Podcasts about CMS

This week I Talk About The 2026 WordPress Website Redesign [powerpress]

Per info: iusondemand.com/siti o sitieassistenza.itRichieste di Sviluppo WebAssicurazione: Consigli per sito semplice e professionale, ricerca sviluppatori o piattaforme.E-commerce (10-15 prodotti): Soluzioni custom o Shopify, SEO, mobile-friendly, gestione ordini.Mock test educativi: Login, dashboard studenti, pagamenti, admin panel, 50+ test per materia.Sito personale per proposta: Aiuto per creazione sito esteticamente gradevole senza competenze tecniche.Offerte di ServiziSviluppo web professionale: Siti business, e-commerce, portfolio, SEO-friendly, da $100.Design & sviluppo SaaS: Esperienza in fintech, banking, SaaS, supporto multilingue (AR/EN/FR).Studio di design custom: Siti su misura per startup, healthcare, consulenti, focus su UX e conversioni.WordPress specialist: Siti business, e-commerce (WooCommerce), landing page, SEO, WhatsApp integration.Manutenzione gestita: Sviluppo + hosting + aggiornamenti mensili, senza costi iniziali alti.Idee e DomandeWebsite inesistenti: Idee per siti che risolvono problemi reali (es. negoziazione abbonamenti, pianificazione viaggi).Feature mancanti: Funzionalità utili non ancora standard (es. miglioramenti per shopping, travel, forum).Automazione SEO: Uso di MERN Stack + n8n per ricerca keywords, content planning, social media.Rebuild vs miglioramento: Quando conviene rifare un sito da zero invece di aggiornarlo.Problemi TecniciLentezza caricamento: Ottimizzazione asset, hosting (Netlify), parallax vs performance.Gestione clienti: Difficoltà a trovare clienti per freelance, strategie di outreach.Vendite e CollaborazioniSito in vendita: "Jeeplanner" (SaaS per esami, 26k visite, 5k utenti in 12 giorni).Feedback gratuiti: Analisi siti esistenti (design, velocità, SEO, UX) per small business.Progetti urgenti: Sviluppo lead page, funnel, automazioni (GHL, Systemeio, WordPress).Strumenti e PiattaformeCostruttori vs custom: Confronto tra Wix, Squarespace, Shopify e soluzioni codificate.Migrazioni: Passaggio da piattaforme chiuse a soluzioni custom più flessibili.CMS: Aggiunta di CMS a siti statici per gestione contenuti senza sviluppatori.AltroTendenze design: Siti "dinamici" con animazioni vs usabilità (es. burger che si assemblano).Risorse per sviluppatori: Idee per portfolio, progetti open-source, nicchie di mercato.Localizzazione: Siti bilingual (AR/EN/FR) o RTL per mercati specifici. Note:Raggruppamento: Categorie basate su intenti (richieste, offerte, idee, problemi tecnici). Chiave-valore: Sintesi diretta delle informazioni, evitando ridondanze. Esclusioni: Omesse discussioni generiche (es. "grazie") e dettagli ripetuti (es. "DM per info").Per info: iusondemand.com/siti o sitieassistenza.it

Chuck and Chris have a potpourri of topics including CMS proposed changes for 2027 (not good for hand surgery), cases, and two listener submitted topics: board preparation and caring for patients with ligamentous laxity/ Ehlers Danlos.Chuck references Christian Pean's Substack called 'Techy Surgeon' as a great resource for value based care and all things tech including AI insights.See www.practicelink.com/theupperhand for more information from our partner on job search and career opportunities.The Upper Hand Podcast is sponsored by Checkpoint Surgical, a provider of innovative solutions for peripheral serve surgery. To learn more, visit https://checkpointsurgical.com/.As always, thanks to @iampetermartin for the amazing introduction and concluding music.For additional links, the catalog.  Please see https://www.ortho.wustl.edu/content/Podcast-Listings/8280/The-Upper-Hand-Podcast.aspx

The Friday Five for July 31, 2026: RegEd CE Courses Available on IntegrityCONNECT Fresh Take on Social Platforms: ThingsBook Medicare GLP-1 Bridge Reminder CMS Files Appeal to Clover Decision CMS & HHS File Expedited Appeal to Colombus I   Get Connected:

D-SNPs are offered by private insurance companies (such as UnitedHealthcare, Humana, Aetna, and Centene) that contract with both Medicare and your state's Medicaid program. According to CMS data, D-SNP enrollment has grown by more than 150% over the past five years, making it the fastest-growing segment within Medicare Advantage

Thursday, July 30, 2026 Today, Senator Cornyn cancelled a meeting with Todd Blanche Wednesday morning because Blanche didn't have the Slush Fund rescission in hand; Dr. Fauci hears Republican conspiracy theories in a hearing on Capitol Hill and refused to answer questions; Senate Republicans confirmed Jay Clayton as the Director of National Intelligence; a judge has ordered the release of a key witness in an ICE shooting; a judge kills a Republican ballot measure that would gut unions declaring it unconstitutional; former DOJ Pardon Attorney Liz Oyer says she's been getting death threats since her testimony about Todd Blanche; Comey files his motion to dismiss for vindictive and selective prosecution in the seashells case; videos show ICE agents using racial slurs to refer to Latinos; plus Allison delivers your Good News. Thank You, MINT MOBILE Make the switch! MINTMOBILE.com/DAILYBEANS The Trump Epstein Memorial Bookmobile The Daily Beans is proud to partner with Miles Taylor and our friends at DEFIANCE.org For a limited time, members of the Daily Beans community can receive a FREE 3-month full membership to DEFIANCE.org and gain access to one of the fastest-growing pro-democracy movements in America. Join here: https://www.defiance.org/beans Join The Daily Beans and give a gift today to ensure The Trevor Project can continue its crucial work in the face of continued challenges. Donate to The Trevor Project - Daily Beans Podcast The Latest Breakdown→ DOJ Must Hand Over Internal Emails About NYT Subpoenas StoriesComey asks judge to ‘86' seashells case, alleges he was surveilled at Trump's direction | MS NOW Former DOJ lawyer spotlights death threats after Blanche testimony | MS NOW ICE agents used racial slurs to refer to Latinos, videos and texts appear to show | ABC News Judge orders immigration officials to release key witness in Texas ICE shooting | NBC News Judge: GOP ballot measure aimed at teachers union unconstitutionally guts police, fire unions too | AZ MirrorGood Trouble Comment on proposed Medicaid requirements: https://www.regulations.gov/commenton/CMS-2026-2047-0002Medicaid Work Requirements: Learn More and Take Action! - Autistic Self Advocacy Network Check your voter registration and deadlines → Voter Registration Deadlines - Vote.org →Blue Wave California- secure.actblue.com/donate/msw-bwc →Help save Texas from Ken Paxton! →Urge Democrats to Oppose and Stop Trump's Crypto Corruption | Indivisible Guide →Defiance.org/beans →Stand With Minnesota →iceout.org Good News Ohiopride.org dana-goldbergs-southwest-funnyfest Oct 9 -Email Dana@DanaGoldberg.com for sponsorship informationTickets for Dana Goldberg: Outrageous - Sep 23 - Den Theater - Chicago  →Share your Good News & Good Trouble - The Daily Beans   →Beans Talk audio -beans-talk.simplecast.com →Email Dana LGBTQ Owned eating establishments in your area - hello@mswmedia.com Subject: “Dana's Project” Subscribe to the MSW YouTube Channel - MSW Media - YouTube Our Donation Links The Trevor Project - trevorproject.org/beans Blue Wave California - https://secure.actblue.com/donate/msw-bwc Donate to Public Citizen - https://citizen.org/beans/ Donate to It Gets Better / The Daily Beans Fundraiser Pathways to Citizenship - https://crm.bloomerang.co/HostedDonation Join Dana and The Daily Beans in support of Human Rights Campaign http://onecau.se/_ekes71National Security Counselors - Donate, ActBlue.com/donate/msw-bwc, WhistleblowerAid.org/beans Dr. Allison Gill - The Breakdown | Allison Gill, Mueller, She Wrote @muellershewrote.com - Bluesky, MSW & The Daily Beans Podcast @muellershewrote - Instagram, MSW Media - YouTube →Federal workers - email AG - fedoath@pm.me Dana Goldberg - Dana is on Patreon! At Dana's Dugout, @dgcomedy - Bluesky, @dgcomedy - IG, Dana Goldberg - Facebook,  DanaGoldberg.com More from MSW Media - Shows - MSW Media, Cleanup On Aisle 45 pod, The Breakdown | Allison Gill Reminder - you can see the pod pics if you become a Patron. The good news pics are at the bottom of the show notes of each Patreon episode! That's just one of the perks of subscribing! patreon.com/muellershewrote Listener Survey:http://survey.podtrac.com/start-survey.aspx?pubid=BffJOlI7qQcF&ver=shortFollow the Podcast on Apple:https://apple.co/3XNx7ckWant to support the show and get it ad-free and early?https://patreon.com/thedailybeanshttps://dailybeans.supercast.com/https://apple.co/3UKzKt0 Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Dr. Oz's proposed 2027 CMS rules dropped, and I've been waiting all week to get into them. The push toward value-based care and Accountable Care Organizations continues, but the headline for anyone in private practice is the multiple procedure cut: if you bill an E&M code and a procedure on the same day, Medicare now pays 100% for the more expensive service and only 50% for the other, regardless of modifiers, regardless of whether they're for two totally separate problems. That is a direct assault on independent practices, and every commercial insurer will follow Medicare's lead. There's one small win. Mandating real-time electronic prior authorization across Medicare Advantage, Medicaid, and ACA marketplace plans One head-scratcher...Medicaid work requirements of 80 hours per month starting January 2027, which I suspect will land squarely on physicians' documentation burden. Also, everyone say it with me: physician compensation is 10% of U.S. healthcare expenditure. After the break, medical malpractice for ophthalmologists. A colleague just came out of a settlement, and it got me looking at the top drivers of ophthalmology lawsuits: cataract surgery complications, missed or delayed retinal detachments, glaucoma management failures, and post-op infections. The uncomfortable truth: the only way to avoid surgical complications is to not operate, and sometimes even perfect communication and documentation don't stop a lawsuit. But they help. Takeaways: The proposed 2027 CMS rules would pay only 50% for a second same-day service when an E&M visit is billed alongside a procedure, regardless of modifier, effectively a major reimbursement cut that will hit independent private practices hardest and be adopted by commercial insurers Physician compensation accounts for just 10% of total U.S. healthcare expenditure, yet Medicare physician reimbursement is cut nearly every year while hospital and insurer reimbursement continues to rise The 2027 rules push physicians further toward Accountable Care Organizations and value-based care, favoring large health systems and insurers over independent physician-owned practices, with one bright spot: mandatory real-time electronic prior authorization across Medicare Advantage, Medicaid, and ACA plans The top ophthalmology malpractice risks are cataract surgery complications (posterior capsule tears, retained lens fragments, unfulfilled patient expectations), missed or delayed retinal detachment diagnosis, glaucoma management failures (insufficient IOP monitoring), and post-op infections Per OMIC, the three biggest drivers of ophthalmology claims are documentation deficiencies, communication gaps, and technical performance, about 60% of claims involve surgical execution errors, and diligent documentation, brutally honest informed consent, and strong physician-patient rapport are the biggest mitigators To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live  We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! knockknockhi@human-content.com Can't get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! –⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ http://www.patreon.com/glaucomflecken⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠  Also, be sure to check out the newsletter: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://glaucomflecken.com/glauc-to-me/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ If you are interested in buying a book from one of our guests, check them all out here: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.amazon.com/shop/dr.glaucomflecken⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ If you want more information on models I use: Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact.  For more information go to Anatomy Warehouse DOT com. Link: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://anatomywarehouse.com/?aff=14⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Plus for 15% off use code: Glaucomflecken15 -- A friendly reminder from the G's and Tarsus: If you want to learn more about Demodex Blepharitis, making an appointment with your eye doctor for an eyelid exam can help you know for sure. Visit ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠http://www.EyelidCheck.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ for more information.  Produced by⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Human Content⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

Everyone has heard about fraud, waste, and abuse, but building an effective fraud prevention program requires more than identifying problems after they occur. In this week's episode of Feds At The Edge, government and industry experts share practical strategies for helping federal agencies stop improper payments before funds go out the door.  Kim Brandt of CMS underscores the scale of the challenge, noting the agency processes roughly $1 million in claims every day. Justin Marisco from the Bureau of the Fiscal Service share how tapping into shared resources, such as Treasury's Do Not Pay list, the Social Security Death Index, and DHS databases can help validate individuals before funds are ever disbursed. Diligent's Jason Venner highlights why preventing improper payments is infinitely better than the traditional "pay and chase" approach and how the era of Big Data introduced agencies to analyzing massive datasets, while today's AI makes it possible to analyze entire datasets, rather than samples, to identify fraud risks.  Tune in on your favorite podcast platform to learn how modern technology and cross-agency data sharing are shifting federal fraud prevention from reactive damage control to proactive defense.  

The drug price negotiation provisions in the Inflation Reduction Act were designed to continue evolving with each passing year. As CMS prepares for 2028 and 2029, the agency has put out new draft guidance codifying and, in some cases, modifying the fine print of the controversial law. They've also recently issued additional draft guidance on how they'll handle the imminent introduction of Part B drugs into the programme. Hogan Lovells partner Alice Valder Curran returned to join pharmaphorum editor-in-chief Jonah Comstock to elucidate some of the finer points of this latest communication from CMS – and to urge the industry to take advantage of the public comment periods associated with it. Curran and Comstock discuss small, but impactful, changes in CMS's policies around deemed biologics, vaccines, and the special provisions that protect small biotechs. And Curran gives a rundown of what's in – as well as what's not in – the new MFP effectuation guidance, laying out how the differences in how Part D and Part B drugs are paid for leave some big question marks hanging over the programme. Tune in for an easy-to-understand deep dive into some complicated subject matter, and for a more comprehensive rundown don't forget to check out Hogan Lovells' policy briefs on the new draft rules and the MFP effectuation guidance.

AOTI CEO Dr. Mike Griffiths joined Steve Darling from Proactive to discuss a major regulatory milestone after the Centers for Medicare & Medicaid Services (CMS) issued a proposed Local Coverage Determination (LCD) supporting the use of topical oxygen therapy for diabetic foot ulcers that have failed to heal after four weeks of optimized care. Griffiths said that following a 45-day public comment period, CMS is expected to finalize the LCD within the next year. Once approved, the policy would establish Medicare coverage and reimbursement criteria for AOTI's TWO2® intermittent topical wound oxygen therapy, significantly expanding patient access across the United States. Management believes the final LCD will be transformative, providing access to approximately 69 million Medicare beneficiaries, including a population with high rates of diabetes and diabetic foot ulcers. The company also expects the decision to accelerate reimbursement across Medicaid, commercial insurers, and managed care organizations, substantially reducing reimbursement risk. AOTI currently holds an estimated 75% share of the topical oxygen therapy market, driven by its TWO2® platform, which the company says is the only intermittent topical oxygen wound therapy available. Multiple peer-reviewed clinical studies have demonstrated improved long-term healing outcomes compared with continuous topical oxygen therapy and other advanced wound care treatments. The company believes it is well positioned to capitalize on the expanded opportunity, with an existing commercial infrastructure spanning 26 states and reaching approximately 86% of the U.S. population. Management estimates its current serviceable market represents a $400 million revenue opportunity, while broader CMS-driven reimbursement could expand the addressable market to approximately $26 billion over the longer term. Griffiths said the proposed CMS decision represents a significant milestone that could drive wider adoption of TWO2® therapy while improving access for Medicare patients suffering from chronic diabetic foot ulcers. #proactiveinvestors #aoti #aim #topicalwoundoxygen #two2 #woundcare #Healthcare #MedTech #OxygenTherapy #DiabeticFootUlcers #WoundCare #MedicalTechnology #HealthcareInnovation #TopicalOxygenTherapy #MedTech #Healthcare

CMS-0057 and HTI-4 are reshaping prior authorization from both sides of the workflow: payer requirements and certified EHR readiness. This Office Hours session will break down what these regulations mean for providers, how they may change day-to-day prior authorization operations, and what questions organizations should be asking their vendors now. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen/

Choosing the right CMS isn't about picking the most popular platform - it's about asking the right questions. In this episode, Matt and Mike break down the framework they use before recommending a content management system for a new website. From understanding who will manage the site to evaluating budget, customization, maintenance, and long-term goals, they explain how different project requirements naturally lead to different solutions. Along the way, they discuss where platforms like WordPress, Webflow, Shopify, and headless CMSs tend to shine, common mistakes developers make when choosing a CMS, and why there isn't a single "best" option for every website. Whether you're building a client website, launching your own business, or simply trying to decide which CMS to learn next, this episode will help you make more informed decisions. Show Notes: https://www.htmlallthethings.com/podcast/how-to-choose-the-right-cms-for-your-website Use our Scrimba affiliate link (https://scrimba.com/?via=htmlallthethings) for a 20% discount!! Full details in show notes.

For this Managed Care Cast episode, The American Journal of Managed Care® (AJMC®) spoke with Anuraag R. Kansal, PhD, who leads health economics research at GRAIL, about his study, “State Medicaid Budgetary Implications of New Cancers," published in the July 2026 issue; it examined how new cancer diagnoses affected state Medicaid budgets. He conducted the study with Amanda C. Chen, PhD, of the USC Mann School of Pharmacy and Pharmaceutical Sciences, and David C. Grabowski, PhD, of Harvard Medical School. Kansal explained to AJMC that despite Medicaid's younger population, cancer remains the third-largest source of program spending. Most existing research had focused on commercial and Medicare populations rather than Medicaid specifically. Consequently, using de-identified CMS claims data, he and his team identified new cancer diagnoses, defined as no prior cancer evidence in the preceding 6 months, and compared spending, hospitalizations, and emergency department use between metastatic and non-metastatic cases. Kansal highlighted the core finding, which was that metastatic diagnoses were associated with significantly higher spending than non-metastatic diagnoses across most cancer types. Notably, health care utilization patterns were consistent between fee-for-service and capitated Medicaid states, suggesting that cost drivers stemmed from the disease itself, particularly the shift to systemic therapies once cancer spread, rather than from program administration models. Kansal pointed to the 4 cancer screenings recommended by the US Preventive Services Task Force, namely lung, breast, colorectal, and cervical, as opportunities to reduce late-stage diagnoses and their associated costs while noting that cancers without established screening protocols presented a distinct policy challenge. On balancing innovative treatment access with cost sustainability, he emphasized that Medicaid's state-by-state administration means that no single policy solution applied universally. Still, Kansal emphasized that earlier detection could offer states greater financial flexibility to support innovative therapies for patients with true clinical need. “Intervening earlier is one of the opportunities we might have to really make a difference,” he concluded.

Let's talk about work-related joint injuries and replacements. Sebastian Negrusa, Ph.D., joins Judson and Alan to share the Workers' Compensation Research Institute's (WCRI) new report, “Recent Trends in Joint Replacement Among Workers' Compensation Claims.”  While back injuries usually come to mind for workplace injuries, joint injuries, and subsequent replacements, are becoming more common. Are you up to speed on this trend? Shoulder, hip, and knee replacements are important parts of making workers whole and getting them back to their jobs and their lives.  How do you prove a workplace-related joint injury when someone has worked at the same job for decades? What's work-related, what's just a function of natural aging? What if the workplace only aggravated a naturally occurring degeneration? It's complicated, but all workers deserve to be treated fairly, and all workplaces should be safe. If you have thoughts on Workers' Comp law or an idea for a topic or guest you'd like to hear, contact us at JPierce@ppnlaw.com or APierce@ppnlaw.com. Mentioned in This Episode: “Recent Trends in Joint Replacement Among Workers' Compensation Claims,” WCRI, By Dongchun Wang, Vennela Thumula, Randall Lea, M.D. “CJR-X (Comprehensive Care for Joint Replacement Expanded) Model,” CMS.gov

This week I Dive Into The NovaMira Plugin [powerpress]

CMS just proposed rules that could decide who gets paid for AI in healthcare, and that's a bigger deal than another “better algorithm” story. Dr. Sanjay Juneja and Dr. Douglas Flora talk with Jordan Johnson (radiation oncology, healthcare finance, compliance and law) about what's actually in the proposal and what happens once it lands. Topics: when does AI actually count as a billable clinical service. Why getting paid also means getting watched more closely. Hospitals leaning toward integrated platforms over one-off point solutions. What to do now, before the rule locks in. Still just a proposal, not law yet, so we should say that somewhere.

In this episode of the ASC Podcast with John Goehle, we run through the ASC news that matters — a sweeping CMS enrollment proposal, the anesthesia squeeze, and more — plus a few things we've been seeing out in the field. Then John sits down with two veteran pharmacy consultants for a practical look at medication safety in the surgery center, from patient screening to drug diversion to malignant-hyperthermia readiness. This episode is sponsored by Surgical Information Systems, RFX Solutions, Medserve and  Ambulatory Healthcare Strategies. Notes and Resources from this Episode: CMS seeks new powers to deny or revoke enrollment for “problematic” Medicare providers — Becker's Hospital Review: beckershospitalreview.com CY2027 Home Health PPS proposed rule (CMS-1844-P) — Medicare enrollment provisions (retroactive revocation, location & affiliation rules, 855B private-equity/REIT disclosure); comments due Aug 31, 2026 — CMS fact sheet: cms.gov Elevance's 10% out-of-network penalty — 3 payer moves disrupting ASCs, physicians — Becker's ASC: beckersasc.com Why anesthesia stipends could be inevitable amid outdated ASC models — Becker's ASC: beckersasc.com Feds: Iowa plastic surgeon defrauded Medicare through false billings — Iowa Capital Dispatch: iowacapitaldispatch.com CMS request for information on episode-based payment for ASCs (ASCA opposed) — ASC News: ascnews.com Companion episode: Episode 283 — Pharmacy Management and Recalls . INFORMATION ABOUT THE ASC PODCAST WITH JOHN GOEHLE ASC Central is our one-stop site for ASC bootcamps, on-demand conferences, and membership programs: conferences.asc-central.com Patron Membership — our base membership for podcast listeners: regular group Zoom sessions, a full resource database to help run your ASC, and several free conferences (Conditions for Coverage, Medical Director, Credentialing, and Finance & Accounting). Become a Patron Member Premium Access Program — includes Patron membership PLUS unlimited Bootcamps (Administrator and Director of Nursing, normally $1,899.99 each), our Credentialing, Conditions for Coverage, Medical Director and Infection Control programs, weekly drop-in Zoom sessions, and up to five hours of private consulting. Sign up for Premium Access Compare both programs: conferences.asc-central.com/membership-programs-2   Important Resources for ASCs: Conditions for Coverage: https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3&idno=42#se42.3.416_150 Infection Control Survey Tool (Used by Surveyors for Infection Control) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107_exhibit_351.pdf Updated Guidance for Ambulatory Surgical Centers - Appendix L of the State Operations Manual (SOM) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_l_ambulatory.pdf https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/updated-guidance-ambulatory-surgical-centers-appendix-l-state-operations-manual-som Policy & Memos to States and Regions CMS Quality Safety & Oversight memoranda, guidance, clarifications and instructions to State Survey Agencies and CMS Regional Offices. https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Policy-and-Memos-to-States-and-Regions Other Resources from the ASC Podcast with John Goehle: Visit the ASC Podcast with John Goehle Website Books by John Goehle Get a copy of John's most popular book - The Survey Guide - A Guide to the CMS Conditions for Coverage & Interpretive Guidelines for Ambulatory Surgery Centers

In this episode, Jordan Johnson, MSHA, Bridge Oncology, ABA Health Law Oncology Advocacy, discusses the major CMS policy shifts reshaping oncology, the growing role of AI governance, and why healthcare leaders must think beyond reimbursement rates to prepare for the future of care delivery. He also shares advice for entrepreneurs on building systems thinking across finance, clinical care, compliance, and technology.

In this episode, Jakob Emerson, Associate News Director, Becker's Healthcare, breaks down the rising costs tied to the No Surprises Act arbitration process, evolving CMS and congressional actions, and what these policy changes could mean for payers, providers, employers, and healthcare pricing.

Hay un debate que lleva tiempo flotando en toda la comunidad del desarrollo web, y en la de WordPress en particular: ¿tiene sentido seguir apostando por una plataforma tradicional cuando una IA es capaz de generar páginas enteras, con código personalizado e interfaces, en cuestión de segundos? Es una sensación perfectamente comprensible. Cuando ves lo que la inteligencia artificial puede hacer al vuelo, es natural preguntarse qué espacio le queda a WordPress. Pero, bajo mi punto de vista, el valor de WordPress no ha desaparecido: simplemente ha cambiado de lugar. En lugar de competir contra la IA, WordPress se está consolidando como el motor de ejecución y la base de datos sobre la que esa misma inteligencia artificial opera. Propiedad y soberanía de los datos La gran diferencia entre las soluciones no-code basadas en IA (o las plataformas SaaS empaquetadas que te alquilan su infraestructura) y WordPress es el control total. Con WordPress, la base de datos, los usuarios, los pedidos y los contenidos son 100% tuyos o de tu cliente. No hay locking. Ese concepto que antes se aplicaba a ciertos temas cerrados hoy lo trasladamos a la IA: no dependes de cambios drásticos en los precios de las APIs de empresas como ChatGPT o Claude, ni del cierre repentino de un servicio. La soberanía digital es un activo cada vez más crítico. Hay empresas que despidieron a mucha gente pensando que la IA lo haría todo, y muchas han terminado quebrando por eso. La IA necesita un backend confiable La inteligencia artificial es extraordinaria generando código y diseñando interfaces al vuelo, pero necesita una estructura sólida detrás para funcionar en el mundo real: la lógica de negocio, la persistencia, la gestión de usuarios y roles, las pasarelas de pago, las suscripciones y los flujos complejos. Un ejemplo real: la web de vozcaster.com la desarrollé entera con IA. Registré el dominio, la alojé en Cloudflare y le pedí a la IA que me creara un HTML estático muy mono, con colores bonitos y una tabla de precios dinámica con su selector anual. Todo rápido y precioso. Pero cuando llega el momento de la verdad —los usuarios, la seguridad, la gestión de suscripciones—, esa tabla enlaza a potencia.pro, donde todo lo gestiona WordPress mediante un plugin. La IA te resuelve la parte estática; la lógica de negocio y la persistencia en condiciones te las da una plataforma madura. Infraestructura lista para usar En lugar de construir desde cero un sistema de autenticación, una base de datos y un panel de administración para cada proyecto generado por IA, WordPress te ofrece toda esa arquitectura probada en batalla de forma nativa. Además, WordPress ya no es el simple generador de plantillas HTML o el gestor de blogs de antaño. Hoy cuenta con: APIs robustas gracias a su REST API y a soluciones como GraphQL. Un funcionamiento excelente como CMS headless, donde la IA alimenta los datos mientras la capa de presentación se gestiona externamente. Integración nativa con agentes de IA gracias al protocolo MCP, que permite conectar un sitio WordPress con modelos de inteligencia artificial para generar contenido, automatizar soporte o procesar datos de forma mucho más sencilla, precisamente por la madurez de la plataforma. Los flecos y los casos de borde Crear un prototipo visual con IA lleva minutos. Pero resolver los flecos finales —el cumplimiento del RGPD, las integraciones con ERP locales, la facturación compleja, los flujos de trabajo específicos— sigue requiriendo un sistema maduro. El repositorio de plugins de WordPress aporta esa flexibilidad para cubrir ese 1% de necesidades complejas que una herramienta automática suele pasar por alto. Es curioso: la IA arranca a toda velocidad, pero al llegar a cierto punto se frena, porque necesita hacer cosas que WordPress ya resuelve de forma simple por estar tan implementado. En una carrera de fondo, WordPress se come a la IA. Pasa igual que con los constructores visuales: Elementor es maravilloso y rapidísimo para la primera versión de una web presencial de cliente, pero cuando quieres implementar cosas más complejas a veces te toca irte a temas como GeneratePress. Son esos casos de borde que WordPress tiene más que superados. El rol del profesional no desaparece: se transforma Es como el agricultor que pasa del arado al tractor: sabe lo mismo, pero lo hace más rápido. El trabajo pesado ya no es picar CSS ni maquetar desde cero. El valor del profesional con experiencia en WordPress ha migrado hacia: La arquitectura de la información y la estrategia. El criterio técnico y la seguridad: saber evaluar si el código generado por la IA es seguro, optimizado y mantenible. La capacidad de conectar el ecosistema de WordPress con flujos de IA para aportar valor real, no solo un sitio estático. Otro ejemplo propio: he desarrollado un bot de Telegram que se conecta con WordPress para publicar capítulos de podcast (de hecho, este capítulo lo estoy publicando con ese sistema porque no tenía ganas de editar). Si yo no tuviera el criterio adquirido a lo largo de más de 15 años, no podría usar la IA de forma eficiente. Sé dónde está la identificación de usuario, cómo se gestiona una suscripción, dónde están los datos, y conozco a fondo plugins como PowerPress. Ese conocimiento profundo es el que me permite establecer la arquitectura y la estrategia adecuadas. No cualquiera puede desarrollar así. En resumen La IA ha democratizado la creación de webs sencillas: cualquiera puede pedirle una página que le diga lo guapo y lo alto que es, y quedará preciosa. Pero, precisamente por eso, las arquitecturas abiertas y extensibles como WordPress se han vuelto aún más valiosas como núcleo de proyectos digitales complejos: gestión de bases de datos, arquitectura, estrategia y capa de negocio. Cuando mezclamos ambos mundos —lo que ya conocemos de WordPress con la inteligencia artificial— aparecen cosas maravillosas. Así que no, la IA no nos va a quitar el trabajo: nos facilita avanzar de forma eficiente. Pero hay que usarla con criterio, y ese criterio es justamente lo que los desarrolladores del mundo WordPress hemos acumulado durante años. La IA sin criterio no sirve de nada. 🤖 El contenido de este post ha sido generado automáticamente con inteligencia artificial a partir de la transcripción del audio. Puede contener errores o imprecisiones. 🎙️ Publicado con VozCaster, el bot de Telegram que convierte tu voz en un episodio de podcast publicado. Pruébalo gratis. ¿Te ha gustado el episodio? Si quieres que sigamos experimentando con bots, protocolos y empanadillas polacas, no olvides suscribirte y dejarnos tu valoración. ¡Nos escuchamos en el próximo capítulo! Métodos de contacto Enviadnos vuestras preguntas al grupo de Telegram. Apuntaos al canal de Youtube del podcast https://www.youtube.com/potenciapro Si nos queréis decir algo directamente lo podéis hacer a @potenciapro , @materron, @mpc, o en el grupo de Telegram Y si eres muy muy muy fan del podcast Echa un vistazo a cómo nos puedes ayudar en https://potencia.pro/se-prosperoso/

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Drs. Michael Mack and Tom Nguyen about the proposed US Centers for Medicare & Medicaid Services changes to how cardiologists and cardiac surgeons interact during transcatheter aortic valve replacement (TAVR) procedures. Chapters 00:00 Intro 01:21 TAVR Heart Team 04:08 JANS 1+2, JACC TAVR vs SAVR 12:19 JANS 3, TAVR Short-Term Outcomes 14:06 JANS 4, SAVR Life Expectancy 17:44 JANS 5, WSJ TAVR Article 19:19 Video 1, Direct AA Cannulation Technique 21:23 Video 2, Endoscopic Redo TVR After CABG 24:25 Video 3, Gaudiani Cox-Maze III 27:33 Dr. Mack & Nguyen, TAVR Heart Team 51:12 Closing Dr. Mack explained the current heart team system, established in 2011 through collaboration with the US Food and Drug Administration (FDA) and CMS, which has been highly successful in ensuring safe and effective TAVR implementation. He argues that the proposed CMS changes could potentially dismantle this collaborative approach by allowing asynchronous patient evaluation and procedures to be performed by single operators without surgeon involvement. Dr. Nguyen provided insights from a system leader's perspective, noting that while the proposed changes raise significant concerns about patient care and data collection, some cardiologists argue that surgeons are already not actively involved in many programs, making the single operator model the norm in practice. Both expressed concern that without mandatory surgeon participation and TAVR registry involvement, smaller programs may adopt practices that lack proper accountability and could lead to inappropriate patient selection and outcomes, potentially creating more contentious debates between TAVR and surgical approaches. Joel also highlights recent JANS articles including a propensity-matched analysis comparing 10-year outcomes after SAPIEN 3 TAVR in the PARTNER 2 SAPIEN 3 Intermediate-risk Registry with surgery in the PARTNER 2A trial; a single-center retrospective study evaluated 61 patients who underwent cardiac surgery after prior TAVR during a 10-year period at a high-volume academic center; whether surgical aortic valve replacement (SAVR) should remain the first choice for aortic stenosis in patients with a life expectancy beyond five years; and an article examining the dramatic rise in the popularity of transcatheter aortic valves, early valve failure, and the impact it has on patients' lives. In addition, Joel explores axillary cannulation as a primary cannulation strategy, beating-heart endoscopic tricuspid valve replacement for high-risk redo patients after CABG and device-related tricuspid valve injury, and a Cox-Maze III operation combined with a left internal mammary artery (LIMA) to left anterior descending artery (LAD), as well as an ascending aortic replacement and aortic valve resuspension. Before closing, Joel highlights upcoming events in CT surgery. JANS Items Mentioned 10-Year Outcomes of SAPIEN 3 Transcatheter Aortic Valve Replacement or Surgery in Intermediate-Risk Patients A Decade of Cardiac Surgery After Transcatheter Aortic Valve Replacement: Short-Term Clinical Outcomes at a High-Volume Center Great Debate: Surgical Aortic Valve Replacement Is First Choice for Aortic Stenosis in Patients With a Life Expectancy Beyond 5 Years A Breakthrough Heart Procedure Comes With Risky Tradeoffs CTSNet Content Mentioned Direct Axillary Artery Cannulation With the Open Seldinger Technique Endoscopic Redo Tricuspid Valve Replacement After CABG The Cox-Maze III Procedure Combined With Valve-Sparing Aortic Surgery and CABG Other Items Mentioned Centers for Medicare & Medicaid Services Database—TAVR Career Center CTSNet Events   Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

We take a deep into the latest MU Law Poll, which finds Francesca Hong and Mandela Barnes distancing themselves from the field. What does the MU poll clearly tell us and what remains unclear and fluid? We look at other Internal candidate polls, which show Francesca Hong with at 35% and 39%, a 20+ point lead over Barnes and David Crowley, who has reentered the race. We also discuss how the headlines about the MU Law Poll misrepresent its findings, and ignore some of its most interesting results. We clarify how the $2 billion Wisconsin tax subsidy for data centers was bipartisan . passing in the 2023-25 state budget with support of GOP Legislature and a Democratic Governor who chose not to line-item vetoed it. We close with a review of Trump Regime impacts in Wisconsin and other States; Milwaukee could be first test case of ICE's refusal to follow mask ordinance; Trump's CMS suspends $1 billion in Medicaid funding to Minnesota and California; and Trump's DOT declares war on “DEI bike lanes” and biker and pedestrian safety. Yes this is for real!

Wednesday, July 22, 2026 Today, RFK Jr pauses a billion dollars in Medicaid to California and Minnesota; Rep. Jamie Raskin is seeking documents related to Jeffrey Epstein's foreign contacts; IRS Chief Frank Bisignano spied on colleagues when he worked at JPMorgan; Trump and the OMB are violating the Impoundment Control Act by ignoring Congressional appropriations; an appeals court has overturned the release order of Mohsen Mahdawi; an appeals court has denied Peter Navarro's bid to overturn his contempt of Congress conviction; and a federal judge says Trump has to hand over his financials in discovery in the BBC libel case; plus Allison delivers your Good News. Thank You, Fast Growing Trees Get 20% off your first purchase  FastGrowingTrees.com/dailybeans The Daily Beans is proud to partner with Miles Taylor and our friends at DEFIANCE.org For a limited time, members of the Daily Beans community can receive a FREE 3-month full membership to DEFIANCE.org and gain access to one of the fastest-growing pro-democracy movements in America. Join here: https://www.defiance.org/beans Join The Daily Beans and give a gift today to ensure The Trevor Project can continue its crucial work in the face of continued challenges. Donate to The Trevor Project - Daily Beans Podcast The Latest Breakdown→ Epstein Survivor Recounts Meeting With Todd Blanche StoriesRFK Jr pauses $1bn Medicaid funding to California and Minnesota Raskin seeks documents into Jeffrey Epstein's foreign contacts - Live Updates - POLITICO IRS Chief Frank Bisignano Spied on Colleagues When He Worked at JPMorgan - WSJ Congress rejected some of Trump's proposed budget cuts. OMB is making them anyway. US appeals court raises prospect of re-arrest of pro-Palestinian advocate Mahdawi | Reuters Judge says Trump must hand over financial records to BBC - POLITICOGood Trouble Check your voter registration status →Vote.orgVoter Registration Deadlines - Vote.org →Help save Texas from Ken Paxton! →Urge Democrats to Oppose and Stop Trump's Crypto Corruption | Indivisible Guide →Defiance.org/beans →Show up for our Libraries - action.ala.org →Stand With Minnesota →ICE List  →iceout.org Good NewsGrassRoots Garden | Food for Lane County – Eugene, Oregon INDIVISIBLE KANSAS CITY sfcva.org dana-goldbergs-southwest-funnyfest Oct 9 -Email Dana@DanaGoldberg.com for sponsorship informationTickets for Dana Goldberg: Outrageous - Sep 23 - Den Theater - Chicago  →Share your Good News & Good Trouble - The Daily Beans →Beans Talk audio -beans-talk.simplecast.com →Email Dana LGBTQ Owned eating establishments in your area - hello@mswmedia.com Subject: “Dana's Project” Subscribe to the MSW YouTube Channel - MSW Media - YouTube Our Donation Links The Trevor Project - trevorproject.org/beans Blue Wave California - https://secure.actblue.com/donate/msw-bwc Donate to Public Citizen - https://citizen.org/beans/ Donate to It Gets Better / The Daily Beans Fundraiser Pathways to Citizenship link to MATCH Allison's Donationhttps://crm.bloomerang.co/HostedDonation?ApiKey=pub_86ff5236-dd26-11ec-b5ee-066e3d38bc77&WidgetId=6388736 Join Dana and The Daily Beans in support of Human Rights Campaign http://onecau.se/_ekes71National Security Counselors - Donate, ActBlue.com/donate/msw-bwc, WhistleblowerAid.org/beans Dr. Allison Gill - The Breakdown | Allison Gill, Mueller, She Wrote @muellershewrote.com - Bluesky, MSW & The Daily Beans Podcast @muellershewrote - Instagram, MSW Media - YouTube →Federal workers - email AG - fedoath@pm.me Dana Goldberg - Dana is on Patreon! At Dana's Dugout, @dgcomedy - Bluesky, @dgcomedy - IG, Dana Goldberg - Facebook,  DanaGoldberg.com More from MSW Media - Shows - MSW Media, Cleanup On Aisle 45 pod, The Breakdown | Allison Gill Reminder - you can see the pod pics if you become a Patron. The good news pics are at the bottom of the show notes of each Patreon episode! That's just one of the perks of subscribing! patreon.com/muellershewrote Listener Survey:http://survey.podtrac.com/start-survey.aspx?pubid=BffJOlI7qQcF&ver=shortFollow the Podcast on Apple:https://apple.co/3XNx7ckWant to support the show and get it ad-free and early?https://patreon.com/thedailybeanshttps://dailybeans.supercast.com/https://apple.co/3UKzKt0 Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

In this episode, host Ross Frey, Senior Product Manager and resident MTM/CMR strategist, sits down with Cindy Henry, Director of Payer Products at Outcomes, to unpack one of the biggest changes hitting Medicare Advantage plans: CMS's intent to return the CMR completion rate to the Star Ratings program beginning in measure year 2027. Ross and Cindy explore how the industry reacted to the latest CMS Advance Notice, why the CMR measure's return matters, and how MTM strategy has quietly shifted during its two‑year placement on the display page. Together, they outline the pressures plans are feeling—from shrinking margins to rising expectations around clinical quality—and the renewed focus on the value of medication therapy management, total cost of care, and local pharmacy engagement. A key topic throughout the episode is the impact of CMS's expanded MTM eligibility criteria, which significantly increases denominators for 2025 and beyond. Cindy explains how this shift forces payers to rethink scale, budget, ROI, and operational models, while Ross shares Outcomes' cut‑point predictions and how performance is likely to redistribute once the measure becomes active again. The conversation also highlights Outcomes' strategy to support both health plans and community pharmacies as they prepare for 2027. Ross describes work underway to reduce documentation burden, streamline workflows, leverage new technology, and allow pharmacists to practice at the top of their license—ultimately helping MTM delivery scale without sacrificing quality. By the end of the episode, the message is clear: Plans that begin modeling, staffing, vendor alignment, and workflow modernization now will be best positioned when Star Ratings recalibrate in 2029. Listeners are encouraged to explore Outcomes' latest prediction models and analysis at outcomes.com

The period immediately after hospital discharge is a critical yet often overlooked phase in stroke recovery, marked by both heightened vulnerability and opportunities for rapid brain repair. This episode explores the concept of transitional stroke care, emphasizing early specialist follow up, coordinated multidisciplinary support, and targeted interventions to improve outcomes and reduce complications. In this episode, Katie Grouse, MD, FAAN, speaks with Mona N. Bahouth, MD, PhD, FAAN, author of the article "Transitional Stroke Care and the Road to Recovery" in the Continuum® June 2026 Cerebrovascular Disease issue. Dr. Grouse is a Continuum® Audio interviewer and a clinical assistant professor at the University of California, San Francisco in San Francisco, California. Dr. Bahouth is the medical director of the Brain Rescue Unit and an associate professor of neurology at Johns Hopkins School of Medicine in Baltimore, Maryland. Additional Resources Read the article: Transitional Stroke Care and the Road to Recovery Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Guest: @MonaBahouth Full episode transcript available here Dr Grouse: A lot of attention has been paid to what happens within hours to days of a stroke, but are we missing an equally crucial time in our patient's recovery after their discharge? Today, I have the opportunity to interview Dr. Mona Bahouth about the latest issue of Continuum on cerebrovascular disease.  Dr Jones: This is Dr. Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast.  Dr Grouse: This is Dr. Katie Grouse. Today, I'm interviewing Dr. Mona Bahouth about her article on transitional stroke care and the road to recovery. This article appears in the June 2026 Continuum issue on cerebrovascular disease. Welcome to the podcast, and please introduce yourself to our audience.  Dr Bahouth: Thank you for having me. I'm Mona Bahouth. I'm a stroke neurologist in Baltimore, Maryland, and I'm the medical director of our brain rescue unit at the Johns Hopkins Hospital. Great to be with you.  Dr Grouse: Thank you so much. This was a very interesting article. I have to confess going into it, I really didn't know a lot about transitional stroke care and the growing sort of recognition of its importance for stroke recovery and improved outcomes. Can you tell me what the key message from this article is that you really hope that readers will take away after reading it and hopefully integrate into their own patient practices?  Dr Bahouth: Yeah. I would say if there's one overarching message, it is that stroke care has come so far over the last couple of decades. We do so much wonderful life-saving work in the first couple of hours and days after stroke, but we haven't really paid as much attention to what happens once a patient leaves the hospital with this devastating acute disease. And I would just like to say that this article allows us to shine a light on providing a little bit more of a system of care, a more structured system of care that could benefit the patient for the long term, then that will benefit a large population of patients who otherwise may have complications that could cause disability longer in life.  Dr Grouse: Now, Mona, could you tell us in a nutshell, what is transitional stroke care, and why are we needing to focus more of our attention on this to improve patient recovery?  Dr Bahouth: Yeah. Over the last few years, we've really done a wonderful job of reducing the time that a patient spends in a hospital after stroke care. But in parallel, we have not really changed anything about what we do in the outpatient setting. So, a patient tells us that they come to the hospital with this acute and very scary and disabling disease. They feel that they're the center of the universe at our stroke centers, where we're hustling around them in groups and in interprofessional teams. But then on the day of discharge, they feel that they leave the hospital, and in some of our focus groups, that they kind of go home to a, a dark bedroom where they have to process all of this sort of on their own. It's quite a transition for both patients and their care partners. And here we've been very systematic about how we structure our care in the hospital for stroke patients, but once they leave the hospital, it's been a sort of free-for-all, or the Wild West, as some of my colleagues say. So transitional stroke care is really a way to extend the care that we deliver in the stroke unit to the patient's home or to their next phase of care. We know that stroke patients have 11 handoffs from beginning to end, in average, that they experience through the course of their acute stroke. And so, what we're really trying to do is extend the, the stroke unit to the patient's home or to their next phase of care so that they feel a bit more extension of that specialty care that they were receiving in the hospital. So, it's really a structure, a system.  Dr Grouse: Now, it seems that when we're thinking about the transitional care period, that it really hinges on this idea of sort of the sensitive period of stroke recovery. What is that, and why is that so important, and why do we really need to focus on that specific time?  Dr Bahouth: There are really two reasons that this is a critical period for patients. One is that we know from work in animal models as well as other sort of human early studies that the brain really has its optimal period of efficient brain repair in the first few weeks after stroke, meaning that it's recovering after this injury and figuring out how to reroute some really important brain functions. I would say it's also a critical period because the time period after stroke is a period that all the comorbid conditions that sort of conspired to cause a stroke are sometimes destabilized. And we know that sort of just putting people back on standard regimens for their hypertension, their diabetes, their heart failure doesn't always equate to sort of long-term improved outcomes at a time that the brain itself is going through changes. So, for example, we know that blood flow is critical to the brain. That's what all the hustle is about in the hyperacute period. And for the next couple of weeks after a stroke, autoregulation remains disrupted, so typical treatments of hypertension could have negative consequences for a subpopulation of patients. This management of hypertension needs to continue for a couple of days and weeks after stroke, and therefore, if a patient is discharged from the hospital, really requires a bit more specialty input. We also know that as the brain is trying to repair during the sensitive period, this high period of efficiency, we really want to inject high-intensity, high-quality activities that really improve their recovery. But in our current system in the United States, our transition to the period of rehabilitation is really quite clunky and disrupted and doesn't often happen in a seamless way. So, a true transitional stroke care program really attempts to manage the stroke itself. The comorbid conditions that conspire to cause the stroke, and the expedition of, of rehabilitation that could really jumpstart the recovery period in a more meaningful way.  Dr Grouse: Now, you mentioned hypertension as being sort of a critical factor that can affect the patients during this transitional period or this sensitive period. What are some other factors that can really play a huge part in their long-term outcomes in this really sensitive time?  Dr Bahouth: In our transitional stroke program, in our interprofessional group, we often talk about all of the changes that a patient is required to make at the time of stroke. Typically, they stay in the hospital several days. The patient and their care partner will receive a bolus of instructions about what their new healthier life should look like, and then they're sort of sent off to sort of self-manage without really accepting that that wasn't the perfect time to teach these things. So really, it's all about sort of lifestyle improvement. How do we get into a system of medication adherence when medications are a central portion of a patient's care? It is about managing the cognitive changes that happen after stroke, whether we acknowledge them in the hospital as a main deficit or something that people realize once they get back into the groove of their usual life, and the emotional consequences of stroke for both the patient and their care partner, who are both adjusting to this very scary moment that resulted in a brain injury. So, I think that the things that are focused on are both medical in terms of, you know, what are we doing with the diabetes? Is our glucose at a target range? Have we started wearing our sleep apnea paraphernalia? Are we managing our smoking cessation as much as we should? How have we done with our low-fat diet? Are we taking our medications as prescribed, or was there some cognitive blip that caused a mistake? But also sort of the emotional support that sometimes paralyze patients into sort of saying they cannot handle this transition into a new healthier way of brain recovery.  Dr Grouse: Yes, and it sounds like when patients sort of hit that wall, they almost just give up, right? There's just so many things they have to manage. They're emotionally trying to cope, and then they may eventually get to their neurologist at some point for a follow-up, and not much has happened.  Dr Bahouth: That's a really well-put statement. Like I mentioned earlier, we had several focus groups to say, "How's our stroke center doing? How is our comprehensive stroke center doing?" And we realized that we were very comprehensive while the patient was with us, but then the experience of the patient going home was really opposite of receiving comprehensive care. You know, the patient in the hospital said they felt well-supported, surrounded, quite busy all the time, but then they did go home, and this sort of set in that they've had a stroke. And many patients told us, "I just laid in bed because I couldn't quite kind of get through the thought that this has happened to me." And so, in our prior state of our comprehensive stroke system where patients weren't seen for a couple of months after their discharge, patients would tell me, "Well, I'm fine now.  But those first couple of months, I sure wasn't. You know, I was laying in bed. I was crying. I wasn't taking my medicines. I had a lot of despair and fear." Care partners would say, "I wasn't sleeping myself. I was watching to see if another stroke was gonna happen every minute." So, there are a lot of elements that are going on in those first two weeks that really require a specialist to say, "This is normal. This requires more attention," and to really help people get through a lot of the changes that come with stroke and brain injury.  Dr Grouse: Now, your article gave a really great, I think, example, where you had a juxtaposition of a hypothetical patient with a stroke and two very different post-discharge courses, one where they really kind of fell into that vacuum, that post-discharge vacuum, where they didn't get support and had some very disappointing outcomes versus a patient who did have a transitional care program with a lot of support post-discharge, and a lot of obstacles were overcome and problems solved such that the patient could do a lot better. And I encourage our listeners to take a look at it. If you could design and run it, how would your ideal transitional post-stroke program be structured? Like, how would you design it so that it would optimally support these patients?  Dr Bahouth: Yeah, you know, we, um, tangle with this every day in our current transitional stroke program that we call the JSTEP program. We've had several chapters of what we think is ideal for a patient, and thank you for sort of acknowledging that, like, the way those cases were written were really to underscore that we can have a lot of influence for patients. And while they were sort of hypothetical juxtapositions of one another, these are things we literally see every single day for our stroke patients. And people say, "Oh, if only we had done this, we would've caught that, and we would've prevented such-and-so." Some of the indicators of success have been we've really reduced our readmission rates to the hospital. We have decreased our length of stay because the confidence people feel to go home because they're well supported. So there have been indicators of success. But if I could take our program even next level, I would probably include a few other things. So currently, some of the strengths of the program are that a stroke specialist sees a patient within days of their discharge from the hospital, a time where some of those questions are sort of raising for the patient. Maybe a complication is starting to pop up that we can address before it, uh, gets out of hand and requires a readmission. We can tackle some of the fears that patients are having to say, "I wonder if this is normal or not. I better just go to the hospital." So, some of that early touch point by a true stroke specialist is really critical. And that visit only happens because the seed is planted in the hospital, so there really has to be some initiation of the program at the time the patient is in the hospital to say, "This is what you can expect when you leave here. You have someone who's walking this with you. They're a stroke specialist. They're gonna know how to help you navigate." The second part of our program that is a success is our rapid connection to specialties. So, we know that stroke patients are gonna need connection to rehabilitation specialists, physiatrists, the therapists. We know they're gonna need connection to cardiology when atrial fibrillation or heart failure or something is really at an extreme.We know endocrinology might be a part of the patient's story going forward. And so, I think the second success of our program is really alliance with key stakeholders in a stroke patient's life and quick access to having the patient be connected to what it is they need in the moment that we realize that there is a situation at home. The third thing that I think has been really a success of our program is this interprofessional education that we schedule patients for at the time of their discharge, just as any other important healthcare visit. During this interprofessional education session, the patients get to meet dietician, pharmacist, nurse, therapist, where key discussions about healthy behaviors, avoidance of complications after stroke really happen in a group session where there can be a lot of interaction. You know, currently our education happens in a time where the brain is injured, the patient is not sleeping well in the hospital. We have a lot of stress and fear. It's not the perfect time for anyone to receive such important education. So, I think the third really most important thing has been this formalized interprofessional education to really bolster the education that started at the hospital. If I were to really take our program next level, and every day we're considering it, I really think we haven't done a couple of key things. One is we have not really found a way for the care partner to be supported, that the care partner is usually the brave one sitting there with a tight lip and nodding and very, you know, concerned about what's happening and taking close notes. But we really haven't done well to just manage the care partner's needs sort of independently of the patient themselves, sort of help them with the experience of going through this. I think that could benefit both the care partner and the patient by sort of bolstering their sort of emotional consequences of this. And they are really our key partner in the patient's success in the outpatient setting, getting the patient motivated, helping them get to appointments, helping them to adhere with medications. So, I think if we can focus a bit more on the care partner, that might really bolster the long-term effect for patients. And I think finally, behavior change is very complex. Sometimes we're taking a group of patients who may have never exercised and said, "You know, we really... You need to walk several minutes a day. You need to increase your aerobic capacity. We need you to stop smoking." And these are not behavior changes that can just happen with sort of a one-time visit. So, I think we really need to incorporate a lot more of exercise therapy and concepts of people who can sort of coach along the continuum for some of these behavior changes so that we can really promote wellness and a return to health. And I think one final thing that could be additive from a transitional stroke program is really a better way to truly measure recovery for stroke patients, some of those in between the line measures that we're not really getting by a three-month modified Rankin score. I think a transitional stroke care model would really allow us to both insert research and potential other therapies along this time period, but also measure the success of those in a more granular way.  Dr Grouse: Thank you so much for that, and also it was really helpful to get a good overview of, like, what the transitional care program really means, right? Like, what is the structure? What is happening with the patient? So, I think all of that's really helpful. But I can't help but think, listening to all of that, that sounds like while certainly in an ideal state, and I don't think anyone can argue with how helpful that sounds, is it always something that's practical? Can we implement things like this, especially where access is limited, resources are dwindling as far as what patients can get and what evaluations patients can get? Do you think that this is something that can actually be implemented in programs throughout the country? And what are strategies we can consider to try to improve getting some of these resources for our patients?  Dr Bahouth: I think this is such a critical topic. I think that we have, in the medical system, tried to force our healthcare practices into old models of care instead of sort of adopting new ones. And so, I think that, you know, while everyone says, "Wow, that sounds like a very resource-rich program," I would have to stop and push back and say, well, a very resource-rich situation is when a stroke patient, sometimes fifteen to twenty percent of the time, are readmitted to the hospital at a time where hospital beds are at a premium. Maybe we need to turn those dollars of savings of sort of these readmissions and extra length of stay into dollars that we put into sort of this transitional period where we help promote success. So, I think it really becomes more of a value proposition when you talk about it. But that said, of course, we have to make sure that we're a high-value, high-productivity system. So, our current transitional care program uses a telemedicine structure. We know that stroke patients cannot drive in most states after their stroke. We know that their care partners are trying to return to work and normalize. It is very difficult for patients with paralysis, cognitive changes to come back and forth to multiple appointments. In the past, we have tried to make this transitional care program an in-hospital program. I think using the technologies that we have available for telemedicine are critical, especially for this population who have barriers to getting to their appointments. So, I think with a very low resource investment, a transitional care program can be created once you really develop the skills of the, the stroke team to really reach beyond the hospital with the tools that we already have in the hospital and just extend that to the next chapter. It is an investment, most certainly, but I think it's one well worth the investment for the patient's success, their quality of life, as well as some of the value metrics that we judge our hospitals by.  Dr Grouse: Are some of the transitional care codes that CMS has put out in recent years helpful to get some reimbursement for these types of visits?  Dr Bahouth: Absolutely. So, I think that's been a really wonderful policy change that has happened, recognizing the importance of these transitional care models. There are billing codes that allow you to have higher billing than a usual neurology appointment when a patient is within a certain window, meeting certain criteria for their eligibility for such a visit.There are codes that have now been developed and are being more and more utilized to have visits with care partners and realize that the care partner is an important member of the equation of this patient's success. So, there are definitely codes that can be used. I think we're very good in healthcare of delivering a lot of free care, but that's not the nature of the beast these days. We have to really be very aware of our dollars and cents, and so utilizing some of these important codes that I hope only continue to expand to recognize the importance of the transitional period for patients.  Dr Grouse: Now, Mona, I wanted to ask, was there anything that you wish you could have included in this article that didn't make it in?  Dr Bahouth: You know, obviously, um, word limitations are always challenging. I think that the article, I think, does a good job going sort of from beginning to end. I think a deeper section, certainly we have commented on the sort of sociodemographic challenges of a program like this that also relies on a technology like telemedicine in many cases. But there are so many nuances to that conversation that I think that section could have definitely gone on for a much longer period of time to talk about some of the strategies, the strategic ways that we work hard to make sure that these type of transitional care programs are accessible to all, especially the vulnerable who may have challenges with accessing technology. But I will say it is possible. You know, we are in a urban city. We see a lot of patients with various insurance status and access to technologies, and we've had a very high show rate in our post-hospital transitional program, so it can be done with a thought and, uh, care to those vulnerable populations who may need more attention across the transition.  Dr Grouse: Well, I really appreciate all the work you've done in this area, and it sounds like it's an area that will continue to grow as we learn more and hopefully improve. And I really appreciate you taking the time out of your day to talk with us about your article.  Dr Bahouth: Well, thank you for having me, and it's a topic that's near and dear to us, so thanks again for highlighting its importance.  Dr Grouse: Again, today I've been interviewing Dr. Mona Bahouth about her article on transitional stroke care and the road to recovery. This article appears in the June 2026 Continuum issue on cerebrovascular disease. Be sure to check out Continuum Audio episodes from this and other issues, and thank you to our listeners for joining today.  Dr Monteith: This is Dr. Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

You’re listening to American Ground Radio with Stephen Parr and Louis R. Avallone. This is the full show for July 21, 2026. We open with a 29-year-old Democratic Socialist named Milat Kiros who just defeated a 15-term congresswoman in Colorado's Democratic primary — with the backing of the DSA and Bernie Sanders — and who has told voters exactly what she believes: that America is exploitative and extractive, that ICE is a terror apparatus, that Israel's military aid should end, and that the existing world order needs a reckoning. We note that she arrived in America because her father won the U.S. diversity visa lottery — a program that saved her family from an Ethiopian civil war and famine — and that she earned degrees at Washington College and Notre Dame Law School on American soil. We are not speculating about her worldview. She has put it in writing. And she is one general election away from Congress in a district Republicans haven't won in half a century. We say what needs to be said: believe people when they tell you who they are. In our Top 3 Things You Need to Know, the federal government suspended $867.5 million in Medicaid payments to California and $199 million to Minnesota after CMS reviews flagged high-risk fraud in home health and other services — with CMS Administrator Dr. Mehmet Oz saying the administration is done chasing stolen funds after they've already left the building. Then New Jersey's Democratic Governor Mikey Sherrill revealed that a software glitch allowed 6,000 non-citizens to register to vote in 2023 and 2024, with 400 of them actually casting ballots — a story the governor got ahead of before the DOJ could, and one that makes the case for the SAVE Act more powerfully than any speech. And 100 New York state lawmakers sent letters to the congressional delegation demanding ICE be abolished — the same ICE that exists because Congress decided in 2002 that someone should enforce federal immigration law. We also cover the Trump administration's discovery that the federal government has been sending nearly $100 million per year to dead people — and has now stopped. The fix required asking one basic question: is the person we're sending this check to still alive? That question, apparently revolutionary in Washington, was answered by comparing 885 million federal payments against death records. Government doesn't have a revenue problem. It has a stewardship problem. Our American Mamas Teri Netterville and Kimberly Burleson debate whether they'd go back to old TV over smart TVs — and the answer is a resounding yes, for reasons that go beyond nostalgia. Streaming costs more than cable ever did, smart TVs are listening and tracking everything, you can no longer skip commercials, the content is ideologically slanted, and nobody can find anything. Teri misses Blockbuster. Kimberly misses the DVR. Both agree that horizontal screens make sense because human eyes are horizontal — and that vertical video on phones is a waste of the aspect ratio God gave us. We dig deep into former North Carolina Governor Roy Cooper's early release of 4,234 prisoners following an NAACP lawsuit arguing that incarceration is racist — a number that exceeded the 3,500 agreed to in the settlement and included 99 sex offenders and 24 people convicted of murder. Within five years, 2,412 of those released — a 57% recidivism rate — had committed new crimes and been rearrested, including charges of rape and murder. Among those released and later arrested for murder was the man accused of stabbing Ukrainian immigrant Iryana Zyrutska to death on a Charlotte train. Roy Cooper is now the frontrunner for the North Carolina Senate seat. We say plainly: we should stop rewarding failure. There are people dead in North Carolina today because their governor let violent criminals out of prison to kill again. We also cover the State Department's follow-up report confirming that Cuba is actively helping Iran, Hamas, and other jihadist organizations expand their influence throughout the Western Hemisphere — connecting the dots between communist Cuba's survival dependence on American adversaries and the broader axis of pressure being applied to the United States from multiple directions simultaneously. No single threat defeats us. Together, they create friction, consume resources, divide attention, and complicate national security. All of it from 50 miles off the coast of Florida. For our Bright Spot, Texas Representative Andy Hopper wrote a letter responding to a Mexican senator who demanded that Texas stop enforcing its border laws because migrants were dying trying to cross illegally. Hopper's response is worth reading in full — citing Texas independence, the Alamo, San Jacinto, and the sovereign right of every nation to determine who enters its territory. He also told Mexico directly: we will not accept border policy instruction from a government that has allowed cartels to dominate vast regions of its own territory. Abandoning enforcement would not save lives. It would guarantee the cartels more victims, more profits, and more power. We call it exactly what it is — a bright spot. We also cover New York City's welfare rolls hitting 865,000 cash assistance recipients under Mayor Mamdani — up from a low of 336,000 under Mayor Bloomberg — and note that a democratic socialist does not view this as a crisis. He views it as an achievement. We view it as what happens when you promise free things and then wonder why more people ask for them. We also discuss the case of a 29-year-old woman who died after a ChatGPT conversation that increasingly centered on themes of sacrifice, death, and resurrection — with the AI telling her she would need to die before becoming who she was meant to be. We make the distinction between a mentally healthy person who reads letting your old self die as a metaphor for personal growth, and someone already struggling with depression or delusion who reads it as instruction. AI is a language tool. It produces eloquent, resonant language. It does not know who is reading it. And we close with Scottish runner Josh Kerr breaking the world mile record in London — running the mile in 3 minutes and 42 seconds to break Hicham El Guerrouj's record that had stood since 1999, the longest anyone had held the official world mile record since records began. In front of 60,000 fans, a man ran a mile in the time it takes most of us to find the remote. May your pursuit of happiness bring you joy. Listen now wherever you get your podcasts, visit AmericanGroundRadio.com, and join the conversation at 866-AGR-1776!See omnystudio.com/listener for privacy information.

CMS-0057 and HTI-4 are reshaping prior authorization from both sides of the workflow: payer requirements and certified EHR readiness. This episode will break down what these regulations mean for providers, how they may change day-to-day prior authorization operations, and what questions organizations should be asking their vendors now.Brought to you by www.infinx.com

This week I Answer Listener Questions [powerpress]

As a nurse with MS, I’m interviewed about AI’s real role in care: pattern recognition, human-in-the-loop skepticism, and the Three T’s and Two C’s framework. Click here to view the printable newsletter. More readable than a transcript. Click here for a verbatim transcript Summary I sit in the guest chair on Practical AI in Healthcare with Steve Labkoff. I walk through my experience feeding my own symptom logs, lab results, and ten years of clinician notes into an AI LLM: a physical therapy referral I needed and hadn’t scheduled, a medication side effect my neurologist later confirmed, and a rating scale buried in my chart that no one had surfaced. I describe the less impressive side: the four-pound box of unsorted paper my primary care practice mailed me and the 296 pages of unsearchable PDFs I got back from another system in fifteen minutes. Along the way, I lay out my framework for judging any digital health tool, the Three T’s and Two C’s: time, trust, talk, control, and connection, and explain why I insist on keeping humans in the loop even though the research on that is more complicated than people assume. This isn’t a pitch for AI in healthcare. It’s a working nurse and patient’s honest field report. What’s your experience been feeding your own health data into an AI LLM? Tell us in the comments. Episode Transcript Proem I usually ask the questions. This time I'm the guest. I met Drs. Steve Labkoff and Leon Rozenblit a couple of years ago at a DCI Network conference. They host Practical AI in Healthcare, a show I've listened to steadily, though it creates more tension for me than any other podcast I keep coming back to. Usually, I jettison podcasts that do that. I stay with this one because I approach AI in healthcare the way I approach best health; I'm an N of one and resist generalizing, while most guests do a fair amount of it. I bristle at most of them, wanting the shades of gray that reflect deep understanding. In four of 33 episodes, the guest has had lived experience: ePatient Dave DeBronkart, Amy Price, Hugo Campos, and me. I invited Steve and Leon to join my virtual Reckoning group, which I've hosted since 2019. We give podcasters warm critiques of selected episodes: the kind of feedback you give when you've made a hundred mistakes yourself, can spot them quickly in someone else's cut, and have endless thoughts about production, audience, dissemination, and life. They took the critique well. When Steve later asked me to come on his show to talk about how I use AI, not the theory but the daily grind, I readily agreed. They let me publish it here unchanged, apart from this Proem and Reflection. I struggled to prepare for this conversation. I wanted to wear all my hats, but had to narrow my focus to two. I chose my lived experience and nurse hats. Underneath it all was the question I keep circling back to. Not a cure. Best health, the most function, and Hello, and welcome to this week’s edition of Practical AI in Healthcare. My name is Dr. Steven Lapcoff, and this week I’m actually on my own because my partner, Dr. Leon Rosenblatt, is actually on spring break with his kids, so I am covering for him and he’ll be back in the next week. This week we have a guest who we met at a conference in Boston a few months ago at the Beth Israel at the DCI network. Steven Labkoff: We have Danny van Leeuwen. Danny is a nurse. He has background in giving actual physical care to patients. He actually runs his own podcast called Health Hats, the Podcast, and he’s been using AI in both his personal life and in his professional life very extensively. Also, Danny has a significant medical condition, and I’ll let him explain that in the course of the discussion because it’s with that lens that we got introduced at our patient-centric AI conference, and that’s why we thought it’d be a good idea to have Danny come and have a chat with us. So welcome to the podcast, Danny. How are you today? Health Hats: I’m good. Thank you. Thanks for having me. I appreciate it. Steven Labkoff: So Danny, as you probably have heard because you’ve helped us with our podcast, and for that I want to say thank you. For those who are listening in, Danny runs actually a group that actually helps folks running podcasts improve their podcasts, and he’s had Leon and I on many times to listen to critiques and feedback, and it’s been very, very helpful. Danny, we often start our podcast with asking for folks’ origin stories, like how did they get their cape and their superhero tights. What did you do to get you to this point in your life? And just tell us the background of what brought you here. Health Hats: Oh, thanks. So I’m a child of Holocaust survivors, and my parents– when I was young, my parents were active in the civil rights and fair housing movement in the ’60s. And when I was 16 and I was thinking about the war in Vietnam and worried about getting drafted, I wanted to learn what I could learn about the draft and how I could protect myself and manage. And I went to a church in downtown Detroit, and I went for a session of draft counseling as, you know, a little precocious at 16, and I found it fascinating, and they found me fascinating, and they encouraged me to become a draft counselor. And so I, uh, I actually took their course and became a draft counselor, and what I learned is that you change systems from the inside, not the outside. And I learned how the sausage was made, and that, uh, really pointed me in a direction. The way I got into nursing is really because I didn’t want to cut my hair I had an opportunity for a job at one point, and I could have read water meters or become an aide at the Detroit Psychiatric Institute. And reading water meters paid more, but I didn’t wanna cut my hair, so I got the job as, as nurse’s aide. And while I was there, they introduced me to the idea of going to nursing school, which was amazing. Steven Labkoff: It was more– You got paid more to read meters, water meters, than you did- Health Hats: Yes. Steven Labkoff: That’s unbelievable. Life gives you some real interesting turns and twists, doesn’t it? Health Hats: It does. And I was really fortunate because my first jobs in nursing were in physical rehabilitation and home care. I just happened to be in a place where the Holyoke Visiting Nurses was dying to hire a guy, and I was a brand-new nurse, and they ended up hiring me. And so my first introduction to nursing was not in acute care. It was in home care, and actually, I was the first male public health nurse in Western Massachusetts in 1976. And really, what I learned there was that most healthcare does not occur in the medical system. It occurs outside the medical system. And so when I ended up getting into medical care, it was always so interesting to me that everybody there thought this is where, you know, health happened, which it doesn’t. So over the 20 years of working as a nurse, I’ve worked in, other than the rehab and home care, I’ve worked in the emergency department, I’ve worked in ICU, I worked in pediatrics, behavioral health. And after about 15, 20 years, I shifted from becoming a student of individual health to a student o- of organizational health. And what I mean by that is I got into performance improvement. I led a couple of electronic health record implementations. I had a couple of gigs in the C-suite. I did some consulting. Now, in 2009, I was diagnosed with multiple sclerosis, and when I was diagnosed, I learned that I had had it for 25 years. And since my father died young, he died at 45 when I was 19 of his second heart attack, and so every time I would have some kind of episode, I would get a cardiac workup. And by the time the cardiac workup was done, you know, the episode was over, and this went on two, three, four times a year for a long time. And there was a pattern there, and nobody was connecting the dots for 25 years. That’s very important to me because the pattern of what was going on was in my records for 25 years, but nobody had synthesized it. Steven Labkoff: Yeah, they may have been biased, right? Because of your family history and having these episodes, you know, as a clinician, you get very biased by family history, and that can actually lead you down roads which may not be correct, and it sounds like that’s precisely what happened with you. Health Hats: So I’ve– I wanna bring in the caregiver role because I have been a caregiver for my grandmother, my mother, and a son in their end-of-life journeys. So I’ve been on many sides of very difficult decisions. As you said, that my shtick is health hats, and I’m health hats because I’m a patient, I’m a caregiver, I’m a nurse, I’m an advocate, I’m an informaticist, I’m a podcast host. I wear a lot of hats. And wearing many hats has gotten me a seat at many tables because they can check off boxes. When it was really different to be bringing patients o-on board, I was an easy choice. Uh, I was at the table for technical expert panels at CMS, at National Academy of Medicine, at AHRQ, National Quality Forum, PCORI, Patient-Centered Outcomes Research Institute. But really, I wasn’t really there in it for the seat itself. My goal was always to open seats for people who weren’t there yet Now let’s build the bridge, since this is a podcast about AI, let’s build that little bit of that bridge. So my first, like, serious experience with– Well, I don’t know about my first. I was involved in something that you probably are familiar with, which was the Blue Button Plus program, and my goal in that, I was there both as a patient and as somebody who was working with people with disabilities. I, I was VP of quality for an organization that supported about 40,000 people with disabilities. And my goal for that couple of years of weekly or every other week, I can’t remember, calls was, uh, to add a f- a caregiver field to the data set, and to also introduce the idea that what people needed was information that would be able to say what works for me when I’m in pain and what works for me when I’m afraid, which was an issue for me, and it was an issue for the organization that I was working with at the time. Now, I have to say that the caregiver field got added, so I felt some success in that. But as a nurse leader in the informatics group I was part of, really they were only interested in putting a name in the field, not doing anything with that information, which I- Just collecting, so just collecting the data. Steven Labkoff: They didn’t care what the data was used for? Is that what you’re saying? Health Hats: Correct. Yeah. And I couldn’t– got no traction on the pain and fear, which now that I’m older, I understand why, how difficult that is. Nevertheless, it’s something that’s important to patients and caregivers. So I think I would close this section with that I am both an early adopter of technology and a rapid skeptic, that I’m kinda making this number up, but I’ve probably tried over 100 health apps, and I would say that I’ve used five more than three times. And so I think there’s a gap between what’s promised with digital technology and what’s useful for people. So that’s really why I’m here and what’s guiding for me in this. Steven Labkoff: So let’s take it to the next step. In our prequel, I didn’t even know about your personal background to that degree. Mm-hmm. We can take that one offline later about the Holocaust survivor issues. We, we have family, I have family in that same situation, frankly. Let’s change gears and talk about the challenges that you’ve seen. You opened the door a little bit on that a few minutes ago- Yeah … in terms of people wanting to collect data but not necessarily doing much with the data, not being able to understand the true value of the data to some degree. And you said it yourself, people weren’t connecting the dots. Medical records have always been complicated. They’ve always been bulky. They’ve always been full of information, some of which is really relevant, a lot of which is not so relevant, and connecting the dots to making that a, uh, an important information source is not always an obvious task. So what, what was the particular angle on that challenge that you were trying to gun at? Health Hats: Well, I think we have to take a step back- and think about what is– Well, I’m just gonna speak for myself, okay? I know that I often, you know, as I said, I get asked to sit at the table because people can, you know, check boxes, like is that I’m a patient. I wanna be clear that I’m a privileged white old man with MS living in Boston, but I’m an N of one, and I don’t represent other patients. I’m representing myself here and my perspectives. My goal in terms of my health is best health, and what I mean by best health is optimal health and function, physical, mental, spiritual. Not a cure, but best health for where I am, what I have right now. And to get there, I need my own health data, not just what’s in my clinician’s chart, but what I know about myself, my circumstances, my environment, my history, my habits. Not just my medical history, my life history, my treatment responses. And so that’s like patient-reported data, and that’s stuff that’s only exists because I observe it and sometimes I record it And that’s where it falls apart right away. You were just alluding to some of it, that there’s all this medical data and what’s useful about that. I think Dave DeBronkart was a guest on your show. And when he launched his Gimme My Damn Data campaign, I responded to him with, “Watch what you wish for. You’ll be trying to drink dirty water from a fire hose.” And, and that was years ago, and it’s still true. So six months ago, I, I’d been on a mission to gather my medical data, and my– I’d been with my, uh, primary care practice since 2011, and I wanted all that data from 2011 to 2025. This was, like, in December I started on this crusade of trying to get my data. And actually, two months later, I got a box, a four-pound box of paper, and it was paper that was not in chronological order. And it’s just sitting right here. I’ve scanned it in. It’s not, um- Was it in– Steven Labkoff: Was it a printout of Epic or something, or was it actual- Health Hats: It’s a computer printout. It seems like it’s a vendor that they use to- Steven Labkoff: It wasn’t digital. They sent you, literally sent you a box of paper. Health Hats: Yeah, it was a box of paper. Oh. And then I use a lot the, the Beth Israel Lahey Mount Auburn system, and I asked for the last three months of my records, and I got 296 pages of redundant, non-searchable PDFs, and I got that in 15 minutes. Uh, I see a lot of doctors, so maybe I had seen Hmm. I think I had maybe eight or nine visits, and it just happened to be a three-month period that was busy for me, but I got s- 296 pages. And so that really adds to your comment, which is that access to data and access to usable data are really different. Steven Labkoff: Oh, absolutely. And yeah, I’ll tell you, in my world, I think you know that I’ve worked in the life sciences for many, many years, and we are consumers of healthcare data on many levels. We consume medical claims, we consume electronic medical records, and one of the hardest things about using medical records for research or for outcome studies and things like that is the very fact you’re describing, which is the data tends to be sparse, it tends to be poorly organized. It doesn’t always come in an encoded fashion. Thank God most of what we get these days is at least digital. No boxes of paper for us these days, but it wasn’t so long ago that when it was all paper, we couldn’t get that data in the first place. It just wasn’t even gettable. So at least you’ve made some progress. And- Yeah … yeah, I know that you sit on some national level boards, uh, around outcomes, and you can talk about that in a moment. But those are, you know, those boards are trying very hard to come up with outcome studies and ways of– Let me back that up. They’re coming up with ways of using data to perform outcome studies by harmonizing and, and distilling down to usable forms of this EHR data, which is so challenging. Health Hats: I think what’s key, I– like I, I think I w- I’d like to focus on my data. And so what I wanna do is I wanna see patterns. I wanna see patterns that takes my circumstances, my environment, my habits, my treatment over time, and because I think that these patterns are how I formulate the right questions, so the right questions before I go into a clinical encounter. They’re how I track when something is actually working, and it helps me to coordinate across care teams that don’t talk to each other and make decisions that I can live with that help me attain this goal of best health. So that’s the job, formulate better questions, g- seek better answers, make better decisions. And AI is the tool that I try to use to do it. Now, whether it’s up to the task or not is different. I wanna stick in the nursing angle, if you don’t mind- You know, one of the things that I learned the way I got started in nursing is that my goal as a nurse was to put myself out of a job. Steven Labkoff: So that sounds counterintuitive, but what I mean is from minute one with a patient and family, I’m planning my exit. Like, and to do that, I need maximum face time. I need real present, real conversation, real relationships, not less charting. I was gonna say not charting, not documentation, so that’s just ridiculous. Health Hats: But less, you know. The way you do that, I think, is, you know, less charting, less documentation, you know, not hunting through information you can’t find. And that’s where nursing, that’s a genuine promise. So pattern recognition across specific cohorts of patients. So as a nurse, even though I worked a lot of different places, in each place I worked, there was commonalities. In– When I lived in West Virginia and I was an ER nurse in a super rural hospital, if I had had more information about my patients, their families, I could get– an AI could help me surface those patterns that exist for the people that I’m taking care of, I think I could get time back as a nurse. And if the nurse gets time back, then the patient and family gets the presence of the clinician. So that’s the trade that I’m interested in I wanna go back to that thing about pain and fear. I wanna add what I’ve learned working on the blue button, plus I wanna add cognition. So when you think about it, the data almost never captures the variability of pain, fear, and cognition, and those things are really important because pain changes what you can do and what you can decide. Fear closes your heart. It closes your mind. And so when you’re scared in a clinical encounter, you’re not making good decisions. You’re just saying yes to end it. And cognition is, you know, it varies. Like I can absorb better at 10 in the morning on a good day compared to 3:00 in the afternoon when I’m spent. You know, you could extrapolate this to other people. They have their own particular patterns and circumstances. But I think What I’m trying to get at in all of this is it isn’t first about the data, it’s first about what about life and what about the things that are important to people, uh, patients, caregivers, and the clinicians that they partner with, and how can AI help them? Steven Labkoff: So you’ve explained to me in the pre-call that you’re doing some of this work, so maybe you can unpack a little bit about what it is you’re actually doing with it and how it’s helping or, in some cases, not helping those efforts. Health Hats: Well, what have I done? I, I’ve done different things. One of the things that, that I’ve done is to try to build my toolkit. You know? So when I say build my toolkit, I’m a, I’m a, a conglomeration of symptoms. I mean, you know, I’m, I’m not MS, I’m not my symptoms, but they’re big and they’re there, and I feel like I’m trying to, I’m trying to figure out for anything that I have to deal with, whether it’s any of the different kinds of pains I have, my, my anxiety, my bladder, you know, my mobility, I have challenges, and I, I need a toolbox. I need a toolbox, and the way I think is I need at least three things that will work so that when they happen, I got something I can go do, and pretty much the most common thing is drink water. Drink water is by far the most successful intervention across all of my symptoms. It’s kind of amazing. It’s so cheap, so easy. It isn’t the drugs. Okay, but so how do I do that? Well, for me, I’ve done that partially just in my head. Partially I’ve done that by keeping lists. Like, I keep track of the steps I take. I keep track of the amount of time I play music. I keep track of my falls. I keep track of my weight. And so I use digital tools to do that when I can. Steven Labkoff: I also record my clinician visits because- When you say record, do you mean like audio record or dig- Health Hats: Yeah. Yeah, audio record, right. And, uh, until recently I used Abridge, which is a company that, um- Steven Labkoff: How did you get to use Abridge? You– I thought Abridge was only selling basically into doctor’s offices, uh, from the clinician side. Do you- Health Hats: So I was before that. Ah. And they started as a patient-facing product, and actually they sponsored my podcast for three years. So I was pre that. So putting all that together, so I play with, you know, trying to put into Claude There’s nothing magic or special. You know, it’s me playing, just trying stuff. You know, some of it, you know, my wife will say, “Hey,” she sees a pattern. My kids will see a pattern, or I’ll- Steven Labkoff: Give, give, give us an example of what, of what this looks like. I mean, you’re saying you’re giving Claude or another LLM- Yeah … a series of symptoms, or you’re giving it a series of, plus your data. Like, unpack it and let us know. Yeah. What have you did- Okay, so what- … with the system, and how is it working for you? Health Hats: I’ve done a couple of different things. One is, you know, I have a spreadsheet, and I just put the spreadsheet in, you know, as a document or whatever you call it when you have a project and, you know, you load. I load my spreadsheet. I keep a annual summary, and I keep the year that I’m working on. And I will have fits of journaling. You know, I, this is not something that I am, like, super consistent on, but I’ll, especially when I’m struggling with something, if I’m struggling with my blood pressure or I’m struggling with my mood. I have a progressive mobility thing going on, and I’ll put that in and I’ll prompt. I’ll say, “Can you– do you see a pattern in this?” You know, and I’ve gotten, you know, that there’s- Steven Labkoff: Has it given you some insights? Is it… Like, give me an example of some of the insights it’s actually given you that you didn’t see yourself. Health Hats: Well, I’ve gotten, like, uh, it’s kind of humorous. But, but I’ve gotten, like, you know, “Have you thought about seeing a physical therapist?” And I, I have. You know, I have a physical therapist, uh, that I don’t go to very often. You know, my relationship with her is I go for a tune-up. But they’ll– I, I want– It’ll show, like, I’ll do my sort of things are clearly, you know, I’m not walking as far, I’ve fell on a few times, you know, and I’ll get this suggestion, you know. I also– What else have I done? Oh, oh, uh, once I had a medication that I was taking for neuropathy, and I was– my mood had, like, changed considerably and, you know, I got a thing on that might be a side effect. You know, “Have you talked to your doctor about this?” Steven Labkoff: And I- And you got that out of the LLM? You fed that to the LLM? Health Hats: I did. Yeah. Steven Labkoff: And it suggested it was a side effect, which you didn’t figure out. Health Hats: I didn’t. A neurologist said that he thought– He said, “It sounds like you have an allergy to it.” And, you know, he wanted it to be listed as an allergy because he thought it was very possible that he’s had people that have had a problem. Steven Labkoff: When you tell me that you’ve loaded your data, you give the LLM your signs, your symptoms, you give it your labs, you give it what’s in, in the system, and it comes up with a recommendation that you hadn’t thought– Now, you’re a clinician. You’re a nurse. Yeah. You’ve been a nurse for many, many decades. Health Hats: 50 years. Steven Labkoff: 50 years. And does it surprise you that it comes up with stuff that you didn’t see? Health Hats: No. Steven Labkoff: Cause I, to be honest with you- I- … if I, if I did what you just said and it came up with something completely radical that I’d never thought of and it was right- I would be scratching my head and thinking, “Okay, that’s in- that’s beyond interesting. I better pay more attention to this, and maybe I wanna use it differently.” Because not, it’s not just yous using it. Like, people around everywhere are starting to use it for the same, in the same sim- in the same exact way. So that’s the simplification of the medical system, right? Health Hats: It does. I mean, like when I tell my neurologist, he laughs, and he’s like a whatever works kinda guy, you know? That he feels like he doesn’t have all the answers, and that he likes- those stories. I feel like I’ve learned, I think you know Amy Price, right? Steven Labkoff: Yeah, very well. Health Hats: Yeah. We’re buddies. And so one of the things that I’ve learned from her is how to query and how to be skeptical and how to ask questions from different angles, from different perspectives so that you– And that’s why I think that’s where the unexpected comes up. Steven Labkoff: Well, you’re describing something that we did at the conference. I don’t know if you were in the room in the working group that we did this on, but you’re describing, and actually we’re submitting a paper on it very shortly, on AI literacy. Yeah. And you, you didn’t label it as such, but you’re describing yourself as being AI literate and understanding how to use the tools, most importantly, how to be skeptical of the answers, how to interpret the information that’s being presented to you. Health Hats: A- and that, those are all components of literacy, of AI literacy specifically. One of the things I’m finding in my world is that painfully few people are indeed AI literate. Even the folks in IT departments in large life science companies or hospitals who even work in the space and think that they’re good at it and are literate sometimes are not. That has other implications, which are if people are taking on these really impressively powerful tools and they don’t quite know how to use them as well as they should, and if they query them incorrectly, to your point earlier about making good queries, the responses that come out may or may not be the point. And if patients use that information inappropriately because they didn’t know how to ask the right questions to start with, that could have deep implications to the healthcare system. You could say that same thing about doctors. Steven Labkoff: I will say it about doctors. I mean, not about AI, about the advice that doctors give. Health Hats: There’s a, a tremendous variation, and it is very different. When I am feeling good enough to be organized and to be directive in the conversation with a clinician, I get a very different output than when I’m not. And I still have to be skeptical of what doctors tell me, and until I build some trust. And, and then I, you know, then there’s just too many decisions to make when you’re a person with chronic illness. It’s like putting in a kitchen. There’s so many decisions to make, and I’m happy for the doctors that I trust to make the decisions for me. But there are certain decisions I don’t want to give to the doctor or to AI, like I don’t wanna mess with my pathological optimism. I wanna progress as slowly as possible, and I wanna keep playing my horn. These are really important things to me, and I don’t give those decisions that affect that, I don’t give up. But all the rest of it I do, and, and I’ve worked really hard to build the team that I have that appreciates me and my strangeness and my assertiveness, and, you know, they’re not threatened by it. Steven Labkoff: Is your team AI literate? Do they also use the, these same tools in your care? Health Hats: Uh, like I don’t know. I mean, AI literate is like, is huge. You know? I mean, that’s just such a big thing. Do they use AI? Yes. Do I know how they use AI? Well, you know, they use what’s attached to Epic. I know that. Uh, I mean, look, my neurologist, who I just love, he thinks like he uses, he uses the portal well because he takes– he just keeps adding things to the end of the, a note. Yeah. And so he feels like… Well, I don’t find his notes at all useful, and I tell him that. I tell him, “What I really wanna know is, how am I doing? Am I getting better? Am I getting worse? Am I stable? What should I be paying attention to in the next six months till I see you again?” And I can’t find that in his note. That’s true. Yeah. Now, on the other hand, I’ve taken his note and asked Claude and say, “Here’s the note. How am I doing? You know, have I progressed? H-how is he measuring it?” Oh, well, then I find he’s using this scale, right? And it’ll come up with looking through this note, which is like 10 years running, and it’ll find, I can’t remember the name of it, but there’s a scale that he uses. And then we go back and I’ll say to him, “Oh, you’re using this scale.” And he goes, “Yeah.” And I say, “Well, why don’t you like put that at the top of your note?” You know, so that I can find it. You know, so we have that kind of conversation- Yeah … that AI has helped. Steven Labkoff: Well, that’s actually an interesting perspective that AI is helping to reorganize things, ’cause one of the use cases that has been discussed at, at length actually, and it was discussed at our conference, is using AI to digest medical records. Health Hats: And when I say digest, it’s not about like ingesting them, which is slightly different, but digesting, which means find all the different pieces, put them together, come up with a narrative that summarizes perhaps 300 pages of information which may be sparse and may be poorly organized, and bring it all together. And that’s actually a task that AI is actually turning out to be pretty darn good at. And that again changes the nature of the healthcare system and the healthcare journey. You know- And it does a fair job. You say it’s really good at it. So- It’s better than I could do. It’s better than I could do. Well, yes. Well, you’re not– First of all, that’s not your training, and you don’t have the time for it. And you still have to review it. Yeah, of course. Because I have never used AI that gave me a, “Oh, this is great.” I mean, the first time I read it pretty much every time I think it’s amazing. And then, you know, my rule is sleep on it and check it again. And then it’s like, oh my God, this, first of all, it either just said nothing very fancy or it got some very basic things wrong. And then I’ll say, “Oh, you know, you missed this and you missed that.” And it’ll go, “Oh, you’re right, I did.” You know? Steven Labkoff: Well, that also speaks to the concept of keeping a human in the loop- Yeah which is something that you espouse and many folks in the healthcare aisle- I do … espouse. Ironically, you know Adam Rodman, I think. He was at our conference, he spoke. Yeah. Uh, he’s done a study which shows actually having a human in the loop in some cases actually makes the conclusions worse, believe it or not. Ah. Which is w- a non-intuitive finding. You would think that the two together would be better than either one alone, but so that’s, that’s now relatively n- well, it’s not even that new anymore. That information came out about a year ago. So I, we gotta start wrapping up in a few minutes here. Yeah. You know, we didn’t cover the concept around outcomes around your three T’s and two C’s. Maybe we can cover that in the last bit here, and then we can get to closing. Health Hats: Okay. So I feel like one of the questions that you’ve asked is how AI helped, right? And so what I need to tell you is the framework that I’ve developed over the years, which I’ve actually shared in my AI Claude project that’s Danny’s Health, what I call the three T’s and the two C’s, and this is like the framework I use to evaluate any digital health technology. And so they are time, trust, talk, control, and connection. What I mean by that is time is, you know, you need time to learn, to plan, to talk, to build trust. So I say the clock isn’t the enemy, it’s the, the wrong things filling the time, so the, the time. The second is trust. You know, trust can take a really long time. It can happen really quickly. Sometimes you never have it, and you know in your gut when you don’t have it. And most digital health tools, AI, have a trust deficit, I think, not because they’re untru- untrustworthy, which maybe they are, but it’s really because the people who use them, use the tools, don’t, don’t trust them, and I think it’s really important. You c- you can’t shortcut trust in the use of any tool. I think talk is really important. It’s woven through all of it, real conversation. There is nothing like actual conversation that is making decisions together, which is a lot of what healthcare is about, is making decisions. AI can help you prepare for it, and it can help process it. And then control. I trust more when I have power in a situation. So if I’m feeling like an ant ready to be crushed, I’m not making good decisions. And finally, I would say connection is, it’s the human lifeline. You know, when somebody greets you when you cross a threshold, that’s a connection. When someone’s been where you’re going and they can say, “Oh, that helped me.” AI can extend that connection. They can help people find communities that are available at 3:00 in the morning, but you can’t manufacture it. I, I think that connection is really important, so that’s where I g- you know, time, talk, trust, control, and connection, and I use that framework when I’m evaluating. Steven Labkoff: And that framework gives you a better, you know, a how do I say this right? It gives you a, like a rubric, if you will, to go- Yes … through, uh, the information that’s coming out of it. Danny- Yeah … we’re gonna have to wrap up here in a second. Sure. Are there any last comments you wanna make that, that will, you know, help other patients in the, in the space in terms of how they might wanna think about adopting- an AI tool in their world? Health Hats: I think that I would say use it, use AI, keep using it, experiment with it. That, that i- i- just like anything else, it takes time to learn. It takes time to be comfortable with it. Use it. I would say advocate for humans in the loop. I don’t care what the study says. It’s about humans. We are human. Keep it humans in the loop. I would say find a buddy, you know. Do this with somebody else. Find a buddy- That’s good advice … and experiment. I would say, yeah, talk to your clinician about it. It’s a good barometer of a physician. If they don’t wanna talk or blow you off, that tells you something. Absolutely right. And I would say if you’re comfortable with it, mentor. You know- That’s a good idea … be the buddy. And for clinicians and for systems and developers, I would say you need to have patients, caregivers, and practicing partner clinicians in the design. They need to be there from the beginning. And, you know, so i- it solves the problems people have, not the problems that the developers think are there or the venture capitalists thinks are gonna make money. You know, y- and if you have an opportunity, join, you know, participate. Steven Labkoff: All good advice. Well, Danny, I wanna thank you very much for your participation in, in today’s discussion. Hopefully that there are other patients out there who listen to the podcast, they’ll take something away. For the clinicians out there who are listening, you know, you’ve heard it straight out from a patient who happens to be a healthcare provider himself, and he’s got very strong perspectives on how this can be used in a positive and productive way, and I think the framework that he’s put together is very useful. Danny, I wanna just say thank you for all the help that you’ve provided helping this podcast get off the ground. That’s been really incredibly generous of you and your friends who have helped us a lot, and a lot of the things that have happened on our podcast, uh, for improvement’s sake, have come directly from those conversations, so thank you for that. I wanna thank you for being a guest and sharing your journey and sharing your experiences here. And for the rest of us, I’m gonna say thank you for joining us, and we will see you again next time on another episode of Practical AI in Healthcare. Thank you for listening. Thank you for joining us this week on Practical AI in Healthcare. If you’re ready to go beyond buzzwords and hype and explore how AI is truly transforming healthcare, stay tuned for more conversations that get us to what works. Until next time, stay practical Reflection When Steve interviewed me, he didn't know that everything I told him is the origin story of TrustMyOwn.Health. The box of paper. The 296 pages that were technically my data and practically useless. Twenty-five years of a pattern that sat in my chart the whole time, that it took a person, my PCP, a year to put together. Could AI have done it in an afternoon?  I got tired of that being the normal experience instead of the exception. [Add: what specifically prompted starting TMOH, and when.] TMOH starts from a premise I didn't have language for until I said it out loud to Steve: trust isn't a feature you bolt onto a health platform after the engineering is done. It's the whole structure, or the whole thing fails. The three T's and two C's I use to size up any digital health tool turn out to be close to a design spec. Time, because a vault of your whole health history takes patience to build, not a single import. Trust, built into governance rather than promised in marketing; TMOH's Data Sovereignty Covenant binds the board and investors to the same terms as everyone else, which is the only version of trust I believe in. Talk, because the point was never to replace the conversation with my clinician, it was to walk in more prepared for it. Control, because I decide what goes in the vault and who sees it, the same way I decide which of my own decisions I hand to a doctor or an AI and which ones I keep for myself. Connection, which no vault can manufacture, but a good one can make room for. I told Steve that AI found a pattern in my chart that twenty-five years of clinicians missed. That's not really a story about AI being smart. It's a story about who owned the data long enough to ask the question. That's the whole bet behind TMOH: put the owner at the center, and let the rest of the ecosystem, the networks, the vendors, the AI, earn its place around that. See you around the block. Practical AI in Healthcare Episodes https://open.spotify.com/episode/4wA4ltjmZfIZ5VpmTeTTOF?si=KbEvc2_ERNWakJ3JeP2Ddg https://open.spotify.com/episode/0LDetUFJJrSV1cy6LtpGFx?si=qAqoqKBBSNm9PiwPjSIXYA https://open.spotify.com/episode/0wXEm1KnnGorOvTt9GTh7o?si=K_DKXzGyThusBPA6KoVkCg https://open.spotify.com/episode/6krV94ob6Lcv7VNo0qahZ5?si=B6lZDkvsQ9y2Z2FhkXzQGQ Referenced in episode Patient data access history: “Introducing Blue Button Plus: The Next Generation in PHRs” — HealthIT.gov (Office of the National Coordinator for Health IT) — https://www.healthit.gov/blog/consumer/introducing-blue-button/ The “Gimme My Damn Data” campaign Danny references: “Gimme My Damn Data (and Let Patients Help!): The #GimmeMyDamnData Manifesto” — Dave deBronkart, Journal of Medical Internet Research — https://www.jmir.org/2019/11/e17045/ Amy Price, mentioned as a mentor in questioning and skepticism: “Welcoming Dr. Amy Price as Editor-in-Chief” — Society for Participatory Medicine — https://participatorymedicine.org/2024/welcoming-dr-amy-price-dphil-as-the-editor-in-chief-for-the-journal-of-participatory-medicine/ AI literacy for patients, the concept Steve names in the episode: “Critical AI Health Literacy as Liberation Technology: A New Skill for Patient Empowerment” — National Academy of Medicine — https://nam.edu/perspectives/critical-ai-health-literacy-as-liberation-technology-a-new-skill-for-patient-empowerment/ Human-in-the-loop research Danny and Steve discuss (Adam Rodman): “AI and the Evolution of Medical Thought with Dr. Adam Rodman” — NEJM AI Grand Rounds (podcast) — https://ai-podcast.nejm.org/e/ai-and-the-evolution-of-medical-thought-with-dr-adam-rodman/ Abridge, the ambient AI scribe tool Danny mentions using: “Pioneers in Generative AI for Healthcare” — Abridge — https://www.abridge.com/about The DCI Network conference where Danny met the hosts: “About DCI Network” — DCI Network, Beth Israel Deaconess Medical Center — https://www.dcinetwork.org/about-us Please comment and ask questions: at the comment section at the bottom of the show notes on LinkedIn  via email YouTube channel  DM on Instagram, TikTok to @healthhats Substack Patreon Production Team Kayla Nelson: Web and Social Media Coach, Dissemination, Help Desk  Leon van Leeuwen: editing and site management Oscar van Leeuwen: video editing Julia Higgins: Digital marketing therapy Steve Heatherington: Help Desk and podcast production counseling Joey van Leeuwen, Drummer, Composer, and Arranger, provided the music for the intro, outro, proem, and reflection Claude, Perplexity, Auphonic, Descript, Grammarly, DaVinci Resolve, DaVinci AI Art Generator, OpenArt AI Creator Studio Inspired by and Grateful to: Steve Labkoff, Leon Rosenbilt, Amy Price, Leon and Oscar van Leeuwen, Laura Marcial Artificial Intelligence in Podcast Production Health Hats, the Podcast, utilizes AI tools for production tasks such as editing, transcription, and content suggestions. While AI assists with various aspects, including image creation, most AI suggestions are modified. All creative decisions remain my own, with AI sources referenced as usual. Questions are welcome. Creative Commons Licensing CC BY-NC-SA This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator. If you remix, adapt, or build upon the material, you must license the modified material under identical terms. CC BY-NC-SA includes the following elements:    BY: credit must be given to the creator.   NC: Only noncommercial uses of the work are permitted.    SA: Adaptations must be shared under the same terms. Please let me know. dannyhealthhats@gmail.com  Material on this site created by others is theirs, and use follows their guidelines. Disclaimer The views and opinions presented in this podcast and publication are solely my responsibility and do not necessarily represent the views of the Patient-Centered Outcomes Research Institute®  (PCORI®), its Board of Governors, or Methodology Committee. Danny van Leeuwen (Health Hats)

Healthcare in America is stuck in a "sick care" model—we wait until people are already ill, then scramble to treat them. Dr. Gloria Winters, VP of Health Innovation at the YMCA of the USA, has spent the last year building something different: a community health operating system that pulls together your wearables, your medical records, and AI-driven insights into one place, so you actually know what to do with your health data instead of just staring at numbers. In this episode, she breaks down her "house" framework for the $5.6 trillion healthcare industry, why falls cost the country more than almost anything else, how she's working directly with HHS and the MAHA movement on preventive health policy, and why personal agency—not just data—is the missing piece in helping people actually change their behavior. If you've ever felt like your Apple Watch tells you everything except what you should actually do next, this conversation is for you. Key Takeaways:

July 17, 2026In this episode, Scott and Mark Painter provide their initial analysis of CMS's proposed 2027 Medicare Physician Fee Schedule and highlight the changes most likely to impact urology practices. The discussion covers the proposed conversion factor reduction, a significant new proposal to apply the multiple procedure payment reduction to E/M services billed with modifier 25, changes to G2211, updates to practice expense methodology, prostate biopsy coding revisions, telehealth proposals, and a substantial reimbursement increase for bulking agent injections. The team also shares practical insight into what these proposals could mean for physician compensation, practice operations, and future commercial payer policies. The key takeaway: while the rule is still only proposed, now is the time for urology practices to understand the changes, submit meaningful comments, and begin planning for what could be a very different reimbursement landscape in 2027. PRS Coding and Reimbursement HubAccess the HubBotox LCD AlertDownload the AlertFree In-Office Prostate Biopsy Calculator (Suppoted by UC-Care)Download NowPRS Coding CoursesFor UrologistFor APPsFor Coders, Billers, and Admins Join the Urology Pharma and Tech Pioneer GroupEmpowering urology practices to adopt new technology faster by providing clear reimbursement strategies—ensuring the practice gets paid and patients benefit sooner.         https://www.prsnetwork.com/joinuptpClick Here to Start Your Free Trial of AUACodingToday.com   The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ 

Welcome back to a special encore presentation of Turn on the Lights! As we continue our transition series, our new host, Dr. Philip, is revisiting some of the most impactful conversations from the archives. For this episode, he selected a standout discussion with Dr. Michelle Schreiber and Brenna Rabel, exploring how quality measures are developed, adopted, and implemented across Medicare and Medicaid programs. Summary: How do we decide what “good care” looks like, and who gets to choose the scorecard? In this episode of Turn on the Lights, Kedar Mate speaks with Dr. Michelle Schreiber of the Centers for Medicare & Medicaid Services and Brenna Rabel of Battelle about how quality measures are developed, adopted, and applied across Medicare and Medicaid programs. They explore why measurement is essential for accountability, patient choice, and improvement, while also acknowledging its vulnerability to politics, feasibility constraints, and “teaching to the test.” Using diabetes and sepsis as examples, they explain how performance cutoffs are established, why “all-or-none” measures often face resistance, and what makes complex measures difficult to report and score. The conversation also addresses efforts to reduce reporting burden, including CMS's shift from broader MIPS reporting toward MIPS Value Pathways and the expansion of digital quality measurement through FHIR-enabled eCQMs. They conclude with a forward-looking discussion on how artificial intelligence could reduce manual chart abstraction and advance quality measurement, particularly as patient-reported outcomes play a larger role in shaping the future of value-based care. Tune in to hear how measures shape what health systems prioritize, what gets improved, and what “value” could look like in the future. Resources: Connect with and follow Dr. Michelle Schreiber on LinkedIn. Follow CMS on LinkedIn and explore their website! Connect with and follow Brenna Rabel on LinkedIn. Follow Battelle on LinkedIn and explore their website! Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode of The Ross Simmonds Show, Ross shares why curiosity, execution, and continuous learning are becoming more valuable than traditional credentials in marketing, tech, and business. He breaks down how hiring managers, marketers, content creators, and business leaders can identify curious talent, build stronger teams, and stay relevant as AI, search, content distribution, and audience behavior continue to evolve. Key Takeaways and Insights: 1. Curiosity as a Career Advantage - Ross shares how growing up outside major tech hubs pushed him to use the internet as his mentor. - Curiosity helped him build a self-directed education across SEO, social media, content, SaaS, Reddit, LinkedIn, Quora, and startups. - The lesson: your location, background, or lack of connections does not limit your ability to learn and grow. 2. The Hiring Trap: Stacked Resume, Weak Execution - Ross warns leaders not to confuse impressive logos and credentials with real-world capability. - Some candidates know how to follow a playbook but struggle when asked to create or adapt one. - Hiring should focus on how people think, learn, ask questions, and solve problems—not just what appears on paper. 3. How to Identify Curious Marketers - Ask candidates what they are reading, what they are learning, and how they stay sharp in their craft. - Look for people actively tinkering with new tools, especially in the age of AI. - Curious marketers bring questions, data, and insights into conversations instead of relying on old playbooks. 4. Insight-Driven Marketing Decisions - Great marketers do not recommend SEO, CMS changes, or content strategies simply because they prefer them. - They gather data, ask about pipeline goals, conversion rates, customer lifetime value, and channel performance. - Curiosity turns marketing from guesswork into a structured, strategic process. 5. Where Curious People Spend Their Time - Curious professionals go where learning is happening: communities, subreddits, Discord servers, Slack groups, LinkedIn threads, and comment sections. - They engage in discussions, debate ideas, and test what they learn. - They do not just consume marketing tips—they apply them. 6. The Signals of a High-Curiosity Team Member - They research before making recommendations. - They reverse engineer why something worked instead of blindly repeating tactics. - They invest in courses, tools, and resources because they want to become better, not just get promoted. - They challenge leaders with data-backed thinking and fresh perspectives. 7. Why Curiosity Matters in the AI Era - AI is reshaping search, content distribution, GEO, AEO, and how buyers discover brands. - Channels that worked three years ago may not be enough today. - Marketers who stay curious will adapt faster as LLMs, Reddit, YouTube, short-form video, and emerging platforms shift the landscape. 8. Building a Learning Advantage - One to two extra hours of intentional learning per week can put you ahead of people doing none. - Those who invest more deeply in their skills create a larger competitive gap. - Continuous learning builds the taste, strategy, distribution skill, and human understanding needed to stay valuable. 9. Hiring for Curiosity and Growth - Leaders should ask candidates about newsletters, podcasts, tools, personal projects, and ideas they cannot stop thinking about. - Experience with tools like Claude, Perplexity, and ChatGPT can signal active experimentation. - Building a culture of curiosity helps teams stay adaptive, strategic, and ready for what comes next. —

One year after the passage of the Working Families Tax Cut Act (formerly known as the One Big Beautiful Bill Act), states and providers are continuing to grapple with the biggest changes to Medicaid in a generation. Harsh P. Parikh, Partner, Nixon Peabody LLP, Lloyd A. Bookman, Founding Partner, Hooper Lundy & Bookman PC, and Anne Winter, Senior Managing Director, FTI Consulting, discuss CMS' June 1 interim final rule related to work requirements, the multi-state lawsuit challenging that rule (Massachusetts v. Oz), new eligibility and coverage requirements, CMS' May 22 state-directed payment proposed rule, the current status of the Rural Health Transformation Program, and how states are responding to Medicaid cuts.Watch this episode: https://www.youtube.com/watch?v=NYIU0YqseHYWatch Harsh, Lloyd, and Anne's episode from December 2025: https://www.youtube.com/watch?v=0vIviLRddzI Watch Harsh, Lloyd, and Anne's episode from September 2025: https://www.youtube.com/watch?v=JDYg4KZwL0M Essential Legal Updates, Now in AudioAHLA's popular Health Law Daily email newsletter is now a daily podcast, exclusively for AHLA Comprehensive members. Get all your health law news from the major media outlets on this podcast! To subscribe and add this private podcast feed to your podcast app, go to americanhealthlaw.org/dailypodcast.Stay At the Forefront of Health Legal EducationLearn more about AHLA and the educational resources available to the health law community at https://www.americanhealthlaw.org/. 

Every career has an origin story, and for longtime CMS leader Lorraine Doo, it begins with the Attachments Rule on her very first day at the agency. In this episode, Lorraine reflects on the evolution of healthcare interoperability—from EDI transactions to APIs, FHIR, and today's digital health ecosystem—sharing behind-the-scenes insights into the policy decisions, collaborations, and regulatory milestones that have shaped modern health IT, along with her perspective on the challenges and opportunities that still lie ahead.

Fraud risks in Medicare Advantage, which now covers more than half of all Medicare beneficiaries, have been flagged as a top priority for government agencies. With that in mind, Rachel Rose, JD, MBA, joins the 1st Talk Compliance podcast to bring her expertise in False Claims Act litigation to the discussion on how best to avoid these risks, or run afoul of the DOJ or CMS. Listen now for firsthand insight into how these cases actually unfold and what providers can do to protect themselves and their practices.

$100 billion. It's a huge number but that's the total amount the Trump Administration believes it can find in fraud across Medicaid and Medicare by 2029. The person helping lead that initiative is Stephanie Carlton, the deputy administrator of the Centers for Medicare and Medicaid Services. She's now directing efforts to make CMS an “AI […] The post Can AI Find Medicaid Fraud? That's the Mission of Stephanie Carlton, Dep. Admin, CMS appeared first on Healthy Communities Online.

About this episode:   Between a growing aging population, the emergence of new technologies, and cuts to Medicaid spending, the landscape of American caregiving is shifting. In this episode: Researcher Jennifer Wolff walks through changes in caregiving trends, underscores the importance of more research on the topic, and highlights new programs that aim to support older adults and their caregivers. Guest:  Dr. Jennifer Wolff is an expert in policy relating to the care of persons with complex health needs and disabilities, the Eugene and Mildred Lipitz Professor in Health Policy and Management, and director of the Roger and Flo Lipitz Center to Advance Policy in Aging and Disability. Host:  Lindsay Smith Rogers, MA, is the producer of the Public Health On Call podcast, an editor for Expert Insights, and the director of content strategy for the Johns Hopkins Bloomberg School of Public Health.  Show links and related content:  About NHATS & NSOC—NHATS The Number Of Family Caregivers Helping Older US Adults Increased From 18 Million To 24 Million, 2011–22—Health Affairs Cognitive assessment & care plan services—http://Medicare.gov GUIDE (Guiding an Improved Dementia Experience) Model—http://CMS.gov America's Caregiver Crisis—Public Health On Call (July 2025) The Potential Impacts of Cuts to Medicaid—Public Health On Call (March 2025) Transcript information: Looking for episode transcripts? Open our podcast on the Apple Podcasts app (desktop or mobile) or the Spotify mobile app to access an auto-generated transcript of any episode. Closed captioning is also available for every episode on our YouTube channel. Contact us: Have a question about something you heard? Looking for a transcript? Want to suggest a topic or guest? Contact us via email or visit our website. Follow us: @‌PublicHealthPod on Bluesky @‌PublicHealthPod on Instagram @‌JohnsHopkinsSPH on Facebook @‌PublicHealthOnCall on YouTube Here's our RSS feed Note: These podcasts are a conversation between the participants, and do not represent the position of Johns Hopkins University.

On today's episode of The Gist Healthcare Podcast, Michigan officials narrow the search for the source of a large Cyclospora outbreak, new CMS data show ACO REACH generated nearly $1 billion in net savings to Medicare in 2024, and a new survey finds clinicians continue to face barriers to using data from consumer wearable devices. Hosted on Acast. See acast.com/privacy for more information.

Send us Fan MailWhen a teenager expresses suicidal thoughts to an AI chatbot, what happens next?In this clip from our episode “Who Sets the Rules for AI in Medicine?”, hosts David E. Williams and John Driscoll and Dr. John Whyte, CEO of the American Medical Association, break down why minors need stronger protections from AI chatbots than adults do, and why the line between a wellness app and a medical device matters more than the industry wants to admit.Listen to the full episode here

────────────────────────────────────────[00:02:58]Telegram Founder Durov: EU's "Child Safety" Surveillance Law Is Classic Banana Republic TacticsArrested in France for running a free speech platform, Durov warns the EU's chat control law allows warrantless snooping on millions of conversations; every tyrannical act is sold as protecting children.────────────────────────────────────────[00:07:18]LAPD Let Its Flock Contract Expire — Flock Secretly Shared Local Camera Data With Federal AgenciesFlock ran an unauthorized data-sharing pilot without local consent; Mountain View, Santa Cruz, and Hillsborough have also walked away.────────────────────────────────────────[00:15:22]Cato and Reason Said Big Tech Censorship Was Fine Because "Private Companies Can Do Whatever They Want"When government uses tech companies as its enforcement arm, it's fascism — the literal merger of corporate and government power.────────────────────────────────────────[00:23:03]Ron Paul: Trump Purchased Partial Ownership of ~30 Companies Using $27 Billion in Taxpayer MoneyGovernment picking winners distorts capital markets and enriches the Trump family; Knight calls it communist fascism.────────────────────────────────────────[00:26:42]Trump's 1990 Playboy Interview: He Praised the Tiananmen Square Massacre as "Showing the Power of Strength"China "almost blew it" but recovered by killing everybody — a good thing, he said; the authoritarian heart of the man building America's surveillance state.────────────────────────────────────────[00:51:33]Dr. James Miller: Hospitals Were "Killing Fields" — Unvaccinated Patients Treated as Dirty Plague RatsCorporate systems denied standard care to the unvaccinated; the 20% CMS bonus for COVID patients created a financial incentive to classify, harm, and kill.────────────────────────────────────────[01:09:14]Democrat Ed Markey's AI Agenda Would Force Universal Online Age Verification and Digital IDMarkey frames it as fighting big tech while partnering with it; both parties using AI as their tool of tyranny, fighting over who gets credit.────────────────────────────────────────[01:11:43]Thomas Massey: "We Won All the Damn Elections — What Are We Doing? Bankrupting the Country and Starting Wars"Trump's election fraud obsession is about his ego; Republicans will face a shellacking in November if they don't wake up.────────────────────────────────────────[01:16:06]Trump Threatens a 20% Toll on Ships Through the Strait of Hormuz — Iran Mocks It ImmediatelyPiracy — exactly what the Barbary pirates did; Iran and Oman, which border the Strait, are prohibited from charging tolls while the US plans to charge them.────────────────────────────────────────[01:22:10]Netanyahu Confirms Plans to Formally Merge US and Israeli Militaries — De Facto to De JureConverting US subordination to Israeli command into legal cover; ICC arrest warrants for Netanyahu preceded the US State Department moving to abolish the ICC. ──────────────────────────────────────── Money should have intrinsic value AND transactional privacy: Go to https://davidknight.gold/ for great deals on physical gold/silver For 10% off Gerald Celente's prescient Trends Journal, go to https://trendsjournal.com/ and enter the code “KNIGHT” For high quality made in America products go to HomeSteadProducts.shop and use promo code “Knight” for 10% off your purchases Find out more about the show and where you can watch it at TheDavidKnightShow.com If you would like to support the show and our family please consider subscribing monthly here: SubscribeStar https://www.subscribestar.com/the-david-knight-show Or you can send a donation throughMail: David Knight POB 994 Kodak, TN 37764Zelle: @DavidKnightShow@protonmail.comCash App at: $davidknightshowBTC to: bc1qkuec29hkuye4xse9unh7nptvu3y9qmv24vanh7Become a supporter of this podcast: https://www.spreaker.com/podcast/the-david-knight-show--2653468/support.

────────────────────────────────────────[00:02:58]Telegram Founder Durov: EU's "Child Safety" Surveillance Law Is Classic Banana Republic TacticsArrested in France for running a free speech platform, Durov warns the EU's chat control law allows warrantless snooping on millions of conversations; every tyrannical act is sold as protecting children.────────────────────────────────────────[00:07:18]LAPD Let Its Flock Contract Expire — Flock Secretly Shared Local Camera Data With Federal AgenciesFlock ran an unauthorized data-sharing pilot without local consent; Mountain View, Santa Cruz, and Hillsborough have also walked away.────────────────────────────────────────[00:15:22]Cato and Reason Said Big Tech Censorship Was Fine Because "Private Companies Can Do Whatever They Want"When government uses tech companies as its enforcement arm, it's fascism — the literal merger of corporate and government power.────────────────────────────────────────[00:23:03]Ron Paul: Trump Purchased Partial Ownership of ~30 Companies Using $27 Billion in Taxpayer MoneyGovernment picking winners distorts capital markets and enriches the Trump family; Knight calls it communist fascism.────────────────────────────────────────[00:26:42]Trump's 1990 Playboy Interview: He Praised the Tiananmen Square Massacre as "Showing the Power of Strength"China "almost blew it" but recovered by killing everybody — a good thing, he said; the authoritarian heart of the man building America's surveillance state.────────────────────────────────────────[00:51:33]Dr. James Miller: Hospitals Were "Killing Fields" — Unvaccinated Patients Treated as Dirty Plague RatsCorporate systems denied standard care to the unvaccinated; the 20% CMS bonus for COVID patients created a financial incentive to classify, harm, and kill.────────────────────────────────────────[01:09:14]Democrat Ed Markey's AI Agenda Would Force Universal Online Age Verification and Digital IDMarkey frames it as fighting big tech while partnering with it; both parties using AI as their tool of tyranny, fighting over who gets credit.────────────────────────────────────────[01:11:43]Thomas Massey: "We Won All the Damn Elections — What Are We Doing? Bankrupting the Country and Starting Wars"Trump's election fraud obsession is about his ego; Republicans will face a shellacking in November if they don't wake up.────────────────────────────────────────[01:16:06]Trump Threatens a 20% Toll on Ships Through the Strait of Hormuz — Iran Mocks It ImmediatelyPiracy — exactly what the Barbary pirates did; Iran and Oman, which border the Strait, are prohibited from charging tolls while the US plans to charge them.────────────────────────────────────────[01:22:10]Netanyahu Confirms Plans to Formally Merge US and Israeli Militaries — De Facto to De JureConverting US subordination to Israeli command into legal cover; ICC arrest warrants for Netanyahu preceded the US State Department moving to abolish the ICC. ──────────────────────────────────────── Money should have intrinsic value AND transactional privacy: Go to https://davidknight.gold/ for great deals on physical gold/silver For 10% off Gerald Celente's prescient Trends Journal, go to https://trendsjournal.com/ and enter the code “KNIGHT” For high quality made in America products go to HomeSteadProducts.shop and use promo code “Knight” for 10% off your purchases Find out more about the show and where you can watch it at TheDavidKnightShow.com If you would like to support the show and our family please consider subscribing monthly here: SubscribeStar https://www.subscribestar.com/the-david-knight-show Or you can send a donation throughMail: David Knight POB 994 Kodak, TN 37764Zelle: @DavidKnightShow@protonmail.comCash App at: $davidknightshowBTC to: bc1qkuec29hkuye4xse9unh7nptvu3y9qmv24vanh7Become a supporter of this podcast: https://www.spreaker.com/podcast/the-real-david-knight-show--5282736/support.

Terry tackles a growing compliance issue in telehealth: where the patient is located at the time of the visit. While physicians generally must be licensed or otherwise authorized to practice in the state where the patient is physically located, evolving payer policies and Medicare rules have added new layers of complexity. From commercial insurance requirements to CMS guidance on services provided outside the United States, Terry explains what providers need to know to remain compliant and avoid costly reimbursement pitfalls. Subscribe and Listen Find all of Terry’s official links in one place: https://www.terryfletcher.net/links The post Telehealth: Where the Patient is or Where the Provider is? appeared first on Terry Fletcher Consulting, Inc..

Read more from VPM News:  Frustration with McGuire drives both sides of 5th Congressional District primary  WATCH: Richmond Coliseum's days are officially numbered (YouTube)    Other links:  Cyclosporiasis Surveillance and Investigation (Virginia Department of Health)  Virginia needs more nurses. Training them requires more than adding classroom seats (WHRO)  Efforts to reform federal drug pricing program 340B continue with new report, proposed CMS rule (Virginia Mercury)  Documents: Former RPS facilities director was paid for six weeks after investigation due to rejected resignation (The Richmonder)  New Kent leaders poised to strike down proposed data center district (Richmond Times-Dispatch)*  ‘Oyez, oyez.' Supreme Court's last official crier is dead at 102. (The Washington Post)*  Virginia approves historical marker to the song that inspired a generation of rock stars (Cardinal News)  *This outlet uses a paywall.  Our award-winning work is made possible with your donations. Visit vpm.org/donate to support local journalism.

Got questions? Send Ericka a Text!Less than 1% of denied dental claims ever get appealed and insurance companies are counting on you to be in the other 99%. I walk you through the denial management mindset shift that changes everything: stop treating the third appeal like the edge of the map and start using the tools that actually hold payers accountable, including your state insurance commissioner for fully insured plans. We get practical and specific about what makes a denial “unreasonable” or “bad faith” and how to spot the pattern: benefits are active, eligibility is confirmed, documentation supports dental necessity, and the claim still comes back denied. I also explain why we start with state and federal laws before we obsess over codes, because language like prompt pay, network leasing, and silent PPO issues gives your conversations more weight. Then we clean up common risk areas by separating an honest mistake, a contract violation, and fraud, because mixing those up can put a practice in real trouble. From there, we talk tactics: why copy-and-paste appeal templates can work against you in a world where insurers use AI to review claims, and what to use instead. Think ICD-10 diagnosis codes, strong narratives, and patient-specific clinical details that make your claim defensible. Finally, I share documented enforcement examples, including a major fine tied to undisclosed “phantom” frequency limits, and why complaints to regulators compound over time. If you want a denial process that protects patients and stops leaving money on the table, listen all the way through, then subscribe, share this with your office team, and leave a review so more billers learn how to escalate the right way.Sources referenced in this episode:Appeal rate / upheld rate: KFF analysis of CMS data — fewer than 1% of denied ACA marketplace claims are appealed; insurers uphold ~56% of appeals (2023 data), 66% (2024 data). Medicare Advantage: ~57% of appealed denials overturned. (On air we used these instead of the "59% upheld because nobody appealed" framing, which conflated the appeal rate with the uphold-on-appeal rate.)Delta Dental of Washington: Washington State Office of the Insurance Commissioner fined Delta Dental + its health care benefits manager (Wyssta) $130,000 (Oct/Nov 2024) for, among other things, denying claims based on time/frequency limits not filed with or approved by the state; 7 service types and 50 billing codes had undisclosed limits. Triggered by consumer complaints. This is an actual regulatory fine.Self-funded vs. fully insured (the "federal path" mention): The commissioner regulates fully insured plans. Self-funded employer plans fall under federal ERISA law and route to the U.S. Department of Labor (EBSA) instead, not the state commissioner. This is covered in depth in the full denial management talk, not this episode. (Government and church plans are a further exception.)Cigna PxDx: 2023 class action (E.D. Cal.), citing ProPublica reporting — ~300,000 denials in two months, avg. 1.2 seconds per claim, "we literally click and submit." Court allowed the case to proceed March 2025 (abuse of discretion). This is litigation, not a fine — described on air as a lawsuit/court ruling.UnitedHealth nH Predict: Class action (D. Minn.) alleging a 90% error rate on the AI tool and that ~0.2% of policyholders appeal. Court ordered algorithm disclosure in 2026. Allegations in active litigation — stated as such on air.The "0.2% will appeal" motive appears in both the Cigna and UnitedHealth complaints as an allegation of intent. Interested in a Demo of Dentiq - The Billing Command Center? Get on the interest list here:https://4063-dentiq.systeme.io/waitlistGet your Dental Billing Toolkit Here:https://www.dentalbillingdoneright.com/the-dental-billing-toolkitDownload "The Most Underused Codes in Dentistry - And How to Get Them Paid" checklist here:https://docs.google.com/forms/d/e/1FAIpQLSfxnnfSlNd0NPhMoBWq-1D_xU5R8LS4xPhHNKIjfLQwStOUag/viewform?usp=headerSchedule a billing chat with Ericka:https://calendly.com/ericka-dentalbillingdoneright/30minEmail Ericka:ericka@dentalbillingdoneright.comEmail Jen:jen@dentalbillingdoneright.com

This week I Share An Update: Three Months After the Layoff [powerpress]

In this episode, Greg and Rob are joined by Ted Slafsky and Will Newton of 340B Report. They recap major developments in the first half of 2026 that have impacted the 340B community. They'll discuss recent Congressional activity, including a newly introduced 340B Program reform bill (SECURE 340B Act), trends in federal administrative agency policies from HRSA and CMS, and the evolution of various manufacturer actions within the 340B Program. In the intro, they discuss recent HRSA audit finding trends and highlight key provisions in the CMS 2027 OPPS proposed rule, including anticipated Medicare Part B reimbursement reductions for 340B hospitals.    Use “SPENDMEND25” to get a 25% discount on a subscription to 340B Report: https://340breport.com/subscribe/ Going to the 340B Coalition Summer Meeting? Come see us at booth #418.

July 10, 2026: Your daily rundown of health and wellness news, in under 5 minutes. Today's top stories: Bold adds Medicare-backed GLP-1 prescriptions to virtual weight management, pairing medication with strength training as CMS's new Bridge program cuts costs to $50/month UK startup Reformed raises $22M Series A after scaling to $70M revenue, embedding collagen and creatine into coffee and matcha to upgrade existing habits Whoop hires former Nike CMO DJ van Hameren to lead global marketing ahead of a potential IPO, broadening beyond athletes past three million subscribers More from Fitt: Fitt Insider breaks down the convergence of fitness, wellness, and healthcare — and what it means for business, culture, and capital. Subscribe to our newsletter → insider.fitt.co/subscribe Work with our recruiting firm → https://talent.fitt.co/ Follow us on Instagram → https://www.instagram.com/fittinsider/ Follow us on LinkedIn → linkedin.com/company/fittinsider Reach out → insider@fitt.co

Wenn ihr das hier lest, ist stayforever.de in neuem Glanz online. Die alte, schon auf dem letzten Loch pfeifende Wordpress-Seite ist Geschichte, nur das Forum ist übriggeblieben. Die neue Seite ist ein Eigenbau, kein vorgefertigtes CMS, von uns und für uns gebaut. Sie hat viele schöne Features, vor allem aber enthält sie unter der Haube eine komplette Membership-Plattform, sie kann Podcasts und andere Inhalte ausspielen, Mitgliedschaften und Abos verwalten, Paymentfunktionen übernehmen, und so weiter. Alles aus einer Hand, alles DSGVO-konform gehostet in Deutschland. Warum das nötig war, was am Ende den Ausschlag gab und wie ein Kaffeegespräch plötzlich zum Megaprojekt wurde, erzählen wir in dieser Folge – zusammen mit Jo und Paul, die die Plattform programmiert und designt haben. Achtung: Wir schalten die Mitgliedschaften auf Patreon, Steady und Youtube nicht ab, das ist alles weiterhin möglich. Wir schreiben euch nichts vor, aber wir glauben, dass wir mit der neuen Plattform ein besseres Angebot machen können. Wer sich für einen Wechsel entschließt, muss auch nichts aufgeben: Wir rechnen bereits bezahlte Zeit auf Patreon/Steady an, wenn ihr direkt zu uns wechselt. Reinhören lohnt sich – vielleicht nicht nur für alle Stay-Forever-Fans und -Unterstützende, sondern für jeden, der wissen will, was es bedeutet, sein eigenes kleines Podcast-Imperium technisch neu aufzuziehen.

Show DescriptionChris & Dave have been challenged to not talk about AI this episode - do they succeed? How do I optimize tracking pixels in my web app, what's the best book on CMS and authoring experiences, picking the best tooling in Rails that won't be obsolete, SPF, DNS, and D-Marc, adding dark mode to a website, and dealing with good old fashioned F.A.R.T. Listen on WebsiteWatch on YouTubeLinks Vizio accidentally made the best dumb TV on the market | The Verge Window: queueMicrotask() method - Web APIs | MDN Jake Archibald on the web browser event loop, setTimeout, micro tasks, requestAnimationFrame, ... - YouTube Designing Content Authoring Experiences Ruby on Rails: Accelerate your agents with convention over configuration Secure AI Agent & User Authentication | Auth0 next.js TanStack | The open-source application stack for the web. RedwoodSDK: A simple framework for humans Heroku | The Cloud Application Platform For Developers Push your ideas to the web | Netlify Agentic Infrastructure - Vercel Astro Jekyll • Simple, blog-aware, static sites | Transform your plain text into static websites and blogs Nuxt: The Full-Stack Vue Framework SendGrid Email API and Email Marketing Campaigns | Twilio Email · The email API for developers who ship the rest of the message too — Bird Cloudflare: Build for the agent era CSS Analytics - Project Wallace Flash of inAccurate coloR Theme (FART) | CSS-Tricks