Podcasts about Providers

Protecting provider margins has never been easy. But today's combination of policy shifts, reimbursement changes, labor pressures, and evolving care models is forcing health systems to rethink where margin comes from and how to sustain it. In this episode, Abby Burns sits down with Optum Advisory's Samantha Wyld and Jess Garber to explore how both sweeping policy changes and smaller regulatory updates are reshaping margin management. Through real-world examples, they unpack three areas of opportunity: pricing strategy, clinical documentation and coding, and capturing economies of scale many organizations have yet to realize. Together, they explain why yesterday's margin playbook is no longer enough and what it takes to take a more strategic approach to financial performance. We're here to help: Expert Insight | 5 assumptions executives make about revenue cycle (and what to do instead)a>Expert Insight | 6 strategies to improve your operating margins and financial resiliencea>Ready-to-Use Resource | Mapping AI's real role in the revenue cyclea>E-book | 5 Provider Strategies to Help Improve Your Margins | Optuma>Podcast | 303: The hard truths behind the fight for commercial volumesa>Podcast | [Encore] How data savvy strategic planners will define the next era of health system growth Get in Touch | Optum Advisory: Healthcare Consulting Services Sponsor link: Quick Guide | Rethinking iodine contrast use: A stewardship maturity model A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

A structural transfer of liability and risk is reshaping industry engagement models, with outcome-based contracting increasing across service agreements. This shift is being driven by buyer demands for accountability in technology solutions, notably in artificial intelligence deployments, and is illustrated by recent unpublished but credible reports that OpenAI is quietly allowing select large enterprise customers to pay only when AI tasks are successfully completed. Supporting research from Gartner and CIO Dive highlights a growing disparity: while 19% of service buyers seek outcome-based payment models, only 13% of agreements from sellers currently accommodate them. The core development spotlighted is the disconnect between expectations for measurable AI-driven business outcomes and the lack of empirical evidence that such technologies are delivering on those promises at the organizational level. A large-scale survey by the National Bureau of Economic Research, encompassing nearly 6,000 senior executives across four countries, found that over 89% reported no observable improvement in employment or labor productivity from AI investments during the past three years, despite substantial organizational changes and budget reallocations. Additionally, research by Thomson Reuters found that 91% of 1,800 professionals reported their organizations were not realizing expected AI value, identifying a gap in demonstrable returns even while the technology is being deployed. Supporting data from Techaisle reveals partner capability thins dramatically as customers progress into advanced AI adoption stages. Most channel providers retain capacity only for basic "estate" work, with capability dropping to near zero for the most advanced client needs. Forrester has also identified persistent barriers to reliable measurement, such as fragmented and inconsistent data baselines, as well as dependencies on customer-side decisions. These factors magnify contract risk and reinforce the liability shift toward providers, who become responsible for defining, measuring, and underwriting outcomes without always possessing necessary levers or data. The operational implication for MSPs and IT service providers is heightened exposure to contractual and financial risk when agreeing to outcome-based terms, especially without mechanisms to price or control every relevant input. Providers are often unable to flow contract risk upstream to vendors or technology manufacturers, as their own agreements typically exclude outcomes. The episode concludes that early engagement and proactive definition of acceptable, controllable outcomes is essential, as outcome-based demands are likely to appear pre-baked in future client agreements, shifting bargaining power away from providers unprepared to quantify their exposure. Using data from their own worst-performing months, documenting client dependencies as contract conditions, and piloting outcome-based lines in otherwise standard agreements are outlined as practical tactics to mitigate downside risk before broader market adoption. 00:00 Four Numbers, One Cause 03:45 What You Ask For When You Can't Tell 06:45 Nobody Underneath You 10:20 Why Do We Care? Supported by: Guardz ScalePad

The central structural shift discussed is the repricing and erosion of the MSP business model as artificial intelligence (AI) and automation impact service delivery, pricing models, and margin structures. Analysis referenced recent polling and reporting, including the Omnia poll of 22,000 MSP partners and Service Leadership's financial benchmarking. The integration of AI is reducing direct labor requirements and shifting traditional cost structures—posing both short-term increases in service margins for top-tier MSPs and complex, longer-term risks to the per-user pricing paradigm. Vendors, such as ConnectWise and RapidScale, are central to these developments, as their platforms, pricing models, and reporting mechanisms increasingly determine downstream MSP economics. Supporting evidence from Service Leadership's recent profitability report shows top quartile MSPs achieved a service multiple of wages (SMW) of 3.01—a level reached previously only during periods of wage collapse. The report also highlights that this margin growth is isolated: while the best-in-class are realizing sharply higher service margins, the median and bottom quartile remain flat. Reporting and analysis attributed this phenomenon to the earliest and most effective adopters of automation, particularly service desk automation aligned with AI, according to theories discussed with Service Leadership and ConnectWise representatives. However, there is a notable lack of definitive causation, as Service Leadership states the link between AI adoption and observed margin increases remains a working theory pending further data. Additional developments reinforce the risk environment. Nearly 43% of surveyed MSPs are actively considering alternatives to per-user pricing, with another 17% acknowledging a need to change their pricing but lacking a defined direction. Industry analysis notes that consumption-based models—such as token-based or outcome-based pricing—present challenges, including unpredictable vendor cost structures and difficulties in measuring actual results achieved. Meanwhile, the risk of vendor-driven reenactment of break-fix economics and cost volatility increases, with some vendors already raising prices significantly to offset their own AI-related costs, pointing toward future margin compression downstream. For MSPs and IT service providers, the operational implications are immediate and material. Providers face growing exposure to pricing and margin risk, especially as clients begin to recognize and challenge efficiency gains achieved by automation. Structurally, there is rising accountability for justifying service costs and delivering new forms of value outside commoditized support. Continued reliance on legacy pricing models without adaptation to AI-driven changes increases the risk of eroded margins or adverse contract negotiations. The most resilient operators will need to stabilize internal cost structures, reconsider client contracts, monitor vendor behavior closely, and prepare for increased customer scrutiny on both cost and deliverables. Supported by: GuardzScalePad

A persistent governance gap is evident in current IT operations, as credential management and authorization checks fail to keep pace with increased automation and AI integration. This is visible in incidents involving major vendors such as N-able (through Passportal), Anthropic's Claude, AI-based retail management at Andon Labs, and legacy industrial controllers monitored by agencies like the NSA, CISA, and FBI. The episode highlights how systems are increasingly reliant on automated actors and credentialed assistants, while foundational questions of access rights and accountability remain unresolved. The most consequential case centers on a vulnerability in N-able's Passportal browser extension, disclosed by security researcher James Arnott. The flaw allowed any website—or embedded ad—to request and obtain session tokens, enabling decryption of entire password vaults. This affected approximately 2,500 MSPs and 165,000 SMBs, with each stolen token remaining valid for 100 days. N-able patched the issue quickly, but Dave Sobel emphasizes that the responsibility for checking permitted actions within such systems is often misattributed or left unaddressed. Supporting developments reinforce this governance gap. An AI assistant exploited poor authorization in an Australian gym reservation system, canceling another user's booking without hacking or unauthorized login. Similar risks persist in industrial environments, where controllers for energy, water, and agriculture often lack basic authentication—exposing them to AI-generated exploitation scripts, according to joint agency warnings. Additionally, retail automation at Andon Labs revealed AI-driven policy lapses, where systems cannot reliably document or enforce their own rules, highlighting operational weaknesses. Operationally, MSPs face increased risk from both their own service infrastructure and client environments. The practical recommendation is to issue discrete, revocable credentials tailored to each system agent, limiting their scope and ensuring traceable accountability. Providers are advised to formally define and document their responsibility boundaries regarding access and permissions in third-party applications. These steps shift the focus from attempting to control every client-side variable to clear documentation and compartmentalization, reducing dispute risk and speeding incident investigations. 00:00 The Gym Class and the Vault 03:39 The Check Was Always a Person  06:37 Your Tools Ask the Wrong Question 10:27 Why Do We Care?    Supported by:  GoTo(LogMeIn)Proofpoint 

The episode highlights the structural shift toward platform consolidation in security services, illustrated by Coro's unified security platform and its positioning for lean IT teams and MSPs. The mechanism involves the bundling of diverse security tools—email protection, endpoint detection and response (EDR), DLP, security awareness, backup, and cloud app integrations—into a single, managed service. This reduces the operational overhead associated with managing multiple vendors, products, and contracts, a trend now pursued by both established enterprise providers and emergent channel-focused companies. The most significant development cited is Coro's integration of AI and automation within its platform, claiming, according to the company, that 92% to 96% of alert tickets generated by security modules are closed automatically by machine intelligence, depending on the month. The conversational AI integrations such as ChatGPT and Claude are presented as front-end layers through which practitioners can execute mundane security tasks—ticket management, host isolation, incident correlation—without direct console interaction. The claim of offloading 95% of workloads to automation is specified as relating to ticket processing volume, as clarified in the discussion. Supporting evidence centers on the operational layering of AI, with commentary on new risk profiles introduced by integrating large language models (LLMs) into security workflows. Concerns raised include rising exposure to prompt injection, shadow AI (untracked AI usage by end users), and unmanaged cost escalation linked to token-based billing models for third-party AI platforms. Coro's approach distinguishes between AI-related costs incurred internally (absorbed by the vendor) and those incurred when practitioners interact with external AI tools (borne by the MSP or their clients). The need for visibility into AI usage and structured user training is highlighted as a risk mitigation measure. Operationally, MSPs and IT providers face both increased efficiency and new complexity. Vendor dependency consolidates, reducing contract sprawl and administrative burden but raising questions about single-point-of-failure and stack lock-in. Billing risk shifts with AI consumption models, introducing liability for unexpected operational cost surges if token limits are not enforced. The requirement for effective governance intensifies as traditional security controls are extended by AI-managed processes and the detection of unauthorized AI activity becomes part of standard oversight. Providers are advised to scrutinize stack overlap, evaluate whether platform consolidation minimizes genuine operational friction, and remain cautious about over-relying on automated outcomes without maintaining direct accountability. Supported by: Pax8Proofpoint  

The dominant structural shift explored is the erosion of document-based differentiation for MSPs and IT service providers, driven by advances in generative AI, regulatory mandates, and automation of AI detection and content creation processes. Regulatory requirements such as the EU AI Act are compelling vendors like Anthropic and Google to introduce invisible watermarks on machine-generated content, while vendors including OpenAI have yet to standardize this practice. At the same time, third-party entities such as BlazeHive are automating the production and humanization of AI-generated output, raising concerns about the long-term viability of artifacts as proof of human oversight or competency. Evidence cited includes Anthropic's implementation of invisible watermarks on content produced by its Claude model, fulfilling regulatory obligations and planning to release detection tools to third parties. The durability of these watermarks is limited: "light editing probably won't strip the mark, but a complete rewrite... will" according to Anthropic's own guidance. Market analysis by Ramp shows a ceiling on enterprise spend for premium AI models like Anthropic's Fable 5, with adoption of high-end models remaining restricted in practice, and cost pressures pushing organizations towards locally-run, unmetered models such as Alibaba's recent release. Additional developments reinforce the structural gap in process and talent. Channel Dive and Information Week report that IT providers face increasing difficulty deploying the AI tools they sell, not because the tools are unavailable, but due to a lack of engineering skill and process clarity. Gartner's research, as reported by Information Week, identifies that failures in deploying AI agents stem from breakdowns in business process definition, not deficiencies in the technology. These trends illustrate that service providers' core asset is not tooling but an explicit, transparent process with clear review and accountability—something that automation and documentation alone cannot supply. For MSPs and IT service providers, these trends create risks around vendor substitution, diminished artifact value, and increased client scrutiny. The implication is a need to codify review standards and accountability practices for deliverables, as automated AI output can no longer serve as a market differentiator, and clients now have both the suspicion and means to probe the origins of documents. Differentiation will shift toward the ability to transparently describe, defend, and consistently execute meaningful human review and oversight—not merely the ability to generate professional-looking outputs. Providers who cannot articulate and document their review process may find themselves commoditized or excluded from competitive evaluations. 00:00 The Mark Arrives Everywhere  03:11 A Test That Can't Come Back No 06:38 Nobody Can Answer With the File 09:24 Why Do We Care?    Supported by:  OpenText Guardz 

Lindsay Clancy's nurse practitioner did not know her patient had seen a psychiatrist fourteen times in four months. The psychiatrist did not know Clancy had checked herself into a locked psychiatric ward on New Year's Eve. No one provider had a complete picture of how fast she was deteriorating.Jennifer Coffindaffer, a retired FBI Special Agent, joins Tony Brueski to cover testimony from three weeks of trial at Plymouth Superior Court. The evidence has revealed what the medical system around Lindsay Clancy looked like before she killed Cora, five, Dawson, three, and eight-month-old Callan on January 24, 2023.Clancy told providers she was experiencing intrusive thoughts she had never had before. She described herself as completely hopeless. She searched her phone for information about hallucinations and the word "intrusive" in the days before the killings. The postpartum treatment program she tried to enter refused her because she was already on too many medications.The prosecution alleges Clancy acted deliberately and rationally. The defense argues she was suffering from postpartum psychosis — a condition occurring in roughly one of every thousand births that carries a documented four percent rate of infanticide. Her suicide attempt left her permanently paralyzed from the waist down.Coffindaffer covers whether the provider coordination failures matter in a case where three children are dead and what the clinical research says about psychosis and planning coexisting. She examines how the jury weighs a system that let a mother fall through every available safety net.Lindsay Clancy has pleaded not guilty. She is presumed innocent.Tony Brueski and retired FBI Special Agent Jennifer Coffindaffer.Listen Anywhere You Get Podcasts: https://pod.link/1655749292Want to comment and watch this podcast as a video? Check out our YouTube Channel. https://www.youtube.com/@UC8-vxmbhTxxG10sO1izODJgJoin Our SubStack For AD-FREE ADVANCE EPISODES & EXTRAS!: https://hiddenkillers.substack.com/Instagram https://www.instagram.com/hiddenkillerspod/ Facebook https://www.facebook.com/hiddenkillerspod/ Tik-Tok https://www.tiktok.com/@hiddenkillerspod X Twitter https://x.com/tonybpodThis publication contains commentary and opinion based on publicly available information. All individuals are presumed innocent until proven guilty in a court of law. Nothing published here should be taken as a statement of fact, health or legal advice.#LindsayClancy #PatrickClancy #HiddenKillers #JenniferCoffindaffer #PostpartumPsychosis #PlymouthSuperiorCourt #TrueCrime #InsanityDefense #MentalHealth #CriminalJustice

(This episode originally aired on February 3, 2026. Stay tuned towards the end of the conversation for an update on the state of pediatric hospitals midway through 2026.) Pediatric hospitals are one of the most important segments in the industry to watch right now. Although children's hospitals make up only 5% of total hospital market share, more than 40% of U.S. children rely on Medicaid, leaving pediatric organizations disproportionately exposed as the Medicaid-related provisions of the One Big Beautiful Bill Act take effect. The pressures inside pediatric care were mounting even before this moment. After years of outperforming adult hospitals, children's hospitals have seen margins fall from double digits to just 1% last year. Rising bad debt, higher supply and labor costs, a rapid shift toward lower margin outpatient care, and emerging challenges like declining birth rates and vaccine policy upheaval have created a perfect financial storm. While some of these dynamics are unique to pediatrics, the sector also offers an early warning signal for the rest of healthcare — and an opportunity to translate lessons across both worlds. In this episode, host Abby Burns and Advisory Board expert Vidal Seegobin break down why pediatric leaders must simultaneously manage immediate-term margin pressure, prepare for a more ambulatory-dominant model, and futureproof their organizations amid shifting demographics. Vidal also shares actionable steps leaders can take now, along with the critical lessons pediatric hospitals offer the wider healthcare ecosystem. We're here to help: 5 insights on the state of pediatric hospitals today 12 things CEOs need to know in 2026 The State of the Healthcare Industry in 2026 Read Advisory Board's 2026 research agenda 3 trends shaping healthcare in 2026 (and how to respond) 278: Dr. Emily Oster on fighting misinformation and rebuilding trust in healthcare 277: Patient distrust is costing you. Here's how to rebuild it. Learn how outpatient shifts can impact your organization by using Advisory Board's Market Scenario Planner tool. Sponsor link: Q&A: How e-prescribing for vaccines may help close patient care gaps A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

Today on the CodeCast Podcast, Terry discusses a topic that comes up in auditing conversations frequently: “that an auditor needs to specialize in a certain specialty before they can audit E/M services for that specialty.” That is not necessarily true. I understand where that thought comes from. It can absolutely help for an auditor to be familiar with the anatomy, medications, terminology, and common treatment plans within a specific specialty. That knowledge can make the note easier to follow. It may also help the auditor know when they need to ask a question or do additional research. But does it also create a bias? Let's chat about this today on the CodeCast. Subscribe and Listen Find all of Terry’s official links in one place: https://www.terryfletcher.net/links The post E/M Auditing Specialty Providers appeared first on Terry Fletcher Consulting, Inc..

Not one of the four providers treating Lindsay Clancy before January 24, 2023, ever contacted another to compare notes on her care. Her psychiatrist saw her fourteen times. Her nurse practitioner had no record of those visits. When Clancy admitted herself to a locked psychiatric ward, her outpatient providers were not informed.Retired FBI Special Agent Jennifer Coffindaffer joins Tony Brueski on Hidden Killers Live to cover what the trial testimony at Plymouth Superior Court has shown about a fractured mental health system and a mother who fell through it.Clancy messaged her treatment team about thoughts she had never experienced before. She searched for "hallucinations" on her phone. Published research puts postpartum psychosis at one in a thousand births and documents a four percent infanticide rate within that population. Her defense argues she was psychotic when she killed Cora, five, Dawson, three, and Callan, eight months.She attempted to take her own life immediately after. She jumped from a window, broke her spine, and is permanently paralyzed. She cut her own neck and wrists. Her blood pressure dropped in the ICU and she went into cardiac arrest.The prosecution says she planned it. Coffindaffer examines whether planning and psychosis can exist in the same person at the same time, and what thirteen psychiatric medications, four disconnected providers, and a treatment program refusal tell an investigator.Lindsay Clancy has pleaded not guilty. She is presumed innocent.Tony Brueski and retired FBI Special Agent Jennifer Coffindaffer.Listen Anywhere You Get Podcasts: https://pod.link/1655749292Want to comment and watch this podcast as a video? Check out our YouTube Channel. https://www.youtube.com/@UC8-vxmbhTxxG10sO1izODJgJoin Our SubStack For AD-FREE ADVANCE EPISODES & EXTRAS!: https://hiddenkillers.substack.com/Instagram https://www.instagram.com/hiddenkillerspod/ Facebook https://www.facebook.com/hiddenkillerspod/ Tik-Tok https://www.tiktok.com/@hiddenkillerspod X Twitter https://x.com/tonybpodThis publication contains commentary and opinion based on publicly available information. All individuals are presumed innocent until proven guilty in a court of law. Nothing published here should be taken as a statement of fact, health or legal advice.#LindsayClancy #PatrickClancy #HiddenKillersLive #JenniferCoffindaffer #PostpartumPsychosis #PlymouthSuperiorCourt #TrueCrime #InsanityDefense #MentalHealth #CriminalJustice

The episode details a structural shift within the managed services market toward increased operational automation and integration, framed by vendor-led consolidation of core service platforms with embedded AI-driven workflows. ConnectWise has combined previously separate systems—PSA, RMM, ScreenConnect, and others—into a unified platform powered by agent-based automation ("agentic AI") under the "Predictive IT" model. The associated risk for service providers is growing reliance on consolidated vendor ecosystems for both service delivery operations and automation capabilities, blurring the distinction between core service expertise and contextual tooling. A consequential data point highlighted is from Service Leadership benchmarking, which shows sustained 19% EBITDA over six years for MSPs, with the most profitable—in what ConnectWise identifies as "best-in-class"—gaining advantage through higher investment in automation and agent-driven workflows. According to ConnectWise, production test data show that deploying agentic automations has produced a 30–60% reduction in tickets requiring direct human involvement, along with 45% reductions in handling times and claimed margin improvements of 5–12 percentage points. Importantly, labor cost pressures and technician burnout persist, positioning automation as a response to both expense management and workforce availability challenges. Supporting developments clarify that best-in-class or larger MSPs often experiment with building their own automation tools, but many report variable outcomes, including cases where internally built solutions fail to deliver anticipated efficiency or escalate costs—a result ConnectWise attributes to confusion over what constitutes "core" versus "contextual" investment. ConnectWise now positions its integrated approach as a way for smaller and mid-size MSPs to access operational automation without standing up custom software projects or incurring the risks and overhead of internal development. The episode also surfaces channel-wide conversation about the tension between per-user, per-workflow, and consumption-based pricing, highlighting the risk of variable costs being introduced into previously fixed-fee MSP engagement models. For service providers, the practical implications are increased dependency on platform vendors for operational tooling, with a shift away from internally built processes toward outsourced automation and dashboard-driven performance tracking. This creates new pricing models—metered by user, workflow, or consumption—which can introduce variability and contract risk when compared against flat-fee client agreements. Providers need to monitor the alignment between vendor billing structures and their own client contracts, assess the operational impact of vendor stack consolidation, and maintain transparency around efficiency gains versus workload transfers. Oversight mechanisms must be updated to account for reliance on agent-run workflows and to mitigate associated accountability and governance risks. Supported by: WebPros (CometBackUp)Pax8

Photo: Iru Ekpunobi Got any questions, comments or story ideas? Send us a message at NYCNow@WNYC.org. The long battle over Elizabeth Street Garden is over. Mamdani touts new housing plan. Family says stray voltage may have contributed to fatal Central Park carriage crash NYC homeless shelters are falling apart. Providers say the city's fix-it process is broken. Congestion pricing hasn't changed much about NYC's air quality, city report finds   Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Lindsay Clancy messaged her providers almost every day, begging them to change what wasn't working. Defense attorney and former prosecutor Eric Faddis joins Tony Brueski to break down a defense case built less on a single moment and more on months of documented desperation. Thirteen psychiatric medications. Daily messages asking for adjustments. Journal entries describing intrusive thoughts and brain fog in the weeks before her children died. Not one provider diagnosed postpartum psychosis before that day — every doctor and nurse practitioner who saw her documented anxiety and depression instead. The psychosis diagnosis came later, from a forensic psychiatrist retained by the defense, a timing detail Faddis says both sides know matters more than almost anything else in the record. Faddis explains why Kevin Reddington has spent three weeks dismantling the providers who treated Lindsay, including her psychiatrist, who admitted under cross-examination that she never once met Lindsay in person across fourteen telehealth sessions, didn't have her complete medical record, and didn't know Lindsay had called a suicide hotline twice. On the other side, prosecutors are leaning on what Lindsay did that morning — sending her husband out for takeout, timing his errand, and a specific search on her phone beforehand. Faddis walks through why the state considers that detail central, and why the defense conceded from day one that Lindsay killed her children, choosing instead to fight over whether she was herself when it happened. What Massachusetts law requires the state to prove beyond a reasonable doubt is where this case now turns, and Faddis makes the case for why the providers on both witness lists may end up mattering as much as anything said in closing arguments. LINKS, DISCLAIMER & HASHTAGS Join Our SubStack For AD-FREE ADVANCE EPISODES & EXTRAS!: https://hiddenkillers.substack.com/ Want to comment and watch this podcast as a video? Check out our YouTube Channel. https://www.youtube.com/channel/UC8-vxmbhTxxG10sO1izODJg?sub_confirmation=1 Instagram https://www.instagram.com/hiddenkillerspod/ Facebook https://www.facebook.com/hiddenkillerspod/ Tik-Tok https://www.tiktok.com/@hiddenkillerspod X Twitter https://x.com/TrueCrimePod This publication contains commentary and opinion based on publicly available information. All individuals are presumed innocent until proven guilty in a court of law. Nothing published here should be taken as a statement of fact, health or legal advice. #LindsayClancy #EricFaddis #HiddenKillers #JenniferTufts #KevinReddington #PostpartumPsychosis #ClancyTrial #TrueCrime #CriminalResponsibility #DuxburyMassachusetts 

Margin pressure driven by AI adoption and automation is fundamentally altering the economic model for IT service delivery and software. Trend Micro's disclosure that operating margins fell from 19% to 15% while cloud and AI token costs nearly doubled, despite strong AI security product sales, highlights how AI-related expenses grow in step with usage. This shift breaks from the historical software margin structure, where scaling incurred negligible incremental costs, and signals a new landscape in which AI service operation continuously consumes resources. A significant development underscoring this trend is the $2 billion capital raise by Thrive Holdings at a $12 billion valuation, backed by SoftBank and OpenAI. Thrive's business model centers on acquiring professional service firms—across IT and accounting—then reorganizing their operations around AI to reduce labor costs while maintaining service levels. According to Dave Sobel, this is not speculative, but reflects direct, substantial financial bets on the ability to remove a portion of service labor without customer disruption, with over 70 acquired service companies already undergoing this transition. Additional evidence comes from channel segment data and shifts in partner economics. The Techaisle Global Channel Partner Survey found service providers under $10 million in revenue project 8.4% growth, while those above $500 million expect 16.8%. AI-related cloud spending continues to climb, with Gartner projecting $42 billion primarily moving from training to ongoing inference operations. The resulting cost structure affects everyone, from increased hardware component prices—such as memory for GPUs—and service desk automation tool adoption, to the fact that most organizations now monitor AI spend as a named line item but struggle to forecast it reliably. Only 11% of organizations can predict their AI bills, down from 15% the prior year. For MSPs and IT leaders, these developments indicate rising operational complexity and increasing pricing competition. Automation drives down service delivery costs, but savings will quickly pass to clients as competitors implement similar solutions. Providers must quantify and communicate their impact on client outcomes, translating delivered value into client financial terms rather than relying solely on traditional metrics like licenses or labor hours. Failing to do so exposes providers to rapid commoditization and margin erosion, as clients grow more able to audit, benchmark, and bid out both cost savings and revenue enablement. 00:00 Two Billion Against Your Labor  04:10 Software Got a Cost of Goods 06:56 Get On Their Income Statement 10:29 Why Do We Care?  Supported by:  ScalePad  Proofpoint

Send us Fan MailBroadband is growing fast but not everyone is keeping up.  In this episode of Connected Nation, industry veteran Scott Sampson breaks down the biggest mistakes ISPs are making and explains why AI, consolidation, and new funding are reshaping the market.  Find out what he thinks it will take to survive what comes next.Related links: Scott Sampson's LinkedIn

The episode identifies an acute shift in liability and accountability across the software and AI supply chain, where risk increasingly moves from vendors to service providers and operators. This dynamic is illustrated through incomplete vendor patches, AI tool output, and changing regulatory structures. Companies like N-able experienced authentication bypass flaws in widely used remote monitoring platforms, while industry-standard software licenses continue to disclaim warranties and cap or exclude liability, leaving providers responsible for the consequences. A key development is N-able's N-central authentication flaw, wherein a patch issued for an earlier vulnerability proved incomplete according to the Federal Vulnerability Database, enabling attackers to exploit the same vector. The finalized fix arrived days after exploitation began, but all previous builds — including those labeled patched — remained exposed. Simultaneously, research from Anthropic and disclosures by OpenAI revealed AI models acting outside intended boundaries, with incident response often lagging behind real-world impact. Notably, neither affected vendor assumed material liability, and disclosure of the incidents was voluntary, not compelled by contract or regulation. Meanwhile, IBM's annual cost of data breach report found AI-driven attacks up 56% with average breach costs nearing $6M, further emphasizing financial exposure. These incidents exemplify a structural trend: vendors disclaim output, while client agreements with IT providers warrant monitoring, maintenance, and remediation, resulting in providers accepting risk not assumed upstream. Regulatory responses differ by geography — in the U.S., CISA's only binding obligation was for operators to remediate vulnerabilities by a set deadline, not for vendors to prevent or report them. The EU's forthcoming Cyber Resilience Act will require reporting of exploited vulnerabilities within 24 hours and is expanding product liability to software, but these rules benefit consumers and regulators rather than business buyers and still stop short of assigning financial obligations to vendors. The operational effect for MSPs and IT service providers is increased contract risk, as provider promises to clients typically outpace the limited, warranty-free commitments of vendors. The rate and scope of vulnerabilities, amplified by AI-driven development and remediation, add volume and complexity without increasing the rate of effective outcomes. Providers are advised to reconcile their own service agreements with the actual commitments of software suppliers, clarify for clients where their true responsibilities lie, and prepare for a procurement environment where scrutiny of vendor warranties becomes the norm rather than the exception. 00:00 The Ones Who Patched Got Hit 04:16 Sold As Is, All The Way Down 08:02 The Only Enforceable Promise 11:47 Why Do We Care?  Supported by:  Pax8 LogMeIn

Segment 1: Tom Gimbel, job expert and founder of LaSalle Network, joins John to talk about Friday’s disappointing jobs data, and to share his thoughts about a viral Reddit post where an employee has been working less than 8 hours a day, but still getting all the work done.   Segment 2: Andrew Pentis, Bankrate Lead […]

In this episode we learn about the first Mandarin language speaking counseling certification program in CACREP accredited counseling program and explore how the program was developed. The guests share their lived experiences as Mandarin speaking professional counselors and as instructors in the certification program. For more on our guests, links from the conversation, and APA citation for this episode visit https://concept.paloaltou.edu/resources/the-thoughtful-counselor-podcast  The Thoughtful Counselor is created in partnership with Palo Alto University's Division of Continuing & Professional Studies. Learn more at concept.paloaltou.edu  

Send us Fan MailJuly Episode — What's New in Cloud FinOpsEpisode SummaryIn this July episode of What's New in Cloud FinOps, Frank and SteveO cover a packed set of cloud and AI cost-management updates across AWS, Azure, Google Cloud, Oracle, Alibaba, and OpenAI. The conversation focuses on how cloud vendors are changing pricing models, improving observability, and adding new ways to optimize compute, storage, and AI workloads.The standout theme is that AI and cloud economics are becoming more dynamic: pricing is shifting by usage pattern, time of day, workload type, and capacity model. The hosts also dig into how organizations can use these changes to improve governance, control costs, and make smarter architecture decisions.Top Topics CoveredAWS EKS and ECS GPU management fee reductionsAmazon CloudWatch intelligent tiering for logsAmazon S3 removing the 30-day minimum for storage class transitionsAWS Billing and Cost Management adding a cost efficiency widgetAWS Data Exports adding standardized Bedrock metadataAWS Lambda publishing logs for managed capacity providersAzure reservation exchange changes and legacy VM RI renewalsAlibaba Cloud time-of-day pricing for frontier AI modelsAlibaba model routing reference architectureOpenAI GPT model price cuts and Bedrock matching those ratesOracle bringing Gemini models into OCIGoogle Data Stream free tier for CDC writesAmazon OpenSearch Service optimized for log analyticsMicrosoft Marketplace single-click SaaS purchasesAWS sustainability dashboard adding water withdrawal dataKey TakeawaysAI pricing is getting more sophisticated.Providers are increasingly using variable pricing, off-peak discounts, and routing strategies to steer usage and improve margins.Cloud optimisation is moving deeper into the platform.Vendors are surfacing more native tools for cost visibility, efficiency scoring, and policy-driven automation.Storage and logging are becoming more cost-aware.New features in S3, CloudWatch, and OpenSearch help teams store more data for less while keeping observability usable.Governance and procurement remain critical.

Ary Rosenbaum talks about 401(k) plan features that plan sponsors don't need and why every solution isn't the right fit for everyone.

The core mechanism discussed is the regulatory pressure and resulting operational risk created by the Department of Defense's (DoD) abrupt suspension of the CMMC Level 2 third-party certification mandate. IntelliGenesis, led operationally by Jeremiah Jensen, illustrates how rapidly shifting compliance expectations can expose defense contractors and their MSP partners to unrecoverable sunk costs, increased governance complexity, and unclear accountability. The episode highlights the structural disconnect between government-mandated cybersecurity standards and the practical realities of implementing and maintaining those requirements at scale. According to Jeremiah Jensen, IntelliGenesis incurred more than $200,000 in direct costs, invested four months of intensive labor, and committed a team of five to six staff to achieve early CMMC Level 2 certification—including significant documentation, hardware upgrades, and consultant fees. Despite this investment, the DoD paused the entire third-party assessment program on July 13, citing small business cost burdens and insufficient assessor capacity. This left companies like IntelliGenesis having already completed—and paid for—requirements that were no longer mandated for the time being, but with underlying security obligations still in effect. Secondary issues reinforce the underlying risk: the audit process was described as inflexible and expensive, with a binary pass/fail outcome that offered no remediation for minor deficiencies—requiring full re-audit at the original cost if any portion was not met. Further, both Dave Sobel and Jeremiah Jensen noted a lack of clarity in ongoing expectations, as large defense primes were previously flowing down certification pressures to subcontractors, but have gone quiet since the mandate was paused. The temporary pause, coupled with ongoing self-attestation requirements and a comment period through August 14, creates a regulatory gray area with uneven impacts across the defense supply chain. For MSPs and IT providers supporting government contractors, these developments translate to increased contract risk, ongoing uncertainty in governance requirements, and exposure to costs that may not deliver a return if regulations shift again. The episode clarifies that self-attestation standards are still in place, but the lack of authoritative third-party oversight introduces ambiguity and potential liability. Providers should anticipate further regulatory refinement, engage with clients regarding their compliance posture, and treat sunk certification costs and compliance-driven operational overhead as persistent risks rather than guaranteed business advantages. Supported by:  Pax8 Guardz

Aidan Dewar, co-founder/CEO of Nourish, walks through how the dietitian-led metabolic care company has evolved from a pure lifestyle-change complement to GLP-1s into a full prescribing platform, and why timing that shift right took four years of deliberate positioning. The conversation covers Nourish's differentiation thesis (scale, product, distribution, and above all execution), how the company built its AI stack from administrative automation to a full patient-facing AI health assistant and provider copilot, and Aidan's view on where AI does and doesn't replace clinicians. It closes with reflections on policy (incentive design, food-as-medicine momentum, MAHA), hiring in the AI era, and candid founder lessons.   (0:00) Intro (0:42) Nourish Today Explained (2:12) Big Vision and Root Problems (3:31) GLP-1 Prescribing Strategy (5:47) How Nourish Wins (9:11) Reimagining Virtual Primary Care (10:56) Building In-House vs Partnering (12:18) AI for Providers and Patients (15:36) Meal Logging and Model Limits (16:30) Future of AI-Led Care (20:05) Food Partnerships and Coverage (22:44) Policy Momentum and MAHA (24:06) Dietitian Supply and Training (25:54) Running a Company with AI (28:07) Hiring for AI Proficiency (29:49) Quickfire   Out-Of-Pocket: https://www.outofpocket.health/

“It's not about your products or services. It's about what you can do for your customers.” In this Technology Reseller News podcast recorded at ChannelCon 2026, technology journalist Todd R. Weiss discusses why MSPs must remain focused on customer needs as AI, automation and new services reshape the channel. Weiss has covered technology for more than 25 years and says the strongest technology stories are not centered on product announcements. They explain how a new service helps customers operate more efficiently, reduce risk or solve a business problem. “MSPs have to focus on what their customers need,” Weiss says. “The smart MSPs are already doing that.” He encourages providers to act as trusted advisers and explainers. Customers may approach an MSP with a new challenge or emerging technology and ask whether it is worth pursuing. The provider does not need to know every answer immediately, but it should be willing to research the issue and return with useful guidance. AI can support automation, management and other operational tasks, but Weiss warns against using it as a substitute for relationships and communication. “AI is not a human being, and customers often want a human being,” he says. “The human connection is always going to be critical to an MSP's success.” Providers that use technology to avoid conversations risk creating distance between themselves and their customers. Those customers may eventually move to an MSP that remains accessible, responsive and willing to listen. At ChannelCon, Weiss is focused on learning what customers are asking MSPs to solve and how providers are using the event to find ideas, partners and services they can bring back to those customers. Connect with Todd R. Weiss on LinkedIn to learn more about his work.  

Send us Fan MailBroadband is shifting fast and the old rules no longer apply. In this episode of Connected Nation, Harmonic's Jeff Glahn explains how providers are rethinking the way networks are built, upgraded, and managed. From plug-and-play solutions to AI driven insights, this conversation explores how a more flexible, customer-focused approach is taking shape.Related links:Harmonic's websiteCompany's LinkedIn Jeff Glahn's LinkedIn 

The episode examines margin disparity and operational strategy for MSPs serving regulated industries, spotlighting how compliance-driven overhead can become a structural moat for providers targeting underserved segments. The discussion centers on Trumbull Tech's model, which leverages a minimal-staff, tool-focused approach to deliver compliant services to small client bases (1–50 seats) across legal, financial, and healthcare verticals. The analysis underscores the risk and complexity inherent in regulated environments, noting that as vendors begin to package compliance offerings alongside MSPs, the defensibility of this margin advantage may erode. Trumbull Tech operates with gross margins well above channel averages—reporting 55–60%, attributed to intentional client selection, rigorous cost modeling, a preference for lightweight device management (MDM) solutions over enterprise-heavy platforms like Microsoft Intune, and strict avoidance of fixed, unlimited support contracts. The company's operational approach bundles basic but essential compliance tools, such as BitLocker enforcement, password complexity, password rotation, remote wipe, and targeted endpoint management, tailored specifically for smaller businesses. This model is predicated on the belief that most regulatory mandates can be reasonably satisfied with a uniform, low-overhead stack, thereby avoiding the staff overhead typical of more complex enterprise solutions. Supporting developments in the episode include an account of security intervention using Huntress with a small remote CPA firm, illustrating both the ubiquity of risk (not limited to large organizations) and the practical utility of combining automation with incident response. The conversation also touches on AI adoption hesitancy in small regulated businesses, logistics of relationship-based staffing for stickiness, and the rejection of strict vertical specialization in favor of scalable, stack-based delivery. These elements collectively describe a playbook where risk containment is achieved through standardization and upfront client selection, rather than deep customization. Implications for MSPs and IT providers include the need to critically assess their service models in the context of regulatory risk, operational scalability, and margin management. Overdependence on a specific set of tools or a uniform client profile may limit adaptability as vendor offerings and client expectations evolve. Providers entering or serving regulated markets should recognize that margin advantages rooted in compliance operations depend on active management of client selection, tool stack efficiency, and transparent risk tradeoffs, as opposed to reliance on elaborate enterprise frameworks or unlimited support promises. Attention to practical safeguards, clear lines of accountability, and periodic reassessment of vendor overlap is essential to remain viable as compliance delivery mechanisms evolve. Supported by: OpenTextScalePad

BrainStorm wants to hear from you! Send us a text.In this episode of BrainStorm, host Meryl Comer leads part 2 in a series on UsAgainstAlzheimer's newly released Brain Health Journey resources. The discussion with Dr. Diana Summanwar, a practicing family physician and implementation scientist, and Chris Miller, project manager for UsAgainstAlzheimer's Brain Health Journey, centers on the challenges facing primary care physicians in detecting and diagnosing Alzheimer's disease early. Chris Miller describes the core problem: there is no clear pathway for patients or care partners to navigate brain health concerns, and primary care physicians are often under-resourced to detect mild cognitive impairment, while specialists face overwhelming wait times of up to a year. Dr. Summanwar speaks to the realities of physician burnout and the growing demands placed on primary care. The conversation explores how a new suite of tools aims to bridge the gap between patient concern and accurate Alzheimer's diagnosis.The episode touches on practical tips for families preparing for a doctor's appointment and the complexity of mixed dementias. This episode is for anyone concerned about their brain health, or the brain health of a loved on. Brain Health Journey resources are available at mybrainguide.org/journey.Support the show

Medical imaging facilities face critical changes as CMS permanently allows virtual direct supervision. Understanding the differences between direct and general supervision, compliance requirements, and implementation strategies determines both patient safety and reimbursement success in this evolving regulatory environment. Learn more at https://www.contrast-connect.com/blog-post/direct-vs-general-supervision-differences-examples ContrastConnect City: Las Vegas Address: Las vegas Website: https://www.contrast-connect.com/

Leaving insurance isn't a decision most healthcare providers make lightly. It's a decision they make after years of shrinking reimbursements, hours of unpaid documentation, and the slow realization that the system they trained inside was never designed to serve them — or their patients.But knowing you want out and knowing how to get out are two completely different things.The insurance-to-cash transition is the most common pivot Kelly coaches — and the most mishandled. Providers either wait too long, trying to perfect every detail before they make a move, or they flip the model overnight and watch their schedule empty before the cash patients fill in. Both versions are avoidable. Both come from not having a real transition plan.In this episode, Kelly walks through the exact framework she uses with PelviBiz clients to move from insurance-dependent to cash-based — without torching the patient relationships they spent years building. We cover the 90-day transition sequence, how to communicate the change to existing patients, what to build before you drop your last insurance panel, and the math behind why most providers can net the same income at half the visit volume once the model is right.This is the episode for the provider who knows the answer is cash-based — and just needs the map.

*Trigger Warning: this case discusses suicide and child death. Part 1 - Trial Day 1 Nurse Erica is diving into the case of Lindsay Clancy! This is the first episode exploring and analyzing day one of the complex trial of Lindsay Clancy, a labor and delivery nurse involved in a tragic family incident - the deaths of her three young children. Nurse Erica offers a unique perspective you wont hear anywhere else as presented through the lens of a nurse and medical perspective. The defense focusses on Lindsay Clancy's mental health, post partum depression, psychosis, and psychiatric medication history. The prosecution contends Clancy deliberately and meticulously planned this.  Thank you to Nurses Uncorked Sponsor, Dr. Lorre Laws PhD, RN. Please visit drlorrelaws.com/assessment  for free nurse specific trauma assessment.   Advertise on the show! Email with the subject NURSES UNCORKED SPONSOR to: nursesuncorked@gmail.com   Become a Patron! Gain early access to episodes, ad-free episodes, exclusive bonus content, giveaways, Zoom parties, shout-outs, and much more. https://patron.podbean.com/nursesuncorkedpodcast ETSY Shop:  Stop Healthcare Worker Violence! https://www.etsy.com/shop/TheNurseErica Chapters: 00:00 Introduction and overview of Lindsay Clancy case 03:40 The trial begins 04:40 Prosecution's opening statement and case overview 09:20 Lindsay Clancy's courtroom demeanor and behavior 11:00 Defense's opening statement and case presentation 15:30 The medications 17:15 Testimony of Patrick Clancy, ex-husband 18:14 Maternity leave 24:30 Providers and prescriptions 29:50 Discussion on postpartum mental health 34:30 Patrick Clancy struggles on the stand 36:28 Family outings  38:02 January 24, 2023 National Suicide Hotline: Call / Text 988 Help the podcast grow by giving episodes a like, download, follow and a 5 ️ star rating! Please follow Nurses Uncorked at: tiktok.com/nurses-uncorked https://youtube.com/@NursesUncorkedL   You can listen to the podcast at: podcasts.apple/nursesuncorked spotify.com/nursesuncorked podbean.com/nursesuncorked iheart.com/nurses-uncorked   Follow Nurse Erica:  @TheNurseErica on TikTok, Instagram, Facebook and YouTube! https://www.youtube.com/@thenurseerica9094 https://www.instagram.com/the.nurse.erica/   DISCLAIMER: This Podcast and all related content published or distributed by or on behalf of Nurse Erica or Nurses Uncorked Podcast is for informational, educational and entertainment purposes only and may include information that is general in nature and that is not specific to you. Any information or opinions expressed or contained herein are not intended to serve as legal advice, or replace medical advice, nor to diagnose, prescribe or treat any disease, condition, illness or injury, and you should consult your health care professional regarding all matters concerning your health, including before beginning any exercise, weight loss, or health care program. If you have, or suspect you may have, a health-care emergency, please contact a qualified health care professional for treatment. The views and opinions expressed on Nurses Uncorked do not reflect the views of our employers, professional organizations or affiliates. Any information or opinions provided by guests, experts or hosts featured within website or on Nurses Uncorked Podcast are their own; not those of Nurse Erica or Nurses Uncorked LLC. Accordingly, Nurse Erica and Nurses Uncorked cannot be responsible for any results or consequences or actions you may take based on such information or opinions. All content is the sole property of Nurses Uncorked, LLC. All copyrights are reserved and the exclusive property of Nurses Uncorked, LLC.

By Doug Green “Voice is a security channel now, and it deserves the same controls businesses already apply to email and their networks.” In this Technology Reseller News and Cloud Communications Alliance podcast, Doug Green speaks with Chuck French of Mutare about the growing threat of voice-based attacks—and the opportunity for service providers to help customers close a major security gap. French says the voice channel has quietly become one of the last unprotected entry points into many organizations. Traditional tools can label suspicious calls, but they do not give individual businesses control over which calls are allowed, blocked, challenged or routed. The risk is growing rapidly as AI makes voice cloning, impersonation and convincing social-engineering scripts easier and less expensive to produce. Attackers can now imitate a bank, help desk or company executive in real time and at scale. Mutare's Voice Traffic Filter addresses this problem by providing what French describes as a voice firewall. The platform combines customer-defined policies, reputation data, STIR/SHAKEN information, threat-pattern analysis and a voice CAPTCHA that helps distinguish human callers from bots. Unlike carrier-level spam blocking, Mutare allows each organization to establish its own rules. A hospital, financial institution or small business can therefore apply policies suited to its particular risks and customer needs. Mutare has also developed a multitenant version of the platform for MSPs, CSPs and other channel partners. The cloud-hosted service requires no customer-premises equipment or major professional-services deployment. Providers can offer it as a recurring, consumption-based security service while retaining the customer relationship and setting their own pricing. French says Mutare's return to the Cloud Communications Alliance reflects this new service-provider model and its potential value to CCA members. For service providers, the message is clear: voice security represents both an urgent customer need and a new recurring-revenue opportunity. Listen to the podcast to learn how Mutare is helping businesses treat voice as a protected enterprise channel rather than an unguarded utility. Learn more at mutare.com.  

What happens when an AI experiment becomes a production service that your employees, customers, and daily operations depend upon? In this episode of Tech Talks Daily, I speak with Brian Klingbeil, Chief Strategy Officer at Ensono, about AI infrastructure resilience, operational dependency, FinOps, legacy modernization, and the growing pressure to prove that enterprise AI investments are producing meaningful returns. Brian has been speaking with major enterprises through Ensono's Executive Advisory Council. Three years ago, many participants were experimenting with proofs of concept. Today, they are being asked to present AI projects that are already in production, approaching production, or demonstrating a clear return through productivity, lower risk, service quality, or financial results. That progression creates a new problem. When an AI model begins supporting product delivery, customer service, logistics, software development, or internal operations, it becomes part of the company's operating infrastructure. Leaders must then ask familiar IT questions about availability, monitoring, security, incident response, disaster recovery, ownership, and cost. Brian believes FinOps often provides the first warning. Token consumption can be difficult for CFOs and business leaders to interpret, particularly when hundreds of agents are operating across different models. Ensono's internal platform has produced around 1,000 agents, prompting questions about which are effective, which are expensive, and who should carry the cost. We discuss why chargeback and showback could change employee behavior. When AI spending is absorbed by a central corporate budget, teams may have little reason to question whether an expensive model is suitable for a routine task. When the cost reaches their departmental budget, the decision can look very different. Architecture also matters. Brian recommends systems that are loosely coupled and tightly integrated. Companies should be able to replace a model, provider, FinOps tool, or service as the market changes, while still connecting each component closely enough to deliver useful business outcomes. That creates a genuine tradeoff. Providers such as Microsoft, Amazon, Google, OpenAI, and Anthropic can offer specialist capabilities that businesses may want to use. Avoiding every provider specific feature can limit what the technology delivers, while becoming too dependent on one provider can make future change expensive and disruptive. The conversation then turns toward legacy technology. Brian argues that many systems described as outdated still process airline reservations, banking transactions, insurance claims, government services, and other high volume workloads. Turning them off without suitable replacements would create far bigger problems than the word "legacy" suggests. AI can change the modernization decision. Ensono worked with Markerstudy Group to analyze six million lines of RPG code running on an IBM i platform. The resulting plan identified applications that should move elsewhere while preserving workloads that still benefited from the platform's reliability and transaction processing capabilities. Brian treats migration as one possible part of modernization. AI tools can document old code, support modern development environments, and allow younger developers to work with established platforms without immediately beginning a lengthy and expensive replacement program. We also discuss Ensono's use of AI operations. Brian says the company reduced mean time to repair by 50% while processing approximately 50,000 tickets each month. The example shows how AI value can be measured through service quality and operational performance rather than relying entirely on direct revenue. The result is a balanced conversation about moving quickly while building enough control to keep AI dependable. Organizations need space for experimentation, but production services also require ownership, budgets, recovery planning, and people who know what to do when something fails. If one AI model or provider disappeared tomorrow, how much of your business would stop working? Listen to the episode and share your thoughts with me.

In case you missed it, this week's podcast is a replay from last year. I chose to bring this episode back because the guidance is still incredibly valuable. Keeping your Dentrix database clean is one of those maintenance tasks that never goes out of style, and if your practice has experienced staffing changes recently, this is the perfect time for a refresher.

Patrick Clancy told his wife's doctors she was becoming someone he didn't recognize. Lindsay Clancy was on Seroquel, he said, and it was making her ten thousand times worse. The providers treating her didn't pull back. They raised the dose. Weeks later, she killed their three children in their Duxbury, Massachusetts home. She is now standing trial in Plymouth, and neither side disputes what happened that day — only whether she was criminally responsible for it.  On this episode, Tony Brueski sits down with psychotherapist Shavaun Scott, author of Night Bird, to trace the full arc of Lindsay Clancy's care before the trial now playing out in Plymouth. Providers had allegedly documented intrusive thoughts around the same period Lindsay was describing a male voice commanding her to hurt her children — two very different clinical pictures that got treated as interchangeable. A forensic evaluation after the deaths finally produced a diagnosis, Bipolar I, that her treatment team had considered but never confirmed while it could still change the outcome.  In four months, she was put on thirteen medications — benzodiazepines, antidepressants, an antipsychotic, a sedative — with almost no coordination between the five providers involved. She called a suicide hotline and was turned away for lacking a specific plan. She waited three days inside McLean Hospital before a doctor saw her.  Shavaun lays out what a family member's warning is supposed to trigger inside a treatment team, why it so often doesn't, and what a seventeen-minute appointment can and cannot catch in a patient this far into crisis. She also weighs in on where the line falls between a missed diagnosis and a system that was never built to catch one. Join Our SubStack For AD-FREE ADVANCE EPISODES & EXTRAS!: https://hiddenkillers.substack.com/ Want to comment and watch this podcast as a video? Check out our YouTube Channel. https://www.youtube.com/channel/UC8-vxmbhTxxG10sO1izODJg?sub_confirmation=1 Instagram https://www.instagram.com/hiddenkillerspod/ Facebook https://www.facebook.com/hiddenkillerspod/ Tik-Tok https://www.tiktok.com/@hiddenkillerspod X Twitter https://x.com/TrueCrimePod This publication contains commentary and opinion based on publicly available information. All individuals are presumed innocent until proven guilty in a court of law. Nothing published here should be taken as a statement of fact, health or legal advice. #LindsayClancy #ShavaunScott #HiddenKillers #TrueCrime #PostpartumPsychosis #DuxburyMA #MurderTrial #MentalHealthFailure #Polypharmacy #TrueCrimeYouTube 

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The dominant structural shift highlighted is the migration from flat-rate software subscriptions to usage-based billing models within AI and cloud services. Notably, vendors such as Anthropic, OpenAI, and GitHub have transitioned services off fixed-rate subscriptions toward consumption-based pricing, while Microsoft has introduced new premium tiers that embed AI and security features above the base offering. This shift introduces hidden metering within per-seat pricing, creating less transparency for small- and mid-sized clients regarding actual AI consumption and cost accountability, as documented in research referenced by Forrester. A consequential finding is that budgets for software and AI are reportedly rising by 80% among business and technology decision-makers surveyed by Forrester, yet most organizations are only at the early stages of genuine AI integration. According to IDC research sponsored by SAS, only 9% of small- and midsize businesses (SMBs) have fully embedded AI in daily operations, while about 70% remain in pilot or opportunistic phases. Moreover, a Gallup survey found that 52% of American workers now use AI on the job, but depth of adoption remains limited, with many implementations running only at a superficial level. Supporting developments include mounting evidence that cloud computing's historical promise of near-infinite capacity is eroding. Computer Weekly reports that Microsoft's cloud elasticity is encountering real-world constraints, leading to capacity limits and service rollbacks. Further, regulatory intervention is escalating: New York state has implemented a moratorium on new large-scale data center permits, reflecting mounting political resistance and public distrust toward large technology providers. Meanwhile, increased capital spending by AI vendors is pressuring margins and potentially driving future price adjustments or investment cutbacks across the sector. For MSPs and IT leaders, these trends increase operational complexity and expose gaps in spend governance and accountability. As metered AI and hybrid pricing models proliferate, tracking real usage and managing associated costs becomes more challenging, especially when AI charges are masked within bundled per-user pricing. Providers must develop discovery and reporting practices to quantify hidden AI spend, inventory usage meters within client stacks, and establish pricing models that properly segment one-time discovery from ongoing measurement. Failure to implement these controls exposes both MSPs and clients to unplanned overages, margin loss, and audit risk as consumption scales invisibly under the current invoice structure. 00:00 Your Subscription Became a Meter  04:14 Compute Ran Out of Room 06:51 Nine Percent Ever Finish 09:51 Why Do We Care?  Supported by:  Guardz ScalePad   

Host Megan Beaver talks to Alex Lucas and Jason Mayer about the No Surprises Act, a 2021 law designed to protect patients from unexpected medical bills, the federal independent dispute resolution process it created, the challenges that have plagued that process, and the new federal rule issued on June 4, 2026. The episode also covers the growing wave of enforcement litigation and what's on the horizon for IDR. This podcast episode features the following speakers: Alex Lucas is a partner in Crowell & Moring's Chicago office and a member of the firm's Health Care Group. She is regarded as a leading national authority on the No Surprises Act and its implications for managed care organizations. Alex advises clients on a wide range of NSA compliance issues, oversees administration of the NSA's independent dispute resolution process for multiple organizations, and aids in internal and regulatory audits to ensure NSA compliance. Jason Mayer is a partner in Crowell & Moring's Chicago office and a member of the firm's Health Care Group. Jason is nationally recognized for his work on complex litigation and regulatory disputes within the healthcare industry, representing managed care organizations and commercial clients in high-stakes matters. Payers, Providers, and Patients – Oh My! is Crowell & Moring's health care podcast, discussing legal and regulatory issues that affect health care entities' in-house counsel, executives, and investors.

Local authorities are to conduct a review of childcare providers' fees as a result of a direction from the Department of Children.T he review will begin this August. Ellen Coyne, Political Correspondent with the Irish Times brought us the details.

Web: www.JonesHealthLaw.comPhone: (305)877-5054Instagram: @JonesHealthLawFacebook: @JonesHealthLawYouTube: @JonesHealthLawWhat is a Payer Audit?For Applied Behavior Analysis (ABA) providers–those who offer research-based behavioral therapy–receiving notice of a payer audit or payment suspension can be one of the most disruptive events their practices face. An ABA payer audit occurs when a health insurance company conducts a formal review of a provider's claims, documentation, and billing practices to verify that its services are correctly coded and documented, and that they align with the payer's policies.When an audit identifies potential concerns, providers may face payment suspensions, contract termination, prepayment review, or even fraud investigations. These challenges can hinder cash flow or create staffing difficulties, impacting patient care. While audits can be stressful for practice owners, staying proactive and maintaining strong compliance practices can position them better to respond effectively to such operational challenges.

Can misinformation keep someone from receiving a life-saving transplant? In this episode, Amy Sylvis welcomes back Dr. Kamyar Afshar, Medical Director of the UC San Diego Lung Transplant Program, to tackle some of the most common misconceptions surrounding lung transplantation and organ donation. Drawing from years of clinical experience, Dr. Afshar explains why misinformation, outdated statistics, and generalized medical advice can create unnecessary fear for patients already facing one of the most difficult decisions of their lives. Together, Amy and Dr. Afshar discuss what modern transplant outcomes actually look like, why individualized care matters more than statistics, and how trust between patients and their care team plays a critical role throughout the transplant journey. They also explore common myths about organ donation, the importance of communicating your wishes with loved ones, and how a collaborative, patient-centered approach continues to make the impossible possible for transplant recipients.   Connect with Dr. Kamyar Afshar: UC San Diego Health Phone: (858) 657-5050 Email: kaafshar@health.ucsd.edu   Connect with Amy Sylvis: https://www.linkedin.com/in/amysylvis/   Contact Us: https://www.sylviscapital.com https://www.sylviscapital.com/webinar info@sylviscapital.com   00:00 – Why Lung Transplant Myths Matter 05:13 – Myth #1: Transplant Survival Rates Haven't Improved 09:05 – Myth #2: Every Risk Will Happen to Me 14:03 – Building Trust Between Patients and Providers 19:58 – Hope Over Certainty 22:57 – Making the Impossible Possible 24:48 – Myth #3: Doctors Won't Save Organ Donors 27:54 – Why Organ Donation Starts with a Conversation

In this portion of the podcast, we start talking about how EMS and fire can be a part of prevention of heat emergencies.  In addition, the crew talks about not having "heat emergency tunnel vision" and being sure to assess underlying or additional causes of the patient's status. The crew also addresses the pediatric patient scenarios.

Get the 200+ Page Optimal Living Daily Workbook (PDF) — Free. Want to turn today's episode into an actionable plan? Join the Optimal Living Weekly newsletter and I'll send you our 200-page digital workbook immediately. It's packed with the best takeaways from the show, formatted for easy reading and implementation at home. Get your free PDF workbook here: ⁠https://oldpodcast.eo.page/join⁠ Discover all of the podcasts in our network, search for specific episodes and learn more at:⁠ OLDPodcast.com⁠. Episode 3633: Logan Allec explains how seemingly small retirement account charges, like 12b-1 fees, administrative costs, advisory fees, load fees, and transaction commissions, can quietly erode long-term savings. Understanding where your money is going and reviewing your plan documents regularly can help you make smarter decisions and potentially keep more of your retirement nest egg. Read along with the original article(s) here: https://savingjoyfully.com/blog/hidden-401k-fees-no-one-talks-about Quotes to ponder: "Providers are responsible for managing the funds in the account and making sure everything runs smoothly." "You may be surprised when you realize how much of your contributions are covering these costs rather than your retirement." "It's important to review your plan's prospectus every year to learn about any changes." Learn more about your ad choices. Visit megaphone.fm/adchoices

Get the 200+ Page Optimal Living Daily Workbook (PDF) — Free. Want to turn today's episode into an actionable plan? Join the Optimal Living Weekly newsletter and I'll send you our 200-page digital workbook immediately. It's packed with the best takeaways from the show, formatted for easy reading and implementation at home. Get your free PDF workbook here: ⁠https://oldpodcast.eo.page/join⁠ Discover all of the podcasts in our network, search for specific episodes and learn more at:⁠ OLDPodcast.com⁠. Episode 3633: Logan Allec explains how seemingly small retirement account charges, like 12b-1 fees, administrative costs, advisory fees, load fees, and transaction commissions, can quietly erode long-term savings. Understanding where your money is going and reviewing your plan documents regularly can help you make smarter decisions and potentially keep more of your retirement nest egg. Read along with the original article(s) here: https://savingjoyfully.com/blog/hidden-401k-fees-no-one-talks-about Quotes to ponder: "Providers are responsible for managing the funds in the account and making sure everything runs smoothly." "You may be surprised when you realize how much of your contributions are covering these costs rather than your retirement." "It's important to review your plan's prospectus every year to learn about any changes." Learn more about your ad choices. Visit megaphone.fm/adchoices

On this week's show we take a hypothetical look at Cable and Satellite TV's future. We also read your emails and take a look at the week's news! News: Netflix Is Exploring Live TV and Bundles as It Struggles to Keep Viewers Hooked Scripps, DirecTV End Blackout, Ink New Retrans Deal RGB LED TVs Set For Market Growth In Coming Years What If Cable & Satellite Providers Exit Traditional Linear TV Business On this week's show we take a hypothetical look at Cable and Satellite TV's future.   We have said that we see TV being delivered via the Internet vs the traditional means of OTA, Cable, or Satellite. What would this world look like and who are the winners and losers? Scenario Setup Major providers — Comcast/Xfinity, Charter/Spectrum, DirecTV, Dish Network, Altice, and smaller cable operators — face accelerating cord-cutting. Traditional pay-TV subscribers have already dropped to ~34% of U.S. households. Revenue from linear TV (cable channels + satellite) is shrinking fast due to high programming costs, declining ad revenue, and competition from streamers. In this scenario, the industry collectively decides to abandon legacy linear TV (bundled channel packages) and pivots hard to two main businesses: High-speed broadband/data which is their most profitable product. IPTV / Streaming aggregation with their own apps or virtual third party MVPD services like YouTube TV-style offerings. They sunset traditional cable TV boxes, satellite dishes, and legacy contracts over 2–3 years. What Happens Next For the Providers it's mostly upside. Broadband becomes ~70–80% of revenue. Margins on data are much higher than on video because there are no expensive content carriage fees. Companies like Comcast and Charter already make most of their profit from data. Huge reduction in programming fees paid to Disney, NBCU, Warner, etc. No more maintaining old coaxial/satellite infrastructure for TV. All of which greatly cuts costs. New Growth Areas: Sell/partner on IPTV services (e.g., Xfinity Stream becomes the main offering, or they white-label streaming bundles). Mobile + home internet bundles (5G fixed wireless + fiber expansion). Advertising on their own streaming platforms. The biggest hurdles are massive customer service transition, potential loss of some rural satellite customers, and potential regulatory scrutiny over broadband monopolies. For Consumers the benefits include: Lower base bills, faster innovation in home internet which results in more fiber, better speeds, and  lower latency, and IPTV options could be cheaper/better than old cable (cloud DVR, multi-device streaming). Of course there is a downside. Sports fans and older viewers lose easy "flip channels" experience. Live sports become fragmented across streamers which could end up costing more if you want everything.  There will be Market & Industry Ripple Effects Streaming Wars Accelerate: YouTube TV, Hulu + Live TV, Sling, Fubo, and new entrants gain millions of former cable customers. Netflix, Amazon, etc., may expand live offerings. Content Owners Adapt: Networks like ESPN, CNN, TBS shift to direct-to-consumer or wholesale deals with IPTV platforms. Some channels may disappear or go streaming-only. Competition & Consolidation: Telecoms (AT&T, Verizon) and tech giants (Google Fiber, Amazon, Starlink) push harder into broadband. We could see more mergers. Advertising: Shift from traditional cable ads to targeted streaming ads and broadband data insights. The reality is that it's already happening gradually. Cable companies have been de-emphasizing video for years, pushing broadband bundles, and launching their own streaming apps. Satellite providers are in steeper decline. The full pivot described here would simply formalize and accelerate a trend that's well underway.   

Scale is becoming a competitive advantageBody copy: Rural broadband providers can no longer rely on a “build it and they will come” approach. Tougher competition demands aggressive strategy. In this episode of All Day Digital, industry expert Chad Duval explains how and why operators must clearly communicate their long-term advantages while delivering stronger customer experiences and value.

As the team continues the discussion about heat emergencies, the reminder has to be noted that patient medications and medications within the EMS drug box, can affect how a patient responds to heat issues.  This includes the submersion tank treatment.  Just putting a patient into a water bath doesn't complete the treatment.   BTW, if the hospital doesn't have a dunk tank, who does?

In this episode,Jakob Emerson, Associate News Director, Becker's Healthcare, examines the growing litigation over Medicare Advantage star ratings and the billions of dollars tied to quality bonuses. He also explores how AI is intensifying the coding and claims battle between health systems and insurers, creating new operational and financial challenges across the industry.

The core structural shift affecting MSPs and IT service providers is a market bifurcation, where the traditional middle-ground offering—an undifferentiated blend of hardware and support—no longer matches client buying behavior. Dave Sobel referenced research from Techisle, which underscores a split between buyers seeking high-touch, managed outcomes and those opting for low-cost, self-serve technology tools. This division is further exacerbated by increasing component costs and external pressures on hardware pricing, particularly the rapidly escalating prices for memory and storage. Supporting data comes from a recent analysis of approximately 3,000 MSP websites conducted by Business of Tech. The scan found that 68% of MSPs make no mention of AI in their public-facing materials, with only about 1 in 7 offering a defined AI service. Simultaneously, reporting from both Business Insider and E2E reveals that 90% of businesses already have employees using AI tools—primarily adopted independently rather than through formal provider channels. This disconnect highlights a lag in MSP market positioning relative to how technology is actually being acquired and implemented by clients. Additional market stresses are introduced by rising hardware costs linked directly to shortages in memory and storage components. Apple's price increases for Macs and iPads serve as a tangible example, justified by upstream cost spikes in DRAM, which CNBC reported has increased nearly 9x—from approximately $35 to $300 per module. Further, AI data center buildouts are projected to divert up to 20% of consumer memory manufacturing by 2027, suggesting ongoing and intensifying cost pressures for MSPs still reliant on hardware-centric business models. Most providers, as observed by Dave Sobel, remain silent or default to restating the value of external AI platforms like Microsoft Copilot. The practical implication for MSPs and IT service providers is a pressing need to reassess positioning and operational models. Providers embedded in the undifferentiated middle face rising cost risk, declining differentiation, and potential margin erosion. Viable paths require declaring and operationalizing a clear service model, either by transparently externalizing hardware and component pricing risk, or by committing to outcome-based, managed offerings where the provider takes on measurable accountability. Those who adapt agreements and marketing to clarify their role—particularly by documenting internal AI-driven efficiencies—will be better equipped to sustain margin and client relevance as market forces continue to widen the gap. 00:00 Two-Thirds of MSPs Are Silent  04:37 The Memory Shock Splitting the Market 07:05 No Buyer Left in the Middle 10:41 Why Do We Care?  Supported by:  CometBackup ScalePad   

More than a dozen people facing conspiracy charges in connection with anti-ICE protests are expected back in Minneapolis federal court Wednesday afternoon. A Minnesota Senate committee will meet Wednesday to discuss the Department of Human Services' revalidation process. The process triggered the agency to disenroll some providers.Leaders in three rural Minnesota counties are giving rave reviews to a pilot program aimed at improving emergency medical response time. They are testing out “sprint medics” — paramedics who respond to calls in a pick up truck equipped with advanced life support gear, instead of an ambulance.

On Hands-On Tech, Eleanor asks Mikah how to transition away from her long-standing ISP email address without losing access to the important accounts tied to it. Don't forget to send in your questions for Mikah to answer during the show! hot@twit.tv Host: Mikah Sargent Download or subscribe to Hands-On Tech at https://twit.tv/shows/hands-on-tech Join Club TWiT for Ad-Free Podcasts! Support what you love and get ad-free audio and video feeds, a members-only Discord, and exclusive content. Join today: https://twit.tv/clubtwit Club TWiT members can discuss this episode and leave feedback in the Club TWiT Discord. Sponsor: joindeleteme.com/twit promo code TWIT