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HITshow Daily: December 1, 2025 (Monday)

ByNorm Freitag

Podcast: Play in new window | Download (Duration: 11:37 — 16.0MB) | Embed

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 concept—it’s enterprise risk. Plus what health systems should demand before AI copilots touch patient workflows.

HOST: RHONDA BROOKS

📍 Hospital-at-Home Extension — 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.

📍 CMS Outpatient Payment Changes — 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.

📍 UnitedHealthcare Lab Enforcement — 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 thing—it hits the whole building.

📍 Medicare Advantage Star Ratings — 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.

📍 Vendor Risk & Cybersecurity — 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.

📍 AI Governance in Patient Workflows — Nate Collier & Jade Romero

Health systems are racing toward AI copilots, but the real question isn’t whether it demos well—it’s what happens when it’s wrong. Safety rails, escalation paths, audit logs, and measurable outcomes are the product now.

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