On July 2, CMS dropped the CY 2027 outpatient payment proposed rule. It's a fat, sleepy document that most people will skim and forget. Buried in it is one line that should make every health system CFO put down their coffee. CMS wants to keep expanding site-neutral payment, and this year it goes after imaging without contrast done in hospital-owned outpatient departments. Same scan, same machine,

CMS put out its 2026 participation numbers and the value-based crowd took a victory lap. 511 ACOs in the Medicare Shared Savings Program now. 12.6 million people in traditional Medicare attributed to them. The largest the program has ever been, up from 476 ACOs the year before. Add the most recent reconciled results on top of it, where ACOs earned around $4.1 billion in shared savings and saved Me

Becker's ran a snapshot this week. Around 50 US health systems are now running clinical AI at enterprise scale. CommonSpirit alone reportedly sits on something like 250 active AI tools across its hospitals and claims north of $100 million in annual value. Big numbers. Big press releases. Every system wants to be on the list, and most of the people on those panels sound like they already won.

Then start moving work down a level and out of the building, deliberately, one pathway at a time. You'll keep more nurses than any retention bonus will ever buy you.The systems that win the next five years won't be the ones who recruited hardest. They'll be the ones who figured out their best nurses were never the constraint. The way they used them was.‍

Twenty-one health systems have terminated Medicare Advantage contracts so far in 2026. Mayo Clinic, Mount Sinai, UNC Health, Memorial Hermann, BayCare, Providence. NewYork-Presbyterian and UnitedHealthcare went out of network on May 1 with no new agreement in place. About 2.9 million MA enrollees, roughly one in ten, are being forced into a new plan this year because their insurer pulled out

The U.S. is short roughly 250,000 nurses and 85,000 physicians, with nearly two thirds of nurses operating at high burnout and a projected 70,000 primary care physician shortfall by 2038. Most health systems are responding by deploying AI on top of broken workflows, which makes burnout more efficient rather than expanding capacity.

CMS just delivered the strongest pro RPM and CCM rule in five years, including a roughly 10 percent reimbursement lift, a new 10-minute RPM code, and a 2 to 15-day measurement code that opens up patient populations that were previously unreachable. In the same window, UnitedHealthcare announced and then postponed a January 2026 rollback that would have stripped RPM coverage.

The 2026 CMS Final Rule raised chronic care management reimbursement by roughly 10%, created a new 10-minute RPM code (CPT 99470), added APCM behavioral health add-on codes, and incorporated AI-augmented services into CPT for the first time. In parallel, the OIG launched a multi-year CCM eligibility audit, and the healthcare workforce is projected to shrink by 4 million workers by year end.

Healthcare is heading into a structural workforce shortfall that recruiting will not solve. HRSA projects a shortage of nearly 700,000 physicians and nurses by 2037, while 55 percent of healthcare employees plan to job-search in 2026. The only realistic path forward is extending the capacity of the clinicians you already have through AI.

Nurses Week 2026 runs May 6 to 12, with the ANA's theme The Power of Nurses anchoring the week. The data tells a harder story behind the celebration: more than half of U.S. healthcare workers plan to switch jobs in 2026, 41.5 percent of departing nurses cite burnout as the primary cause, and turnover-driven costs reach an estimated $4.6 billion annually with roughly $52,350 to replace a single RN

The remote patient monitoring market is projected to reach $88.3 billion by 2035, but only 3 percent of health systems have deployed agentic AI in live clinical workflows. The gap between AI hype and real-world deployment is where most health systems will lose the next decade. Agentic AI alone does not solve chronic care, because the bottleneck is operating model, not algorithm.

CMS approved more than 150 organizations on April 13 for the ACCESS Model, a 10-year outcome-aligned chronic care payment program launching July 5. Combined with the bipartisan Chronic Care Management Improvement Act introduced April 14 (which would eliminate beneficiary coinsurance on CCM) and the new RPM CPT codes that took effect January 1, the economics of chronic care in Original Medicare.

Healthcare's AI investment is accelerating, but the dollars are concentrated in administrative and documentation use cases that will commoditize within eighteen months. The AI deployments producing real clinical and financial returns are the ones that shorten time-to-intervention rather than time-to-bill, including bedside predictive monitoring, continuous remote monitoring, and clinical workflow

Two federal actions in the past week, the launch of CMS's ACCESS Model with 150+ accepted participants and the introduction of the bipartisan Chronic Care Management Improvement Act of 2026, just rewrote the economics of chronic care. ACCESS pays providers for outcomes over a ten-year horizon. The new bill would eliminate the 20 percent patient cost-share that has suppressed CCM enrollment for a d

UnitedHealthcare attempted to strip RPM coverage for chronic hypertension, diabetes, and COPD, limiting it to heart failure and gestational hypertension only. They delayed after industry backlash but still plan to enforce the policy in 2026. The evidence directly contradicts their "no evidence" claim: large studies show RPM reduces blood pressure by 7-17 mmHg and cuts uncontrolled hypertension rat

CMS's 2026 Final Rule lowered the RPM threshold from 16 days and 20 minutes to as few as 2 days and 10 minutes, raised CCM reimbursement roughly 10 percent, and made the Ambulatory Specialty Model for heart failure and low back pain mandatory.

CMS is launching the ACCESS model in July 2026, a 10-year initiative that ties chronic care payments directly to measurable patient outcomes rather than time-based billing. At the same time, UnitedHealthcare tried to gut RPM coverage for chronic hypertension, diabetes, and COPD, only to postpone after industry backlash. These opposing moves create a defining moment for health system leaders.

CMS's new ACCESS model, launching July 5, 2026, introduces outcome-aligned payments for technology-enabled chronic care management across conditions like hypertension, diabetes, chronic pain, and depression. This is a 10-year model that ties full reimbursement to measurable patient health outcomes, not just documented activities.

The U.S. is short roughly 84,000 physicians and 250,000 RNs, and traditional hiring strategies cannot close that gap. AI adoption in healthcare has nearly doubled since 2024, but most organizations are deploying it without redesigning workflows around their clinical teams.

American healthcare is failing its doctors, not the other way around. I started Welby Health because physicians deserve a system built around keeping people healthy, not one that burns them out treating preventable crises. On National Doctors' Day, let's honor the people and fix the model.

UnitedHealthcare is pulling RPM coverage for hypertension, diabetes, and COPD, calling it "unproven." At the same time, CMS is launching ACCESS -- a 10-year payment model that ties Medicare Part B dollars directly to technology-enabled chronic care outcomes -- and the FDA's TEMPO pilot is fast-tracking digital health devices to support it. The evidence overwhelmingly supports RPM.

CMS is making three structural moves in 2026 that change the economics of chronic care management: a 10% reimbursement increase on all CCM codes, new RPM billing flexibility that rewards continuous patient engagement over episodic check-ins, and the launch of ACCESS -- a ten-year payment model that ties Medicare Part B dollars directly to technology-enabled outcomes.

For National Kidney Month, learn how to tackle the silent crisis of Chronic Kidney Disease (CKD) affecting 35.5 million American adults. Our upcoming article explores how combining Remote Patient Monitoring (RPM) and Chronic Care Management (CCM) closes gaps in traditional care by providing continuous patient visibility and structured care coordination.

Hiring a cheap MA to run your CCM program looks like a smart move on paper. But when you factor in audit risk, missed code stacking, patient attrition, physician oversight time, and scope limitations, the "cheaper" option often costs more than doing it right.

Most medical groups say they're "doing CCM." The numbers say they're barely scratching the surface.