“Some of the smartest people I've met in healthcare run surgery centers, and no one outside their market knows the difference.”
What We’re Watching
This week we talked with Danilo D'Aprile of Merritt Healthcare on succession, margin, and why the smartest operators in healthcare run surgery centers. Meanwhile, the split-screen on AI in the revenue cycle keeps sharpening. Providers are posting real numbers, one CFO lifted Medicaid enrollment 162% and added $13.4 million through an AI-enabled financial counseling platform, while payers use the same tech to drive up prior authorization denials, which the AMA says is generating batch denials with little human review. It comes to a head in 2026 as new CMS rules require payers to justify every AI-assisted denial and publish their approval data, while Waystar, Exactrx, R1, Epic, and others race to own the agentic layer.
This Week's Reads
The HealthEx conversation points to something most RCM conversations still miss: healthcare failures are not primarily a technology problem. They are a timing problem. The articles published this week on exactrx.ai dig into what that means operationally, and what it looks like when payers get there first.
M&A Activity and Roadmaps
What to Watch Next
Before you go
Shoot us a message if you’re going to be in Boston for HIMSS AI Leadership Summit! We’d love to grab a cup of coffee.
"Using AI-enabled tools to automatically deny more and more needed care is not the reform of prior authorization physicians and patients are calling for."
What are you seeing on the ground? Whether it is a denial pattern, a payer behavior, or a cost that keeps showing up in the wrong place, hit reply. We read everything.
This newsletter goes out to a focused group of operators, finance leaders, and revenue cycle professionals working in ambulatory and outpatient settings. If someone forwarded this to you and it felt relevant, it probably was.