HITshow Daily Audio Newscast

Today on HITshow: AI is moving from innovation into real operational friction, and governance is catching up. Medicare launches a new AI-driven model to review outpatient procedures, Oracle's breach fallout widens to include AdventHealth, and OpenAI says 40 million people are using ChatGPT daily for healthcare questions. Plus: Corewell and Quest form a major lab joint venture, New York nurses issue strike notices covering 15 hospitals, and a Bright Spot on Epic and Penn Medicine's smarter clinic collaboration. HOST: RHONDA BROOKS 📍 Healthcare Policy & Advocacy --- Peter Betterworth Medicare is officially testing the WISeR Model, using AI and machine learning paired with human clinical review to assess certain outpatient procedures. The model runs January 1, 2026 through December 31, 2031, launching across six states: Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington. Hospitals should expect new workflow realities including documentation requirements, turnaround times, and algorithmic triage at the front door. 📍 Strategy & Transformation --- Teresa Vaughn Oracle's breach fallout is widening, with new reporting indicating AdventHealth has been ensnared and multiple health systems affected. The incident highlights third-party vendor risk, with leaders needing to quickly confirm integrations, validate access logs, and review patient-notification playbooks. 📍 Digital Health --- Nate Collier OpenAI says more than 40 million people are using ChatGPT daily for healthcare-related questions, with about 1 in 4 weekly users prompting about healthcare. Clinicians are increasingly spending visit time validating, correcting, or reframing what patients read from AI, creating both risk (misinformation driving unnecessary utilization) and opportunity (building trusted digital front doors and better triage). 📍 Finance & Capital --- Logan Stokes Corewell Health and Quest Diagnostics are forming a lab joint venture called Diagnostic Lab of Michigan, with Quest holding 51% and Corewell 49%. Quest will manage lab operations across all 21 Corewell hospitals, with plans for a 100,000 square-foot centralized laboratory targeted for Q1 2027. 📍 Healthcare Policy & Advocacy --- Jade Romero About 21,000 New York nurses have issued ten-day strike notices covering 15 hospitals, with a potential strike date of January 12. Even if a strike is avoided, preparation is disruptive with staffing contingency plans, potential delays to elective procedures, and pressure to keep critical units stable. Epic and Penn Medicine are working on a smarter clinic collaboration aimed at practical improvements: fewer friction points for patients, smoother scheduling and communication, better coordination across care teams, and less administrative drag for clinicians. 🎙️ Subscribe here or wherever you listen to podcasts, and if you like our show, please follow us on LinkedIn at https://www.linkedin.com/company/hit_show. HITshow is made possible by EY, Ovatient, and Kimmchi.

Today on HITshow: Three big forces collide: AI is moving from pilot to production in revenue cycle operations, New York puts more than $300M into hospital health IT and cybersecurity, and payers are tightening reimbursement rules. Plus: Northwell Direct lands a major contract covering 170,000 participants, UnitedHealthcare narrows RPM coverage starting January 1, and a Bright Spot on how Tendo is making bundled care shoppable. HOST: RHONDA BROOKS 📍 Finance & Capital --- Teresa Vaughn A new survey shows 8 in 10 health systems are now exploring, piloting, or implementing generative AI tools for revenue cycle management, with leaders targeting faster throughput, fewer denials, less manual work, and relief on staffing pressure. The fastest CFO wins are in denials and under-coding—anything that turns into dollars quickly with a clean audit trail. 📍 Healthcare Policy & Advocacy --- Anika Shah New York is awarding more than $300M to 22 hospital projects through the state's facility transformation programs, focusing on expanding electronic medical records, strengthening cybersecurity and patient data security, and expanding telehealth services. Cyber readiness and IT modernization are being treated like essential infrastructure alongside bricks and mortar. 📍 Finance & Capital --- Logan Stokes Northwell Direct and the 32BJ Health Fund announced a direct healthcare agreement covering about 170,000 participants, cutting out a layer of third-party administration. The fund estimates meaningful first-year savings, signaling that large purchasers want more predictable pricing and control over where care is delivered. 📍 Digital Health --- Jalen Cross UnitedHealthcare has a new RPM medical policy effective January 1, 2026, making coverage more restrictive. For health systems and provider groups running RPM at scale, this is a "check your cohorts" moment to map current patients against new criteria and build transition plans for anyone who no longer qualifies. 📍 Quick Roundup --- Nate Collier Humana is lining up a leadership transition in its insurance business, bringing in a former Amazon healthcare executive. Banner Health is transitioning facilities to a cashless payment model with completion targeted by March 2026. Bayhealth has a proposed $2.5M settlement fund tied to a patient data breach pending court approval. Evernorth's Behavioral Care Group is highlighting expansion and access improvements with more growth planned into 2026. 📍 Digital Health --- Jade Romero (Bright Spot) Tendo is combining performance insight for providers with a marketplace that lets employers and care navigators shop bundled episodes with upfront pricing and quality signals. Co-CEO Kevin Riley says the platform saves consumers an average of $740 per service with a 92% five-star rating, signaling employers want predictable prices and providers want channels that reward quality. 🎙️ Subscribe here or wherever you listen to podcasts, and if you like our show, please follow us on LinkedIn at https://www.linkedin.com/company/hit_show. HITshow is made possible by EY, Ovatient, and Kimmchi.

Today on HITshow: Stability is getting expensive across healthcare. The VA plans to eliminate up to 35,000 healthcare positions, 57 health systems push back on proposed cybersecurity rules, and Cencora takes majority control of OneOncology in a $7.4B deal. Plus: Connecticut approves a hospital acquisition with strict access guardrails, and Philips moves to acquire SpectraWAVE for AI-enabled coronary imaging. HOST: RHONDA BROOKS 📍 Healthcare Policy & Advocacy --- Anika Shah The Veterans Affairs system is planning to cut up to 35,000 healthcare positions, largely roles currently unfilled. The concern for hospital leaders isn't just federal belt-tightening but second-order effects: if VA capacity tightens or hiring slows in certain markets, pressure could shift into community care through ED volume, outpatient access, and specialty bottlenecks. .📍 Cybersecurity --- Peter Betterworth A group of 57 health systems is urging HHS to rescind a proposed cybersecurity rule, arguing the requirements and timelines could be financially and operationally unrealistic. If the rule moves forward as written, it could force faster spending decisions on controls, audits, documentation, and staffing, landing on clinical uptime, third-party risk, and enterprise governance. 📍 Finance & Capital --- Logan Stokes Cencora is taking majority control of OneOncology in a deal valuing the business at about $7.4B. The practical message for health system leaders is that the community oncology ecosystem keeps getting more organized and better-capitalized, affecting referral dynamics, site-of-care strategy, infusion economics, and partnerships. 📍 Strategy & Transformation --- Teresa Vaughn Connecticut regulators approved Hartford HealthCare's acquisition of Manchester Memorial and Rockville General with specific conditions, including keeping the Rockville emergency department open 24/7 for at least three years and maintaining inpatient behavioral health services within a set radius. States are increasingly writing access guarantees and service-line protections into M&A approvals. 📍 Digital Health --- Nate Collier Philips agreed to acquire SpectraWAVE, adding technology focused on coronary intravascular imaging and physiological assessment with an emphasis on AI. Vendors are stacking capabilities to own more of the interventional workflow, including imaging, interpretation support, and decision guidance. 🎙️ Subscribe here or wherever you listen to podcasts, and if you like our show, please follow us on LinkedIn at https://www.linkedin.com/company/hit_show. HITshow is made possible by EY, Ovatient, and Kimmchi.

Today on HITshow: The financial squeeze is easing a bit, but the pressure to restructure is not—and the "front door" of healthcare is getting more AI-powered by the day. Nonprofit hospital margins are expected to see modest gains into 2026, but systems are tightening now ahead of Medicaid uncertainty. A major payer-provider combo emerges in Hawaii. CVS raises guidance and lays out a new AI platform strategy. Measurable gains from AI scribes in the emergency department. Medline sets terms for what could be the biggest U.S. IPO of 2025. Plus a Bright Spot on a milestone in the physician pipeline. HOST: RHONDA BROOKS 📍 Nonprofit Margins & Medicaid Tightening — Teresa Vaughn Nonprofit hospitals expected to see modest margin improvement through 2026, but the message is clear: don't confuse "better" with "back to normal." Systems are tightening now because of policy risk on the horizon, especially around Medicaid. The window to lock in resilience won't stay open long. 📍 Hawaii Payer-Provider Merger Talks — Logan Stokes Hawaii Pacific Health and Hawaii Medical Service Association (the state's largest payer) are exploring a possible merger or affiliation. The stated goals are affordability and access, but the real question: what changes when the biggest payer and a major provider start rowing in the same direction? Regulators and employers are watching. 📍 CVS Raises Outlook & AI Strategy — Nate Collier CVS raised 2025 guidance and is pushing a new AI-powered platform designed to unify consumer experience across pharmacy, benefits, and care delivery. The real implication: the consumer front door is becoming more automated. Payers will guide members in real time—shaping volume, routing, and patient expectations. 📍 AI Scribes Show ED Throughput Gains — Jade Romero Cabrini Health in Melbourne, Australia piloted an AI scribe with Heidi Health in the emergency department—and care wrapped up about 24 minutes earlier on average. The takeaway: AI scribes are moving from "promising" to "measurable," but only if you build governance and accountability to scale responsibly. .📍 Medline Sets IPO Terms — Peter Betterworth Medline is targeting a valuation of up to $55.3 billion in what could be the biggest U.S. IPO of 2025. Supply chain is strategy—contracts, standardization, inventory discipline are no longer "back office" topics. Expect the entire segment to sharpen. Bright Spot: U.S. medical school enrollment tops 100,000 students for the first time in the 2025–2026 academic year. Applications are also up about 5%, reversing a three-year decline. The pipeline is strengthening—essential for long-term care delivery stability. 🎙️ Subscribe here or wherever you listen to podcasts, and if you like our show, please follow us on LinkedIn at https://www.linkedin.com/company/hit_show. HITshow is made possible by EY, Ovatient, and Kimmchi.

Today on HITshow: Big decisions in the background—deals that don't close, policies that reshape the market, and operational "leaks" that quietly drain health systems. Aya Healthcare walks away from its planned $615 million acquisition of Cross Country Healthcare. Hologic heads toward privatization with Blackstone and TPG acquiring the company for up to $79 per share. Federal health agencies roll out a unified AI strategy coordinating efforts across CDC, CMS, and FDA. The FDA introduces TEMPO, a new pilot pathway for digital health technologies. New research shows acute care at home can improve outcomes for rural patients. Plus a practical look at how health systems stop losing money on referral leakage. HOST: RHONDA BROOKS 📍 Healthcare Staffing Deal Falls Apart — Teresa Vaughn Aya Healthcare is walking away from its planned $615 million acquisition of Cross Country Healthcare. Regulatory scrutiny made the path too uncertain. For health systems relying on external labor partners, the vendor landscape can shift fast—expect contract leverage conversations and margin protection pushes. 📍 Hologic Heads to Private Equity — Logan Stokes Blackstone and TPG are acquiring Hologic for up to $79 per share in a roughly $18.3 billion deal. When PE commits at this scale, expect shifts in commercial strategy, contracting posture, and product investment priorities in women's health diagnostics. 📍 Federal AI Strategy Alignment — Anika Shah Federal health agencies are moving toward a unified AI approach, coordinating efforts across CDC, CMS, and FDA. Less "every agency does its own thing," more shared principles for trust and oversight. Expect more attention to auditability, governance, and cybersecurity fundamentals. 📍 FDA's TEMPO Pilot — Nate Collier The FDA is introducing TEMPO to complement CMS's ACCESS model—a structured pathway for certain digital health technologies to be used under a defined framework while evidence is gathered. The due diligence burden moves closer to the health system. 📍 Rural Hospital-at-Home Outcomes — Jalen Cross New research suggests acute care at home can improve outcomes for rural patients. The make-or-break factor: reliable escalation. Rural hospital-at-home works when the "what if the patient turns" plan is crystal clear and resourced. 📍 Stopping Referral Leakage — Peter Betterworth Health systems continue to lose money and continuity when referrals slip out of network. The fix: tighten pathways, standardize workflows, reduce manual handoffs, and track outcomes. One metric to demand weekly: closed-loop rate on outbound referrals. 🎙️ Subscribe here or wherever you listen to podcasts, and if you like our show, please follow us on LinkedIn at https://www.linkedin.com/company/hit_show. HITshow is made possible by EY, Kimmchi and HLTH 2025 — the epicenter of healthcare innovation, where the future of care happens.

Today on HITshow: Today's theme is trust: trusting what we see, what we hear, what we sign, and increasingly, what the machines are generating. We've got a new warning about AI-powered scams aimed at hospitals, a watchdog report on ACA subsidy fraud risk, a lab divestiture that signals where systems are drawing boundaries, a major privacy settlement that's a wake-up call for digital governance, a rapid AI rollout inside a hospital, and a note on where federal AI expectations are heading. Plus a Bright Spot on AI's creative era in cancer care. HOST: RHONDA BROOKS 📍 AI-Powered Scams — Anika Shah The American Hospital Association is warning healthcare organizations about scams using AI-generated voices, video, and deepfakes to impersonate executives and vendors. Build verification into workflows—call-back rules, second-channel confirmation, approval limits that can't be overridden by urgency. 📍 ACA Subsidy Fraud Risk — Xavier Banks The Government Accountability Office is raising concerns about enhanced ACA subsidies creating fraud risk. For health systems, the downstream issue is coverage instability: when policy shifts, patients churn, confusion rises, and you feel it in access and uncompensated care pressure. 📍 Community Health Systems Lab Divestiture — Logan Stokes Community Health Systems is selling select ambulatory outreach lab assets to Labcorp for $194 million. Systems are deciding what they truly want to own versus what they'd rather partner on for scale and margin predictability. 📍 Kaiser Privacy Settlement — Jade Romero Kaiser Permanente agreed to a $46 million+ class-action settlement tied to online tracking and data sharing. Marketing tech can become a clinical brand risk fast. Health systems need clear governance over trackers and data flows across digital properties. 📍 Tampa General AI Voice Agents — Nate Collier Tampa General Hospital rolled out AI voice agents with Hyro in about three months for patient access workflows. The success metric isn't deployment—it's whether wait times fall, abandonment drops, and escalation is clean. 📍 HHS AI Strategy — Peter Betterworth HHS is rolling out an AI strategy signaling expectations on governance and responsible use. The practical takeaway: move fast, but be able to document oversight, monitor performance, and justify how AI is used in real workflows. Bright Spot: AI's Creative Era in cancer care. Platforms like 4D Path are extracting actionable insight from routine pathology images—predicting tumor behavior, estimating treatment response. The trend: routine pathology becomes a predictive sensor, not just a diagnostic snapshot. Jalen Cross reports. 🎙️ Subscribe here or wherever you listen to podcasts, and if you like our show, please follow us on LinkedIn at https://www.linkedin.com/company/hit_show. HITshow is made possible by EY, Kimmchi and HLTH 2025 — the epicenter of healthcare innovation, where the future of care happens.

Today on HITshow: It's a show about margins and maneuvering—hospital operators flexing, policy fights that hit the safety net, and big payers tightening the map. We'll check the pulse on interoperability because "data sharing" still isn't the same as "data you can actually use." HCA Healthcare's stock hits an all-time high. Hospitals sue to block a 340B rebate pilot that could hit cash flow. CMS finalizes the 2026 home health rule with payment decreases. UnitedHealth fully exits Latin America with the Banmedica sale. And a distressed-hospital settlement shows what stabilization really costs. HOST: RHONDA BROOKS 📍 HCA Stock Hits All-Time High — Logan Stokes Wall Street is grading hospital operations in real time. The signal: big, efficient operators can keep delivering despite labor pressure and a messy payer environment. For CFOs, it's a mirror—double down on capacity management, length-of-stay discipline, and clean charge capture. .📍 Hospitals Sue Over 340B Rebate Pilot — Anika Shah Hospitals and hospital groups are suing to block the federal 340B rebate pilot before it takes effect January 1, 2026. The core issue: rebate-style setup could create cash-flow risk and administrative churn compared to upfront discounts. 📍 CMS Home Health Payment Rule — Teresa Vaughn CMS finalized the 2026 home health rule with an estimated 1.3% aggregate payment decrease. For hospitals, the pressure point is discharge flow—if home health capacity tightens, length of stay and ED bottlenecks become real problems. 📍 UnitedHealth Exits Latin America — Jade Romero UnitedHealth agreed to sell Banmedica to private equity firm Patria for roughly $1 billion, completing its retreat from South America. Watch for sharper priorities and tighter contracting posture as the company refocuses. 📍 Interoperability Still Misses the Mark — Peter Betterworth Even as data sharing expands and networks grow, clinicians report poor usability of EHR data. The gap: connectivity without usability doesn't count if it doesn't show up at the point of care. 📍 Waterbury Hospital Tax Settlement — Jalen Cross A judge approved an $8.8 million tax settlement tied to Prospect Medical Holdings—a reminder that turnaround is expensive, and modernization costs follow distressed-asset deals long after the handshake. 🎙️ Subscribe here or wherever you listen to podcasts, and if you like our show, please follow us on LinkedIn at https://www.linkedin.com/company/hit_show. HITshow is made possible by EY, Kimmchi and HLTH 2025 — the epicenter of healthcare innovation, where the future of care happens.

Today on HITshow: Today we're looking at how regulators, risk, and AI are shaping the year ahead for hospitals and health plans. CMS gives hospitals a bit of breathing room in the new outpatient rule with a slower recoupment path on prior 340B clawbacks. UnityPoint Health teams up with Mayo Clinic on a big data and AI play. A Wisconsin health system puts AI to work in the revenue cycle. Abbott makes a $21 billion bet on at-home cancer screening with the Exact Sciences acquisition. We zoom out on the Medicare Advantage coding wars, and Optum Rx says prior auth can shrink from hours to seconds. HOST: RHONDA BROOKS 📍 CMS Outpatient Rule — Logan Stokes CMS finalized the 2026 outpatient and ASC rule, avoiding worst-case scenarios on 340B clawbacks—at least for now. The agency sticks with a slower recoupment path and punts any bigger adjustment to 2027. Drug acquisition cost surveys will keep pressure on hospital pharmacy margins, but 2026 feels like a small sigh of relief before the bigger fight comes due later. .📍 UnityPoint Joins Mayo Platform — Jade Romero UnityPoint Health becomes the first health system partner on Mayo Clinic's Platform_Insights, a shared data and analytics environment. The move signals that multi-system data collaboratives will be a bigger part of the landscape going into 2026, raising stakes for everyone still treating data strategy as an IT side project. .📍 AI in Revenue Cycle — Teresa Vaughn Sauk Prairie Healthcare in Wisconsin is using AI with Jorie AI to automate repetitive billing and coding work—flagging claims likely to be denied, pre-populating appeals, and surfacing payer patterns. A glimpse of where practical AI is actually taking hold: reducing the cost of getting paid, not replacing frontline staff. 📍 Abbott Buys Exact Sciences — Anika Shah Abbott is acquiring Exact Sciences (maker of Cologuard) in a $21 billion deal, betting big on at-home cancer screening. Health systems need a strategy for how at-home tests fit with their GI, oncology service lines, and population health targets as the front door to early detection moves from endoscopy centers to kitchen tables. 📍 Medicare Advantage Coding Wars — Peter Betterworth CMS's RADV audit rule was vacated in court, KFF analyses show heavy reliance on chart reviews that increase risk scores, and the American Academy of Family Physicians is pushing back on algorithm-driven downcoding. For hospitals in MA risk deals, plans are under revenue pressure and regulators are pushing back on coding and payment—leaving contracts caught in the middle. 📍 Prior Auth Gets Faster — Logan Stokes Optum Rx has deployed automated prior authorization workflows reducing average turnaround from 8.5 hours to roughly 30 seconds for low-risk requests. Systems like Cleveland Clinic are seeing many routine requests go straight through without manual review, setting a clear benchmark for the rest of the industry. 🎙️ Subscribe here or wherever you listen to podcasts, and if you like our show, please follow us on LinkedIn at https://www.linkedin.com/company/hit_show. HITshow is made possible by EY, Kimmchi and HLTH 2025 — the epicenter of healthcare innovation, where the future of care happens.