Insurance applies hip-fracture metrics to brain injuries, then uses ‘plateau’ to cut coverage when neuroplasticity doesn’t fit the algorithm.

Satirical data-driven analysis of non-clinical variables that influence P2P review outcomes. Tracks background variables including animal acoustics, musical…

Officially, the peer-to-peer (P2P) call is a clinical review. Unofficially, it's sabermetrics for suffering. We don't change the facts of a brain injury; we cha

The Out-of-Area Care Burden — Houston is a destination hospital. Patients arrive from across the state and region. Discharge planning into an unfamiliar zip…

The Hot Potato Protocol — the patient who doesn't fit any department's scope gets transferred between them. Each department's discharge criteria are met, but…

The Family Presence Variable — the same discharge plan succeeds or fails based entirely on which family member shows up. Presence is the single strongest…

Perverse Incentives by Design — every actor in the discharge ecosystem is responding rationally to their incentives. The patient just isn't the one the…

Data-driven analysis of how high-deductible health plans devastate catastrophic injury patients. JAMA Health Forum research shows commercially insured trauma…

The Difficult Conversation Industrial Complex — everyone agrees someone should talk to the family. Nobody agrees it's their job. The hardest conversations get…

The Complexity-Admission Mismatch — the hospital's reputation attracts the hardest cases, but its financial model rewards throughput. When census pressure…