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Newsletter | Executive Insight Hub
What “One Big Beautiful Bill” Means for Industry

On July 4, President Trump signed a sweeping healthcare overhaul into law. Officially titled The One Big, Beautiful Bill Act, the legislation introduces major changes to Medicaid and ACA programs, with long-term financial and operational consequences for health systems.  As systems adapt to the new landscape, industry partners have a key role to play in supporting their resilience and success. Four key shifts highlight where health systems are most likely to seek solutions:

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Newsletter | Executive Insight Hub
Prior Auth Gets an AI Makeover: Are You Ready for WiSeR? 

On June 27, CMS’s innovation arm (CMMI) announced a new pilot: the Wasteful and Inappropriate Service Reduction (WiSeR) Model, a six-year program launching January 2026. The model aims to reduce the administrative burden of prior authorization, limit the use of medically unnecessary care, and curb fraudulent claims by leveraging AI and machine learning. This opens both a competitive opportunity and a compliance imperative.  The model: 

  • Automates and streamlines prior authorization  

  • Targets fraud and overutilization in Medicare  

  • Invites industry partnerships to co-develop tech infrastructure  

Why It Matters for Industry  

  • CMMI is actively encouraging industry participation: Especially for companies that already streamline prior authorization processes, there are straightforward avenues to seamlessly partner with health systems.   

  • WiSeR pushes providers to modernize their prior auth pipelines: Tools that help providers bridge the gap between current-state workflows and AI-enhanced expectations will be in high demand. 

Key Questions to Ask  

  • Is your tech WiSeR-compatible, both functionally and from a federal compliance standpoint?  

  • Can your teams speak to revenue cycle savings or FTE reduction tied to AI-enhanced prior auth?  

  • Are you positioned to partner with payers or health systems pursuing WiSeR funding?  

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Newsletter | Executive Insight Hub
What We're Reading

Becker's Hospital Review - Hospitals feel summer squeeze as margins, volumes dip: 5 things to know  

Epic Research - Patient Portal Use Associated with 21 Million Fewer Visit No-Shows in 2024 

Johns Hopkins Bloomberg School of Public Health, International Vaccine Access Center - U.S. Measles Cases Hit Highest Level Since Declared Eliminated in 2000 

Modern Healthcare - BD biosciences business, Waters to merge in $17.5B deal 

NPR - The health of U.S. kids has declined significantly since 2007, a new study finds 

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Newsletter | Executive Insight Hub
The Conversation Starter

On July 1, San Diego-based Sharp HealthCare announced it would eliminate 315 roles, roughly 1.5% of its workforce. The layoffs target non-clinical, non-revenue-generating positions, including senior-level marketing and medical information roles. Executives also took voluntary pay cuts, including a 10% reduction by the CEO.  

A perfect storm of rising expenses, seismic retrofit mandates, and stagnant reimbursements opened the door for these cuts. But Sharp’s moves aren’t isolated—they’re a signal about where priorities are shifting across the C-suite. Tighter margins in an already-narrow game call for a re-ranking of what systems view as essential, not merely cost-cutting. Systems are re-evaluating the necessity of “strategic” roles like marketing, informatics, and non-clinical services, analyzing them through a direct-value lens.  

To address the challenges health systems are facing, partners should emphasize their ability to directly impact ROI through capacity gains, measurable cost avoidance, or clinical throughput. With internal roles cut, health systems’ will need more external support.  

Partnership Framing for Industry Members 

  • Reframe “non-core” offerings through a margin or mission lens. If it doesn’t tie to cost savings, access, or care efficiency, it’s at risk.  

  • Ask who owns the problem now. If your buyer’s role is gone or reduced, map to adjacent stakeholders in finance or operations.  

  • Show empathy but stay anchored in value. Messaging that pairs cost sensitivity with measurable impact will land best.