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HITshow Daily: December 1, 2025 (Monday)
Season 1 ยท Episode 82

HITshow Daily: December 1, 2025 (Monday)

HITshow Daily Audio Newscast

December 1, 202511m 37s

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Show Notes

Today on HITshow: A major push to stabilize hospital-at-home for the long haul. New outpatient payment moves that could hit margins and shift site of care. A payer policy change going live today that could create real friction for labs and revenue cycle teams. A Medicare Advantage Star Ratings proposal that could shift billions to plans and change contracting dynamics. And a reminder that vendor risk is not an abstract conceptโ€”it's enterprise risk. Plus what health systems should demand before AI copilots touch patient workflows. HOST: RHONDA BROOKS ๐Ÿ“ Hospital-at-Home Extension โ€” Anika Shah Fresh momentum in Washington for a longer extension of hospital-at-home programs. For health systems, this is about planning certainty: the difference between a "nice pilot" and true operational redesign. ๐Ÿ“ CMS Outpatient Payment Changes โ€” Teresa Vaughn CMS finalized major 2026 changes including site-neutral shifts and continuing the phase-out of the inpatient-only list. Translation: don't just read the rule. Run the scenarios on what this means for your margins and operations. ๐Ÿ“ UnitedHealthcare Lab Enforcement โ€” Teresa Vaughn A major payer's automated lab-testing enforcement goes live today. Health systems should brace for a spike in denials and documentation requests, especially in outpatient workflows. This isn't just a billing thingโ€”it hits the whole building. ๐Ÿ“ Medicare Advantage Star Ratings โ€” Logan Stokes A proposal on the table could shift roughly $13 billion more to plans through bonus payments. For providers, that changes negotiating power and contracting posture heading into 2026 talks. ๐Ÿ“ Vendor Risk & Cybersecurity โ€” Peter Betterworth Continued fallout from an Oracle Health incident is a reminder: third-party risk isn't theoretical. Boards should treat vendor risk as enterprise risk, not a check-the-box IT issue. ๐Ÿ“ AI Governance in Patient Workflows โ€” Nate Collier & Jade Romero Health systems are racing toward AI copilots, but the real question isn't whether it demos wellโ€”it's what happens when it's wrong. Safety rails, escalation paths, audit logs, and measurable outcomes are the product now. ๐ŸŽ™๏ธ Subscribe here or wherever you listen to podcasts, and if you like our show, please follow us on LinkedIn at https://www.linkedin.com/company/hit_show. HITshow is made possible by EY, Kimmchi and HLTH 2025 โ€” the epicenter of healthcare innovation, where the future of care happens.