor in the Department of Public Health and Community Medicine this summer! It’s a dream come true to join an interdisciplinary department that does important policy-relevant work around health disparities.

Latest paper @jamapediatrics.com led by SPHERE postdoc @emilydore.bsky.social finds longstanding disparities in infant health by poverty status using national data, e.g., for preterm birth and low birthweight. www.doi.org/10.1001/jama... @ameracadpeds.bsky.social @harvardpopcenter.bsky.social 1/

Increasing patient cost-sharing to address rising health care costs is a lazy solution. gazettenet.com/2026/02/11/w...

🚨🚨🚨 @alexhoagland.bsky.social and I wrote an overview on health insurance claim denials, what they mean for patients and health care providers, and what data researchers can use to study them. www.ashecon.org/newsletter/h...

“We measure the impact of increased immigration on mortality among elderly Americans, who rely on the immigrant-intensive [health care] sectors… [we find] striking effects on mortality: a 25% increase in the steady state flow of immigrants to the US would result in 5,000 fewer deaths nationwide.”

He was so close to saying "your body, your choice," but caught himself in the last split second.

It sounds appealing at first, but it means paying $2,400 for primary care and still having no insurance in case one needs expensive medication or gets in a car accident. Insurance, especially in the US, has many problems, but doctors not accepting it is not a solution. www.kitv.com/news/honolul...

The biggest risk in this moment is something sociologists call “symbolic compliance.” That’s when an institution that is violating civil rights gives the public just enough symbolic victories that accountability efforts lose steam before there has been any meaningful change.

Václav Havel’s moral philosophy (of the Power of the Powerless) is still timely and relevant even after nearly 50 years…

A good guy with… bare hands.

This is college in the United States. Video from inside a Brown University building shows the moment that police found a group of students who were sheltering after the shooting on campus. This isn't freedom.

So thrilled!! @mirandayaver.bsky.social

MEPS seems to be gone as of now. This is very bad. These are critical pieces of data about health care and they belong to the American public.

Latest study by SPHERE postdocs A. Ali & @emilydore.bsky.social finds that expansions of EITC for young adults w/out kids boosted mental heath. This group is often excluded from safety net policies, but they are at a critical juncture of life course. doi.org/10.1111/1468... @mdrc-news.bsky.social 1/

Do you have a paper on health insurance policy in the Marketplace, MA, or group markets that you would like to present @ashecon.bsky.social in a panel with @dmaanderson.bsky.social @paulshafer.bsky.social sky.social and me? If so, please shoot me an email or DM!

Health care: the only product that you can buy while unconscious.

I wouldn't mind if this is how we get a single-payer health care system...

Tired: “Financial toxicity” Wired: “Financial hardship” (based on research) #PIC25

“More patients worry about medical bills than about dying.” #PIC25

“Why is crowdsourcing the [health care] payment model?” #PIC25

“When insurance was expanded [ACA], we saw fewer people with perforated appendix, because they came to get care sooner.” #PIC25

Annual premium of $26,211.60, plus $8,000 deductible, plus co-insurance (most likely 20%). That is brutal!

Important: this is exactly how propagandists operate.

Postdoc @emilydore.bsky.social @hsph.harvard.edu provided an interview to @healthyfutures.bsky.social discussing the findings of this study, highlighting the importance of social policy design for improving #healthequity. www.healthyfutures.blog/p/how-social... @rwjf.org @policies4action.bsky.social

This is why we fund scientists to study things like oyster slobber even if you don’t think it sounds important

Contrary to what Trump is saying, there is a “down side” to separating MMR into three separate vaccines. That’s three unnecessary office visits and three unnecessary copays. This type of policy puts up more barriers to vaccination.

I’m so sad to hear this! Allan was such a wonderful colleague and mentor, and I am glad I had the honor to work with him. Rest in peace, Allan!

Some of y’all forget the reason we have food safety regulations is because companies used to do things like adding chalk to spoiled milk so it looked normal. Regulations don’t exist because governments enjoy them. They exist because pure unadulterated capitalism would kill us.

Our new study shows that policy changes to the Temporary Assistance for Needy Families (TANF) program that increased access during the COVID-19 pandemic increased breastfeeding: tinyurl.com/ycxpf2cn @ritahamad.bsky.social @hsph.harvard.edu @pamherd.bsky.social @urbaninstitute.bsky.social

Our latest study @jamahealthforum.com shows the harms of work requirements for safety net programs. Women who were subject to harsher requirements and who received less cash assistance from TANF were less likely to breastfeed. jamanetwork.com/journals/jam... @donmoyn.bsky.social @hsph.harvard.edu 1/