Today on HITshow:

Are we really set up to care for people after the visit? From urgent care to employer benefits to post-acute care, there are a lot of moving pieces. Experity teams up with Amazon Pharmacy to turn urgent care prescriptions into in-visit orders with home delivery. Nomi Health and Henry Ford Health try a different way to pay for care with direct employer contracting and zero-dollar deductibles. We're tracking highlights from seven health systems that are actually moving the needle on physician recruitment and retention. A new OIG report reveals nursing homes failed to report 43% of serious falls that sent residents to the hospital. And we close with a Bright Spot about workforce innovation—how one company is helping get clinicians to the bedside faster by shrinking the hiring and credentialing slog.

HOST: RHONDA BROOKS | CO-HOST: STEVE DAILY

???? Urgent Care & Convenience — Nate Collier

Experity is integrating Amazon Pharmacy right into the urgent care visit, so patients can order prescriptions before leaving the exam room with automatic discounts applied and same-day or 1-2 day delivery in most markets. The integration aims to reduce abandoned prescriptions, cut "where's my script?" calls, and meet consumer expectations for a retail-like experience.

???? Direct Employer Contracting — Logan Stokes

In Michigan, Henry Ford Health and Nomi Health are partnering to offer direct employer contracting for self-insured companies. Employees get zero-dollar deductibles and copays when using Henry Ford's network, no surprise bills, and clearer pricing. For employers, it's a way to offer richer benefits while working directly with a specific system instead of only through traditional carrier products.

???? Physician Recruitment & Retention — Teresa Vaughn

The AMA looked at seven health systems seeing real gains in physician recruitment and retention. Four themes kept surfacing: real pipelines with local residencies and medical schools; structured mentorship and leadership development; less administrative friction through scribes and EHR support; and well-being as design, not perks—rethinking schedules and coverage models so well-being is how the work itself is structured.

???? Nursing Home Reporting — Xavier Banks

A new Office of Inspector General report found nursing homes failed to report 43% of falls with major injury and hospitalization among Medicare residents. Under-reporting was more common in for-profit, chain, and larger facilities. Hospital and health-system leaders should use their own readmission and ED bounce-back data to judge post-acute partners instead of relying solely on star ratings.

Bright Spot:

Axuall is shrinking the credentialing gap so clinicians can get to the bedside faster by creating a portable, verified credential wallet. Verify education, licenses, certifications, and work history once, keep it current, and reuse that verified data across multiple employers and roles instead of starting from zero every time. Jalen Cross reports.

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HITshow is made possible by EY, Kimmchi and HLTH 2025 — the epicenter of healthcare innovation, where the future of care happens.

Today on HITshow:

Health systems are trying to stay safe, solvent, and scalable all at once. New Leapfrog safety grades show patient safety is increasingly a system-level sport—roughly 94% of A-graded hospitals are system-affiliated. Sarasota Memorial is breaking ground on a $507 million hospital in North Port, Florida, one of the fastest-growing cities in the region, with strategic shell space for future expansion. Luma Health acquires Tonic Health from R1, combining patient engagement and dynamic intake for Oracle Health customers. After the break, House Rx raises $55M to scale in-clinic specialty pharmacy as an alternative to traditional PBM models, Maven Clinic expands maternity and NICU support with wearables data integration, and we close with a Bright Spot on kindness and connection in healthcare.

HOST: RHONDA BROOKS

???? Patient Safety Systems — Logan Stokes

The Leapfrog Fall 2025 Hospital Safety Grades reveal that patient safety is now very much a system game—roughly 94% of A-graded hospitals are system-affiliated, and 95% of Straight-A hospitals have kept an A for multiple cycles. States like Utah, Virginia, New Jersey, Connecticut, and North Carolina are leading on the share of A hospitals. The systems winning on safety have centralized playbooks, standardized protocols, and treat harm events as system problems.

???? Growth Market Expansion — Teresa Vaughn

Sarasota Memorial is breaking ground on a $507 million full-service acute-care hospital in North Port, Florida, opening in 2028 with 100 inpatient beds and three floors of shell space designed to scale to 200+ beds. The capital-efficiency strategy lets the system follow population growth without overbuilding on day one.

???? Digital Front Door — Nate Collier

Luma Health acquired Tonic Health from R1, combining patient engagement and communication with dynamic intake forms, e-consents, and patient-reported outcomes surveys. The combined platform now supports 1,000+ health systems and reaches roughly 100 million patients, using AI to automate form routing, reminder timing, and response routing back into the record.

???? In-Clinic Specialty Pharmacy — Anika Shah

House Rx raised $55M, bringing total capital to roughly $100M, to scale an in-clinic specialty pharmacy model as an alternative to traditional PBM-centric pharmacies. The company is working with 80+ clinic sites and 1,000+ providers, processing $1.5B in specialty prescriptions annually, with AI-powered "Smart PA" automation handling prior authorization work.

???? Data-Rich Maternity Care — Jade Romero

Maven Clinic is integrating wearables data and launching intensive NICU support to flag risks earlier and support discharge readiness. The approach is showing shorter NICU stays, fewer complications, reduced C-section rates, and significant cost savings per birth for employers.

???? Bright Spot — Jalen Cross & Nick Adkins

Co-founder of Pink Socks Life Nick Adkins discusses the new PINKSOCKS book and what the movement of kindness and connection means inside hospitals and clinics today.

Today on HITshow:

After 40+ days of shutdown drama, Washington has flipped the lights back on under a short-term funding deal running through the end of January. Buried in that continuing resolution are very real, very immediate implications for hospitals and health systems—from telehealth and hospital-at-home to rural payment support and DSH cuts. We're tracking what the government funding deal actually does for providers in the short term, what it means to have Ochsner CEO Pete November heading to the AHA Board of Trustees right as these debates roll into the next round, and one quick example of infusion interoperability going live on the hospital floor.

HOST: RHONDA BROOKS

???? Government Funding Deal — Anika Shah

Congress passed a continuing resolution funding the government into late January. For providers, the short-term lifelines on telehealth, hospital-at-home, rural support, and DSH are back—but the real problem is the timing. Everything expires again in January, which means round two of negotiations starts immediately.

???? AHA Leadership — Teresa Vaughn

The American Hospital Association elected Pete November, president and CEO of Ochsner Health, to its Board of Trustees starting January 1. His experience navigating Gulf South realities—hurricanes, workforce shortages, tough payer mixes—brings operational grounding to national advocacy at a critical moment for telehealth, payment, and safety-net funding decisions.

???? Infusion Safety & Interoperability — Peter Betterworth

Duncan Regional Hospital in Oklahoma is now live with BD Alaris infusion interoperability connected to a MEDITECH EHR—one of the first real-world deployments in a community setting. Medication orders now flow directly from the EHR into smart pumps, and infusion data flows back into the record, reducing manual keying, dose errors, and improving visibility into what's actually running on each patient.

Bright Spot:

Fundamental XR and Elsevier are partnering on a mixed reality training program that takes anatomy and procedure training off flat screens into three-dimensional space, potentially changing how quickly clinicians get up to speed. CEO Richard Vincent discusses the partnership with Jalen Cross.

Today on HITshow:

Hospitals are walking a narrow financial line with thin margins, outpatient volumes doing most of the heavy lifting, and expense pressure from workforce and supplies showing no signs of letting up. Rural maternity care is in crisis—116 rural hospitals have closed or scheduled closure of L&D units since 2020. Indiana just approved a closely watched COPA merger between Union Hospital and HCA's Terre Haute Regional with price caps and conditions. We're tracking a privacy push for wearables data that currently falls outside HIPAA, and Congress is pushing back hard on AI-driven prior authorization in Medicare before the pilot even launches.

HOST: RHONDA BROOKS

???? Hospital Financial Snapshot — Logan Stokes

Kaufman Hall's National Hospital Flash Report shows September 2025 data pointing to continued thin margins, with outpatient volumes doing most of the heavy lifting. Expense pressure from workforce and supplies hasn't let up, so CFOs are threading the needle on Q4 and early 2026 capital plans. The playbook: protect outpatient growth, watch contract labor, and get more disciplined about service line contribution.

???? Rural Maternity Crisis — Jade Romero

A CHQPR analysis reveals 116 rural hospitals have closed or scheduled closure of labor & delivery units since the end of 2020. Today, only 41% of rural hospitals still deliver babies—and in a dozen states, it's less than one-third. The financing gap: 24/7 staffing costs for low-volume L&D aren't reliably covered by payers, forcing patients to travel 30-50+ minutes to reach maternity units. The report recommends standby capacity payments plus smaller delivery fees so hospitals aren't penalized for safer, lower C-section rates.

???? Indiana Hospital Merger — Teresa Vaughn

The Indiana Department of Health approved a Certificate of Public Advantage for Union Hospital in Terre Haute and HCA's Terre Haute Regional, creating a single system with price caps and conditions. Supporters say it preserves access and constrains prices; critics warn it reduces competition. Expect more states to dust off COPA frameworks as a path through consolidation fights.

???? Wearables Privacy Legislation — Anika Shah

Senator Bill Cassidy is advancing a bill to tighten protections for wearable and app-generated health data that currently falls outside HIPAA. The proposal requires clearer disclosures and stronger user controls as consumer-grade devices increasingly blend into clinical workflows. Hospitals need to map non-HIPAA data streams, prep standardized consent language, and prepare for stricter state-federal alignment.

???? Prior Authorization Pilot Under Fire — Jalen Johnson

House Democrats introduced the Seniors Deserve SMARTER Care Act to repeal the CMS Innovation Center's WISeR model before it launches. WISeR would add AI-backed prior authorization for some Medicare services in six states starting in January. Hospital revenue cycle and access teams should prepare for scenario A or B—repeal or rollout—because operational changes for ordering and documentation are non-trivial.

Leadership Moves:

Joint Commission names Arjun Srinivasan, MD (ex-CDC) Deputy CMO—signal: infection-prevention and quality emphasis. Clearway Health taps Brandon Newman, PharmD as CEO—specialty pharmacy plus health-system focus. AdventHealth Altamonte Springs (Florida) names David Goldman, DO CMO. Oracle Health now reports to co-CEO Mike Sicilia after September's leadership shift.

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HITshow is made possible by EY, Kimmchi and HLTH 2025 — the epicenter of healthcare innovation, where the future of care happens.

Today on HITshow:

We're starting where it matters most: health systems quietly doing the work, taking care of real patients, real clinicians, and real communities while the AI headlines yell in the background. Three organizations are expanding access, women's health, and workforce training in ways your board should be watching. We're tracking a clean patient portal rollout in California, a smart rehab joint venture in Texas, and after the break, Medicare's big move on AI heart scans, a patient engagement-plus-AI platform play, and what Clearway Health's new CEO signals for health system specialty pharmacy strategy.

HOST: RHONDA BROOKS

???? Healthcare Access & Workforce — Teresa Vaughn

Marshall Health Network's "Marco" mobile medical unit is rolling into rural West Virginia communities with full exam rooms wired for telehealth, bringing prevention and primary care instead of crisis ED visits. Marshfield Medical Center–Weston opened a dedicated Women's Health & Imaging Center with advanced breast imaging capabilities, signaling women's health as strategic. Dignity Health YRMC in Arizona launched a simulation and education center with high-fidelity training for nurses, techs, and physicians—real capital investment in safety and retention.

???? Patient Portal Strategy — Nate Collier

Salinas Valley Health rolled out a unified MyChart experience across hospital and clinics—one portal, one login, one place for labs, messages, bills, and scheduling. The health system is modeling what table stakes should look like in 2025 after too many organizations left patients juggling multiple sites and passwords.

.???? Rehab Joint Venture — Logan Stokes

Encompass Health and BSA Health System opened the 50-bed Rehab Hospital of Amarillo as a joint venture, expanding high-acuity rehab capacity without one party absorbing all capital, keeping complex cases in-network, and aligning both partners around outcomes and throughput.

???? Medicare AI Reimbursement — Jade Romero

Medicare moved to support reimbursement for AI-assisted coronary CT analysis, helping identify coronary artery disease risk and guide decisions on whether patients need invasive catheterization. The shift nudges AI from demo to billable clinical decision support while potentially reducing unnecessary procedures, but requires real-world outcomes data, not just vendor promises.

???? Patient Engagement Platform — Nate Collier

Get Well and Rhythmx AI are combining as GW Rhythmx, pitching a unified patient engagement layer with AI-driven care pathways, fewer disconnected outreach tools, and personalized nudges based on risk and behavior. Success depends on clean EHR integration and willingness to retire point solutions rather than stack more on top.

???? Specialty Pharmacy Strategy — Teresa Vaughn

Clearway Health named Brandon Newman as its new CEO—a PharmD with health system and specialty experience signaling a push to deepen hospital partnerships around specialty pharmacy ownership. Health systems need clarity on specialty pharmacy strategy, trusted partners, and visibility into which high-cost scripts are leaking out of their network.

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HITshow is made possible by EY, Kimmchi and HLTH 2025 — the epicenter of healthcare innovation, where the future of care happens.

Today on HITshow:

Major payer moves are reshaping virtual care economics while the federal government doubles down on AI-powered cost controls. We're tracking UnitedHealthcare slashing remote patient monitoring coverage, a controversial AI prior authorization pilot raising alarm bells on Capitol Hill, the $50 billion rural health positioning officially underway, pharma giants striking White House deals to cut GLP-one prices, Microsoft targeting medical superintelligence, and breakthrough funding for brain-computer interfaces that could transform neurology care.

HOST: RHONDA BROOKS

???? Virtual Care Economics — Xavier Banks

Starting January 1, 2026, UnitedHealthcare will only cover remote patient monitoring for heart failure and hypertensive disorders in pregnancy under Medicare Advantage, eliminating coverage for diabetes, hypertension, and COPD monitoring. Legal experts are calling this legally dubious and a dangerous precedent that blows a massive hole in virtual chronic care economics.

???? AI Prior Authorization Pilot — Anika Shah

CMS selected six tech companies to run an AI-powered prior authorization pilot called the WISeR model in six states starting January 2026 through 2031. The concerning part: vendors get paid based on how much they save Medicare—deny more services, earn more money. Congressional pushback is already brewing, with ongoing lawsuits against UnitedHealth and Humana for AI-driven denials in Medicare Advantage.

???? Rural Health Transformation — Teresa Vaughn

All 50 states submitted applications by the November 5 deadline for the federal Rural Health Transformation Program, designed to offset Medicaid funding cuts over five years. The positioning and partnerships phase begins now, with fairness concerns about whether politically strong health systems could crowd out fragile rural hospitals that need help most.

???? GLP-One Price Agreements — Jade Romero

Eli Lilly and Novo Nordisk struck new White House agreements to make GLP-one medications like Ozempic and Wegovy much more affordable through TrumpRx and future Medicare and Medicaid pricing guarantees. Hospitals must anticipate major shifts in bariatric surgery, endocrinology, and cardiometabolic service line volumes as access broadens at lower cost.

???? Medical Superintelligence — Nate Collier

Microsoft is forming a dedicated AI team led by Mustafa Suleyman to pursue medical superintelligence for diagnostics, with a line of sight to deployment in 2-3 years. This signals AI moving from hobby pilots to core infrastructure requiring partnerships, imaging workflow integration, and robust governance frameworks.

???? Brain-Computer Interfaces — Logan Stokes

Synchron raised $200 million in Series D funding for their brain-computer interface platform, preparing for pivotal trials and commercial launch of their Stentrode system for paralysis patients. The minimally invasive, catheter-based approach represents a longer-term signal about neuro-restorative care models and rehabilitation differentiation opportunities.

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HITshow is made possible by EY, Kimmchi and HLTH 2025 — the epicenter of healthcare innovation, where the future of care happens.

Today on HITshow:

AI, access, and affordability are under the federal spotlight today, while cyber risks and at-home care are pressuring providers to modernize. We're tracking Washington's aggressive push for AI adoption, a major obesity drug deal that could reshape hospital service lines, federal funding clarity on SNAP and Medicare claims, and the 2026 telehealth landscape. After the break, serious capital backing hospital-at-home care, AI expanding beyond radiology into rehabilitation, a cybersecurity warning about ecosystem vulnerabilities, and we'll close with a mental health collaboration that's making real community impact.

HOST: RHONDA BROOKS

???? Federal AI Push — Anika Shah

The HHS Chief Technology Officer is signaling an aggressive push for AI-driven modernization across healthcare, including a unified national provider directory, API-first infrastructure, and a potential app store ecosystem for health applications. Health systems need robust governance frameworks now to match the federal pace responsibly.

???? Obesity Drug Deal — Jade Romero

Eli Lilly and the federal government announced a framework to cap certain obesity medications for Medicare beneficiaries at $50 per month starting in 2026, with expanded Medicaid options and discounted self-pay pricing through Lilly Direct. The deal has massive implications for cardiovascular and metabolic service lines and long-term volume planning.

???? Federal Funding & SNAP — Teresa Vaughn

A federal judge ordered full November SNAP benefits funded while CMS resumed some claims processing operations. Food insecurity directly impacts ED utilization, readmissions, and pediatric/obstetric volumes, making payment clarity critical for cash-flow planning, especially for safety-net systems.

???? Medicare & Telehealth 2026 — Peter Betterworth

The latest AMA summary details the 2026 payment and telehealth landscape, including sustained support for key virtual care flexibilities and physician payment adjustments. Virtual care is now permanent infrastructure—health systems should budget for telehealth as core capability, not temporary accommodation.

???? Hospital-at-Home Investment — Logan Stokes

SteelSky Ventures led an investment in myLaurel, targeting acute and transitional care at home with virtual clinical oversight. Serious capital is backing hospital-at-home as core infrastructure, signaling that home-based acute care will become standard delivery model.

???? AI in Rehabilitation — Nate Collier

New data highlights growing use of AI and automation in rehabilitation and therapy operations, offering mid-market hospitals an opportunity to use automation in post-acute and outpatient settings to relieve workforce pressure. Rehabilitation settings offer good testing grounds for AI tools before deploying in higher-stakes clinical environments.

Hospital leaders are being graded on digital maturity, and the bar keeps rising. We're tracking who's setting the standard—from CHIME's Level Ten designations to the first paperless hospital in the UAE achieving full digital maturity. Then we dive into precision medicine at scale, a $100M bet on AI-native virtual care, transplant breakthroughs, and smart hospital case studies from Malaysia and Vietnam that show what digital transformation actually looks like in practice.

HOST: RHONDA BROOKS

???? Digital Health Leadership — Nate Collier

Eighteen health systems earned CHIME's Level Ten designation for 2025, demonstrating measurable outcomes in AI deployment, virtual care, cybersecurity, and patient engagement. Level Ten organizations aren't running pilots—they're deploying AI and virtual care across entire health systems with proven ROI.

???? Global Innovation — Peter Betterworth

Fakeeh University Hospital in Dubai became the first healthcare organization in the UAE to achieve HIMSS EMRAM Stage Seven—full digital maturity. The hospital is completely paperless with real-time data across all departments and AI-driven decision support in clinical workflows.

???? Precision Medicine — Teresa Vaughn

Princess Margaret Cancer Centre is launching the Our-Genes study with Helix, screening up to 100,000 patients for hereditary cancer and familial hypercholesterolemia. The population-scale genomics program represents a shift from reactive to proactive cancer care.

???? AI Virtual Care Investment — Logan Stokes

Tala Health raised $100M to build an AI-native virtual care platform designed as the front door for entire health systems, using AI to handle triage, scheduling, and initial assessments before connecting patients with human providers.

???? Transplant Innovation — Jade Romero

CareDx launched AI-informed kidney transplant tools including the HistoMap Kidney assay and updated molecular surveillance data, helping transplant teams predict rejection risk more accurately and personalize immunosuppression protocols.

???? Smart Hospital Case Studies — Nate Collier

Regency Specialist Hospital in Malaysia cut critical lab response time by 16% and reduced manual documentation by two-thirds with their integrated smart ward system. Sun Group's new hospital in Phú Quốc, Vietnam is launching as a born-digital facility built on Amalga, with AI-ready integrated workflows designed from day one.

???? Pediatric Care — Xavier Banks

Hackensack Meridian Health and the Valerie Fund announced a $3.5 million expansion of pediatric pain and palliative care services, increasing workforce capacity and access to specialized pediatric comfort care across the network.

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Today on HITshow:

Major operational shifts and innovation funding dominate the day. Today's HITshow Daily covers Banner Health's Colorado restructuring with 351 layoffs, Allina Health strike in Twin Cities, and the longest federal shutdown gap in recent history. Then in our second half, Smarter Technologies aquires Pieces Technologies, Carrum Health's employer behavioral health bundles, Hippocratic AI's $126M raise, and Sheba Medical Center's personalized RNA therapy breakthrough.

HOST: RHONDA BROOKS

???? Hospital Restructuring — Teresa Vaughn

Banner Health completes northern Colorado restructuring with 351 layoffs, ED and urgent care closures. Competing systems should expect immediate patient volume changes and transfer pattern shifts as Banner consolidates footprint. Remaining providers face capacity planning challenges and emergency service volume surges.

???? Labor Action — Teresa Vaughn

Allina Health providers strike over staffing levels, wages, and benefits affecting multiple Twin Cities facilities. Strike creates care delays and patient diversions, watched as template for winter labor negotiations. Industry-wide workforce pressures (staffing shortages, wage demands, benefit costs) make resolution important for contract negotiations nationwide.

???? Federal Shutdown

Government shutdown continues marking longest gap in recent history. Today is deadline for states to apply for $50B CMS Rural Health Fund, potentially reshaping rural hospital support later this year.

???? Health Tech M&A — Logan Stokes

Smarter Technologies acquired Pieces Technologies in deal signaling health tech consolidation. Company's AI-powered documentation and revenue cycle automation tools reduce clinician burden while improving coding accuracy. Market rewards proven operational ROI over future efficiency promises.

???? Employer Benefits — Anika Shah

Carrum Health expands substance use disorder bundles for employer-sponsored plans with fixed-price packages covering detox through long-term recovery. Shift toward bundled payments in behavioral health shows employers taking direct action on costs. Health systems must decide whether to compete or partner on employer-direct models.

???? AI Funding — Jade Romero

Hippocratic AI raises $126M to scale patient-facing AI tools handling routine interactions, appointment scheduling, and basic health guidance. Massive funding shows investor confidence in patient-facing AI moving beyond back-office automation to first point of contact.

???? Medical Breakthrough — Nate Collier

Sheba Medical Center develops personalized RNA-based therapy for 8-year-old with rare GNAO1 gene mutation. Lab results show 75% reduction in defective gene expression. Marks rare instance of customized genetic drug created for individual patient. Sheba plans to expand RNA drug development program to help other children in 2026.

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HITshow is made possible by EY, Kimmchi and HLTH 2025 — the epicenter of healthcare innovation, where the future of care happens,

Today on HITshow:

Modest wins and mounting pressures for hospital operations. Today's HITshow Daily covers CMS's 2026 physician fee schedule increases, surging CEO turnover worrying boards, and MetroHealth's credit downgrade. Then in our second half, Medicaid work requirements create planning urgency, another 92K-patient email breach, and CMS pledges payment accuracy crackdown.

HOST: RHONDA BROOKS

???? Physician Payment — Teresa Vaughn

CMS finalizes 2026 Physician Fee Schedule with 3.77% increase for most services, 3.26% for primary care visits. Modest gains barely pace inflation, requiring hospitals to maintain creative recruitment strategies beyond compensation adjustments.

???? Leadership Turnover — Logan Stokes

Hospital CEO exits jump 12% year-over-year (January-September), creating strategy gaps and hampering long-term initiatives. Boards need proactive succession planning and deeper internal leadership pipelines beyond reactive C-suite searches.

???? Credit Rating — Logan Stokes

Moody's downgrades MetroHealth to Baa3 with negative outlook, citing liquidity and operational pressures. Signal that many hospitals struggle despite outpatient growth. CFOs should monitor debt service coverage and days cash on hand closely.

???? Medicaid Policy — Peter Betterworth

Managed care plans urge CMS for clearer Medicaid work requirements guidance, requesting details on eligibility verification, appeals, and exemptions. Hospitals should scenario-plan now for eligibility churn, ED volume increases, and expanded charity care exposure.

???? Cybersecurity — Anika Shah

Oglethorpe mental health network reports email compromise affecting 92,000 patients. Attack highlights persistent email security vulnerabilities. Multi-factor authentication, least-privilege access, and vendor mailbox monitoring remain critical basics often treated as afterthoughts.

???? Payment Integrity — Nate Collier

CMS highlights efforts to cut wasteful spending and improve chronic care management with vague operational details. Agency recalls 3,000 federal staff during shutdown to maintain Medicare and ACA enrollment. Hospitals should expect heightened payment accuracy scrutiny alongside potential enrollment processing delays.

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