Gist Weekly: November 13, 2026

In the News

What happened in healthcare recently—and what we think about it.

CMS delays third-party remote monitoring payment halt. The Centers for Medicare & Medicaid Services (CMS) postponed for two years plans to halt payments for third-party remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM) services. CMS first proposed the policy in July to limit payment for RPM and RTM services starting next year. The recently finalized Physician Fee Schedule Rule delays the start date until 2029. Under the rule, to receive payment for RPM or RTM, the service must be performed by clinical staff directly employed by the practitioner or the practitioner’s practice; contracting out to third-party companies will not be allowed after that date. CMS is expected to clarify permissible staffing arrangements for remote monitoring services in the future.

• The Gist: Hospitals have increasingly relied on third-party RPM and RTM services, with many investing in third-party RPM and RTM technology and its related care delivery. A payment stoppage or disruption to existing arrangements, for instance academic health systems that employ clinical staff and faculty staff under different entities, could fundamentally change how these services fit within existing care models. Although uncertainty persists, the two-year delay gives organizations time to prepare, but the change could profoundly affect clinical workflows, including staffing plans. The delay creates an opportunity for hospitals to evaluate their remote monitoring services and structure, and develop an alternative before the restriction takes effect. The delay also gives hospitals an opportunity to find common ground with CMS.

And—what we’re following.

• HealthSpan Partners raised its offer to acquire Surgery Partners to $6 billion after Surgery Partners announced Monday that it received an unsolicited competing bid.
• Amazon Web Services announced it will invest $100 million over five years to expand healthcare access, food access, and women’s and children’s health research through its AWS Health Impact Initiative.

Plus—what we’ve been reading.

Shining a light on ED boarding. This article published last week in The Wall Street Journal highlights emergency department (ED) boarding, the practice of keeping admitted patients in the ED while they wait for an inpatient bed. It cites a study published in Health Affairs finding that one in four patients admitted through the ED waited at least four hours for a bed in September 2024, double the share in 2017. The proportion waiting at least 24 hours tripled during that period. From April through June 2026, the median wait for an inpatient bed reached five hours, up 25% from the previous year, according to Vizient data cited in the article. Staffing shortages, longer stays among an aging population, and delays transferring patients to rehabilitation and other post-acute facilities are limiting bed availability. Research has linked extended boarding with missed medications, early clinical deterioration, and higher mortality among patients who deteriorate.

• The Gist: ED boarding is a signal that the hospital’s system for moving patients through care is not working reliably. Boarding is a key indicator of access, quality, and overall system performance. Others include wait times, patients leaving before treatment is complete, and total ED length of stay. It’s not a new problem, but the Journal’s article is a sign that patience among patients has worn thin. Hospitals should therefore look hard at ways to reduce ED overcrowding and examine where flow breaks down, including bed management, inpatient capacity, diagnostic services, consultations, and discharge planning. Start with internalizing the mindset that “good enough” is not good enough and consider shared accountability across the ED, inpatient units, and operational leaders, rather than treating boarding as an ED problem alone.

Graphic of the Week

A key insight illustrated in infographic form.

Patients’ comfort with AI in care

Clinicians underestimate patients’ openness to AI, especially when clinical providers can override AI-generated decisions, according to the latest West Health-Gallup web survey. More than half of adults who have seen a primary care practitioner in the last year are comfortable with AI in their care if the clinician can review and change a decision, yet this figure drops to 9% if clinical review is not an option. Across a range of scenarios, clinician review outranked privacy, safety, cost, and speed as a top concern for patients, with 48% of patients comfortable with AI in diagnosis and treatment if they had the ability to request review by a clinician.

This Week at Kaufman Hall

Academic health systems are increasingly facing a care distribution problem, as routine and lower-acuity services accumulate at academic medical centers while community facilities are underused. In this new article, Kaufman Hall's Matthew Bates and Dawn Samaris examine how academic health systems can align care delivery with patient needs, organizational capabilities, and available capacity. The article outlines strategies for distributing care more effectively across the enterprise while preserving the academic center’s role in complex care, research, and teaching.

On Our Podcast

The Gist Healthcare Podcast—all the headlines in healthcare policy, business, and more, in 10 minutes or less every other weekday morning.

Previously, Gist Healthcare Podcast host J. Carlisle Larsen spoke with Joel Klein, M.D., of Hackensack Meridian Health in a two-part conversation about the system’s approach to AI governance, clinician adoption and evaluating new technologies.

This Monday, with Democrats set to take control of Congress, Vizient’s Shoshana Krilow joins the podcast to discuss what the shift in power could mean for federal healthcare policy, where bipartisan compromise may be possible, and why some potential reforms could put additional financial pressure on hospitals and health systems.

Thank you for reading! Please check out our Gist Weekly archive for past editions. We also have all our recent Graphics of the Week available here.

The Gist Weekly team at Kaufman Hall