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.