Articles by Tyler
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Why I'm Joining Everbright Health
Why I'm Joining Everbright Health
I am thrilled to share that I have joined the team at Everbright Health! Throughout the majority of my career, I’ve…
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Tyler Lakin shared thisI'm hiring! We're looking for a Director of Strategy & Operations to join our early team. You'll lead our implementation operations and scalability, support our enterprise deals, and own our key vendor and partner relationships. Whoever steps into this seat will directly shape how many patients get access to advanced mental health care over the next several years. If you want to make a real impact — on mental health, on psychiatry practices, and on patient lives — I'd love to talk. Feel free to reach out and referrals are very welcome! #hiring #mentalhealth #behavioralhealth
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Tyler Lakin shared thisExciting things continue to happen at Everbright Health -- now pleased to share our AI enabled platform that can provide unique, specific insights to our partner practices about their population, performance, and opportunity. Congrats to the team on getting this live! Alex (Goldy) WeismanTyler Lakin shared thisOver a third of patients in a typical mental health practice qualify for advanced interventions like TMS and SPRAVATO®. Most never get there — and most practices never offer them. Today, we're announcing our AI-enabled platform to change that — helping practices identify eligible patients, navigate prior auth, and run fully operational interventional psychiatry programs without the typical complexities. Read more: https://lnkd.in/e4PZNhAK #MentalHealth #InterventionalPsychiatry #BehavioralHealthEverbright Health Announces AI-Enabled Platform to Unlock Access to Advanced Mental Health InterventionsEverbright Health Announces AI-Enabled Platform to Unlock Access to Advanced Mental Health Interventions
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Tyler Lakin shared thisThanks to Health Tech Nerds for spending time diving into what we're working on here at Everbright Health. Great listen and conversation between Martin Cech and Ben Kuhn going through the clinical and market opportunity in interventional psychiatry, the complexities for a practice to launch and manage these operations, and how practices can effectively offer these treatments to their own patients instead of referring them outside.Tyler Lakin shared thisThe future is psychiatry is here, it just isn't evenly distributed is how I'd describe the current state of the market. Borderline miraculous interventions like TMS and Spravato have been on the market for years, but lately, it seems like they're increasingly getting covered by insurance with higher uptake among the patient populations most likely to benefit. There's been a ton of financing activity in the space, as Ben Kuhn, CEO of Everbright Health mentions in the clip below, and a lot of different potential business models here. I enjoyed hearing Ben/Everbright's theory of the case on the MSO approach for independent psychiatrists and what's on the horizon for interventional psychiatry. Links in the comments!
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Tyler Lakin shared thisReally excited to be joining the team at Everbright Health as Head of Commercial! While clinical innovation in psychiatry and mental health continues to make significant advances, the operational complexity behind launching these services continues to be a barrier for most practices. We want to bring that barrier down. Read more here:
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Tyler Lakin shared thisWhat a week at Radiological Society of North America (RSNA). The energy was incredible, and we had the chance to connect with so many leaders who care deeply about where radiology is heading. A few themes stood out: - Quality matters more than ever. Even amid staffing shortages, radiologists want to differentiate on the quality of care they deliver. - AI is advancing fast, but the market is still sorting out what works, which models perform reliably, and how to deploy AI effectively in clinical workflows. - Population health is rising as a core use case -- especially where AI can help identify risk earlier, provided the right incentives exist. - MR and CT innovation isn’t slowing down. The technology leap year after year is remarkable. And one last takeaway: water was harder to find than reimbursement clarity. Next year we might just bring pallets of water bottles and become the most popular booth on the floor. All in all, great week with the Covera Health team! Ron Vianu Richard K.J. Brown, M.D., FACR Bilal Khan Raveena Kaur J.P. DeVincenzo Micha Kornreich Jacob Johnson Erik Rainey #RSNA2025
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Tyler Lakin shared thisExcited to be heading to the annual Radiological Society of North America (RSNA) conference next week! I’ll be there with the Covera Health team and would love to connect with anyone who is passionate about elevating radiology quality and strengthening the role imaging plays in value-based care. Radiology drives nearly 9 in 10 downstream clinical decisions, yet variability in imaging quality remains one of the most under-recognized challenges in healthcare. At Covera, we’re working hard to change that: advocating for high-quality diagnostic care, partnering closely with radiologists, and supporting them with thoughtful AI and population health-based initiatives. If you’ll be at RSNA and want to talk about quality science, AI’s impact on imaging, or how radiology can help drive better outcomes in value-based models, I’d love to meet you. Drop me a note or stop by the Covera booth. Looking forward to great conversations in Chicago!
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Tyler Lakin shared thisVery excited to be partnering with Advanced Radiology Services and Strategic Administrative & Reimbursement Services in Michigan -- welcome to the Covera Health program!Tyler Lakin shared thisRadiology sits at the center of modern medicine, yet it is still treated like a commodity. It anchors almost every care journey, but because it has been so difficult to measure diagnostic quality, high-quality work is rarely recognized or rewarded in a meaningful way. At Covera Health, a lot of my time is spent trying to change that. We work with radiology practices and payers to build a shared standard for quality, reduce diagnostic errors, and make sure the value of good radiology is visible and rewarded, not assumed. That is why I am proud that Advanced Radiology Services and Strategic Administrative & Reimbursement Services is joining our national Quality Care Program. ARS is one of the largest physician-owned radiology practices in the country and has a long track record of investing in subspecialty expertise and quality improvement. Together, we will bring greater visibility to the quality ARS has built over many years, help shape the next generation of radiology quality measures, and use our analytics platform to support earlier identification of patients at risk of serious disease. This work is about a shared belief that radiology should not be treated as a commodity, but as a core driver of accurate diagnosis and better outcomes, and that we can build the infrastructure to prove it. For payers and employers, it is about partnering in a way that reduces unnecessary downstream care while doing the right thing for patients. I am grateful to the ARS team for stepping into this with us and to all of the practices and partners who have already joined. We still have a lot of work ahead, but each partnership like this moves us closer to a future where radiology quality is measured, improved, and recognized across the system. https://lnkd.in/euyF4Hrv Richard Herzog, M.D., FACR Richard K.J. Brown, M.D., FACR Andrew Moriarity, MD, MBA Bilal Khan Joshua Habib Carrie Walecka Erica P. Robert Epstein MD, FACR Strategic Radiology, LLC Scott Bundy Lisa Woods Elizabeth Mitchell #radiology #diagnosticquality #healthcarequality #populationhealth #valuebasedcareAdvanced Radiology Services Joins Covera Health's National Quality Care Program to Advance Diagnostic Excellence and Radiology Quality MeasuresAdvanced Radiology Services Joins Covera Health's National Quality Care Program to Advance Diagnostic Excellence and Radiology Quality Measures
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Tyler Lakin shared thisCome work with me! Really exciting opportunity to lead a novel program at the intersection of value based care, AI, radiology, and primary care. Reach out to me to learn more (and bonus -- or at least I think it's a bonus -- we'd be spending quite a bit of time together!) Covera HealthTyler Lakin shared thisWe’re hiring a VP of Population Health at Covera Health 🎉 This is not your typical role. It’s an opportunity to build and scale a first-of-its-kind program at the intersection of AI, quality assurance, and value-based care. Our Protect AI platform is already reshaping how providers, payers, and primary care groups think about population health. Now we’re looking for a proven leader to take it to the next level. As VP of Population Health, you’ll: - Partner with our Executive Leadership Team to set and drive strategy - Build strong networks with ACOs, payers, and providers to accelerate adoption - Lead cross-functional teams across tech, AI, product, and growth to operationalize and scale pilot programs - Serve as a thought leader in the market and a trusted partner to payers and providers - Drive meaningful impact for patients through better care quality and outcomes Who we’re looking for: - You’ve spent your career building in healthcare – with a deep understanding of value-based care and risk-sharing models. - You’ve partnered with both payers and providers on high-priority initiatives, closed strategic deals, and scaled adoption. - You bring both strategic vision and the ability to execute. And you’re motivated by the chance to build something that matters for patients everywhere. While we are a remote-first company, this role will require significant travel to meet partners and lead in-market efforts. If this sounds like you, or someone in your network, let’s connect! Apply below or DM me directly. https://lnkd.in/ezKTfha6
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Tyler Lakin liked thisI am incredibly proud of the brilliant minds behind Advarra's Study Design solution. We are focused and determined to change the game in clinical research. Our solution transforms clinical trials by enabling faster, smarter study design that reduces amendments, enhances quality, and lowers site and patient burden. It leverages an unparalleled dataset, intelligent agents 🤖, and advanced Graph-RAG techniques, all guided by experts with decades of industry experience. By combining domain mastery, cutting-edge AI 🧠, and a commitment to challenge the status quo, we deliver actionable insights that accelerate patient access 🚀 and elevate the standards of clinical research. This is what happens when expertise, innovation 💡, and relentless focus come together to push the boundaries of what’s possible in clinical trials.Tyler Lakin liked thisWe’re excited to share that Advarra's Study Design solution has been named “Best Clinical Study Design Solution” in the 2026 MedTech Breakthrough Awards! 🎉 The MedTech Breakthrough Awards highlight organizations advancing innovation and patient care across global health and medtech industry, with this year’s program drawing a record 5,000+ nominations from over 20 countries. This recognition highlights the rising importance of smarter, data-driven protocol design. Powered by Braid™, our data and AI platform, Advarra Study Design leverages the industry’s most comprehensive trial operations dataset to deliver actionable insights at the earliest and most dynamic stages of protocol design—helping sponsors and CROs: ✔ Identify protocol risks earlier ✔ Reduce costly amendments ✔ Minimize site and patient burden ✔ Make faster, more confident design decisions Special thanks to MedTech Breakthrough for the recognition, and kudos to #TeamAdvarra for advancing innovation across the most complex parts of the trial lifecycle. Read the full release here: https://hubs.la/Q04fPmpG0 #Advarra #AdvarraStudyDesign #ClinicalTrials #MedTech #DigitalHealth #AI #Innovation #ResearchTechnology #ClinicalResearch
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Tyler Lakin liked thisLots of opportunity here! Would also endorse working with/for Tyler Lakin any day!
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Tyler Lakin liked thisTyler Lakin liked this*RTM in Behavioral Health is Broken, Unless We Reduce Patient Friction* One of the biggest problems is engagement. The moment monitoring depends on patients actively documenting symptoms, filling questionnaires, or consistently interacting with an app outside the clinic, engagement tends to drop significantly over time. This creates fragmented data, low temporal resolution, and a very incomplete picture of what actually happens between visits. At the same time, PROs (Patient Reported Outcomes) remain incredibly important, but they also come with limitations: • They are episodic rather than continuous • They can be influenced by recall bias and current emotional state • They often miss subtle day-to-day behavioral changes that emerge before clinical deterioration CMS has made major progress by expanding RTM reimbursement opportunities for behavioral health, which is an important step forward for the field. But many clinicians are still asking: • How do we actually implement RTM in a way that fits real clinical workflows? • Which tools are truly useful vs. creating more administrative burden? • How do we improve care without overwhelming clinicians or patients? • What does “continuous monitoring” actually look like in behavioral health? This is exactly why we launched the Behavidence RTM Design Partnership Program. We’re looking to work with forward-thinking psychiatrists, psychologists, nurse practitioners, therapists, and behavioral health clinics that want to explore how completely passive daily digital biomarkers can: • Improve visibility between visits • Help identify behavioral triggers and deterioration patterns • Reduce dependence on constant active patient input • Support more proactive interventions • Create smarter and more scalable clinical workflows The goal is not replacing clinicians or questionnaires. The goal is augmenting behavioral health with continuous, objective behavioral signals that can help clinicians make better-informed decisions while reducing friction for patients. Behavioral health deserves the equivalent of “vital signs.” We believe passive digital biomarkers can become part of that future. Behavidence https://lnkd.in/euV78EZfBehavidence Launches Clinical Partnership Program to Advance Mental Health RTM with Passive Digital BiomarkersBehavidence Launches Clinical Partnership Program to Advance Mental Health RTM with Passive Digital Biomarkers
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Tyler Lakin liked thisTyler Lakin liked thisI've always known I wanted to become a sales leader, but my career hasn't gone how I planned: Every company I worked at had changes that made it much less straightforward than I'd planned for. When I first started as an SDR, I knew I was building toward a senior closing role. But layoffs hit, and the AE role I was working towards disappeared. My options were limited, so I took on a different role in partnerships. It wasn't what I wanted, but I was grateful to have a job, a team, and stability after a chaotic stretch. A few months in, I started asking myself: should I stay in this role even though it isn't what I really want? If I stayed too long, the door back to sales leadership would close. The longer you spend specializing in something else, the harder it can get to switch. So I made another move: Account Management. Focusing on renewals and expansions wasn't perfect, but it was closer to what I actually wanted. From there, I had to figure out how to position myself for new business sales. In every one-on-one and performance review, I was clear with my boss that I wanted opportunities to build the transferable skills I’d need to move into sales. When I wasn't moving there fast enough, I took control again and started looking elsewhere. I landed the enterprise sales role that started my journey with Attentive because I'd held a quota, overperformed in mid-market, and had people in my network who could vouch for me. Through all of these twists and turns, I learned that when your career path doesn't happen the way you imagine, it’s important to stay close to your North Star. It means asking, at every step, for opportunities that get you closer to it. And being honest with the people around you about where you're trying to go. Even though I was a partnerships manager and an account manager, I was determined to become an Account Executive. I just had to be creative, honest, and focused. I learned that the path won't always be linear, and that definitely made the first 10 years of my career exciting and rich. Plus, I can 100% say that the skills from those roles made me an even better sales leader.
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Tyler Lakin liked thisCome join my team! Excited to meet you if a passion for healthcare, a collaborative team environment and a high performance environment align with your interestsTyler Lakin liked thisWe’re hiring a Knowledge Management Associate to join Oxeon in NYC! 🗽 Our Knowledge Management team is the strategic engine behind our work: driving insights, mapping markets, uncovering talent, and partnering directly with Search teams on high-stakes, high-impact searches across healthcare. We’re looking for someone with experience in executive search, consulting, or expert networks who thrives in fast-paced environments, loves solving complex problems, and wants exposure to some of the most influential leaders in healthcare. Not to mention, the culture here is incredibly special. High bar, low ego, deeply collaborative, and full of genuinely great humans who love what they do. Interested? Reach out: jackie@oxeon.com
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Tyler Lakin liked thisTyler Lakin liked thisFor anyone who's new here... I'm the Founder of Hemingway, an organisation supporting mental health innovators to do their best work. One way I do that is through my newsletter (https://lnkd.in/gFqE-Dqv) - I write about the latest developments in technology, research, policy and markets - I publish analysis on the most impactful companies and trends driving this space - And I share the winning playbooks from the leaders in the field The other way, is through our vetted community of mental health innovators (https://lnkd.in/gjpK2wDU) - We have a private Slack group of over 450 founders, clinicians, researchers and investors - We host online events where experts share best practices on how to run a clinically and commercially successful business - And we run curated IRL events (dinners, meetups, etc.) in cities around the world If you care about making a mentally healthier world, feel free to sign up for any and all of what we do. Disclaimer: not my doggo (sadly)
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Tyler Lakin liked thisTyler Lakin liked thisDuring Nurses’ Week, I’m incredibly proud to share that my wife Jen just launched a new company: Nightlight Health. Built by a former NICU nurse, nursing professor, perinatal mental health specialist, and mom of three, Nightlight Health gives expectant and new parents on-demand access to real nurses and real human support - never bots. Jen and I have been a couple since we were 16 years old and I promise you, she was born for this. I would tag her here, but she somehow launched an entire company before ever creating a LinkedIn profile, which honestly feels very on-brand for an actual healthcare worker. If you know a new or expectant mom who could benefit from extra support, reassurance, or guidance, please share this with them. https://lnkd.in/eAjD6HPx
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Tyler Lakin liked thisTyler Lakin liked thisAs a Psychiatry Group Practice Owner marketing, branding and networking are a must. About to kick off our Therapist Happy Hour Social Bellevue Psychiatry #alwaysbecommecting #BellinghamWA
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Education
Volunteer Experience
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Young Professional's Committee - Co-Chair, Community Engagement
Chess in the Schools
- 3 years
Spreading word about Chess in the Schools to external organizations, setting up events for both fundraising and education
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Mentor, College Bound Program
Chess in the Schools
- 8 months
Education
Mentor high-potential inner-city high school students, advising and guiding them through the college application process
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Melissa Sturgess
I love everything about this. When we get MRX1 CBD oral solution for the treatment of pain associated with endometriosis approved it will be no-brainer for employers to offer it direct to women employees via one of these schemes. Bring on the future of regulatory approved, accessibly priced therapeutics. Ananda Pharma Ltd Andy Rust
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Inna Sheyn
𝗣𝗿𝗶𝘃𝗮𝘁𝗲 𝗘𝗾𝘂𝗶𝘁𝘆 𝗗𝗼𝘂𝗯𝗹𝗲𝘀 𝗗𝗼𝘄𝗻 𝗼𝗻 𝗦𝗲𝗹𝗲𝗰𝘁 𝗛𝗲𝗮𝗹𝘁𝗵𝗰𝗮𝗿𝗲 𝗦𝗲𝗰𝘁𝗼𝗿𝘀 Healthcare private equity deal activity grew about 10% in 2025 to roughly 747 deals, with investors expected to accelerate activity as regulatory and policy uncertainty clears. Investment concentrated in specific areas: • 𝗔𝗺𝗯𝘂𝗹𝗮𝘁𝗼𝗿𝘆 𝘀𝘂𝗿𝗴𝗲𝗿𝘆 𝗰𝗲𝗻𝘁𝗲𝗿𝘀: health systems deploying capital for expansion • 𝗦𝗸𝗶𝗹𝗹𝗲𝗱 𝗻𝘂𝗿𝘀𝗶𝗻𝗴 𝗮𝗻𝗱 𝘀𝗽𝗲𝗰𝗶𝗮𝗹𝘁𝘆 𝗽𝗵𝗮𝗿𝗺𝗮𝗰𝘆: deal growth up 143% and 138%, tied to aging demographics • 𝗢𝗻𝗰𝗼𝗹𝗼𝗴𝘆 𝗮𝗻𝗱 𝗺𝘂𝘀𝗰𝘂𝗹𝗼𝘀𝗸𝗲𝗹𝗲𝘁𝗮𝗹 𝗰𝗮𝗿𝗲: viewed as strong near-term opportunities • 𝗚𝗮𝘀𝘁𝗿𝗼𝗲𝗻𝘁𝗲𝗿𝗼𝗹𝗼𝗴𝘆: slowed due to uncertainty around GLP-1 impact on long-term demand Overall, capital is shifting toward services aligned with aging populations, site-of-care migration, and specialty drug economics rather than broad provider rollups.
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Tal Healthcare
🌟 Insights from the Healthcare Leaders of New York (HLNY) 9th Annual Mini-Congress: “Back to the Basics – Adding Value at Every Step” The Tal Healthcare team had the privilege of attending this year’s HLNY Mini-Congress at the New York Academy of Medicine, an event packed with thought-provoking conversations about leadership, workforce innovation, and the future of patient care. Here are a few highlights that resonated with the team: 🩺 Maximizing the APP Workforce Advanced Practice Providers (NPs and PAs) want to work at the top of their license. When empowered to do so, they can greatly expand access to care and allow physicians to focus on more acute patients. The key is cultivating strong, collaborative relationships between physicians and APPs. They’re essential providers who deserve recognition, autonomy, and trust. 💬 Transforming the Patient Experience As one panelist said, “Every moment counts; the patient experience is their story.” Technology is helping make that story smoother: real-time information sharing, automated results, and online access to tools are giving patients more control. But the human touch still matters most. Agility, empathy, and authenticity are the new imperatives, seeing each patient as a person. AI can support this by handling administrative work so providers can truly listen. 💡 Leadership & Culture Fred Sganga’s keynote reminded us that “Culture is the organization’s personality, the reflection of its corporate soul.” Trust remains the foundation of every great healthcare organization. Transparency, humility, and courage are leadership essentials. Employees thrive when they’re given dignity, respect, and the tools to succeed. Pride, joy, and team spirit turn competence into excellence. Events like the HLNY Mini-Congress remind us that while healthcare evolves rapidly, its core remains constant: people, purpose, and trust. Thank you Valerie Anne Swatz, Nancy Izzo, Lisa Haimson, Donna Bozek, and Isabella Ramirez for these insights. We’re energized to bring this back to the organizations we serve every day. #HealthcareLeadership #HealthcareRecruiting #Leadership
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Dr Wendy M Smith, DSc, MHA
Stay ahead in US healthcare: explore breakthrough trends and emerging solutions: • A lower list price is resetting the GLP-1 market, and new entrants may be forced to compete at comparable or lower prices. https://bit.ly/4rPLmuY • New supreme court decision and what it means for employer healthcare costs. https://bit.ly/4sXk334 • Are you ready for higher 2027 contribution and coverage limits for HSAs, HDHPs, and excepted-benefit HRAs? https://bit.ly/41pfrqA #Healthcare #Benefits #Health
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Jessica C. Lindley
Enhancing U.S. Healthcare: Three Essential Policy Changes As we strive for better healthcare outcomes, here are three key policy changes that could make a significant impact: 1. Empower Pharmacists Allowing pharmacists to practice at the top of their license can greatly enhance patient care. They are expert medication managers who can conduct chronic condition management, medication reviews, and health screenings, particularly in underserved areas, thereby improving access to necessary services. By leveraging their skills, we can help mitigate medication errors and promote better health outcomes. 2. Streamline Telehealth Licensing Revamping credentialing and licensing for interstate telehealth could eliminate barriers to care, ensuring that patients, especially in rural areas, can easily access specialists. Simplifying these procedures would encourage providers to utilize telemedicine more effectively, allowing for improved continuity of care without the administrative hurdles that currently exist. This is crucial in a landscape that increasingly relies on virtual care solutions. 3. Adjust Medicaid Payment Rates Increasing Medicaid payment rates to reflect the true costs of care would encourage more healthcare providers to accept Medicaid patients. Adequate reimbursement not only supports quality healthcare but also facilitates innovations in care delivery. By addressing this financial gap, we can boost access to essential services, especially for low-income Americans, and focus on preventive measures that contribute to overall public health. These reforms could transform healthcare delivery in the U.S. and create a more equitable system for everyone. What other changes do you think are necessary? Let’s connect and discuss at HLTH 2025! #HealthcareInnovation #PolicyChange #Telehealth #Medicaid #Pharmacist #HealthEquity #HLTH2025
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Rich Tinsley
In healthcare M&A, growth isn’t created at close — it’s created in integration. This piece is a strong reminder that value realization in healthcare lives in the details: systems, workflows, clinical alignment, revenue cycle, and culture. When integration is treated as a growth strategy, not a clean-up exercise, outcomes improve for patients, clinicians, and investors alike. Especially relevant as providers, PE sponsors, and health systems look to scale in a more regulated, margin-compressed environment. 🔗 https://lnkd.in/ekEH75gn Curious how others are thinking about integration as a growth lever, not just a risk to manage. #healthcare #MergersAndAcquisitions #GrowthStrategy #IntegrationStrategy #ValueCreation #DealMaking
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John Matthew Douglas (JMD)
One of Healthcare’s Weakest Links: Consumer SDOH “Ignorance Is Bliss” Executive Summary Most healthcare consumers experience the effects of Social Determinants of Health (SDOH) but do not understand them as drivers of health outcomes, safety, equity, or cost. This gap quietly undermines performance, accountability, and trust—and represents a material risk to health system strategy. What consumers know Consumers broadly recognize that factors such as housing stability, food access, transportation, stress, and neighborhood safety affect their health. Post-COVID, there is growing acceptance that health is shaped by more than medical care alone. Where understanding fails Few consumers recognize SDOH as a defined health framework or understand: • How SDOH drive preventable mortality, utilization, and cost • The accountability of health systems, payers, employers, and policy • How structural and historical factors shape health long before care is delivered As a result, SDOH are viewed as personal or social challenges—not healthcare performance issues. Why this matters Healthcare has historically communicated in clinical terms, while SDOH interventions remain fragmented and largely invisible to patients. Consumers are rarely shown the direct link between SDOH and avoidable hospitalizations, patient safety events, inequities, or shortened life expectancy. What you as a hospital or healthcare system CEO should takeaway: Consumers feel SDOH but do not connect them to system performance, payment models, or quality and safety outcomes. This knowledge gap: • Creates risk when systems assume understanding that does not exist • Creates opportunity to build trust, engagement, and accountability through plain language, shared definitions (including common Just Culture language), and transparency Bottom line Consumer SDOH ignorance is not bliss. It obscures root causes, weakens patient agency, and perpetuates preventable harm, inequity, and cost. Informed consumers are not just better patients—they are catalysts for safer care, equity, and sustainable value-based performance. #HealthCareEquityForAll #MySDOHEdu John Matthew Douglas, ChatGpt, et al 2025
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Lisa Piercey
FORCING CHANGE IN SITE OF CARE McKinsey & Company's recent paper on the forces pressuring healthcare, including the possibility of margin compression of up to 13 percentage points for health systems, does a good job of putting numbers around what most operators already feel. Two of the biggest drivers they mention are policy shifts in reimbursement and rising utilization driven by an aging population. The cohort of 70+ year old Americans will grow the fastest over the next 5 years, and it is well established that older patients have more complex needs, more chronic disease, and more touchpoints within the healthcare system. Layer that on top of continued clinical workforce shortages, and the supply-demand gap widens further. From my perspective, optimizing for site of care is the most important lever we have to address this challenge. We can’t quickly reduce how much care older patients need, but we can change where and how services are delivered. Supporting aging patients in lower-cost settings like the home, ambulatory sites, and virtual environments is no longer just a preference or convenience, it’s a necessity. This is where the conversation around site-neutral payments becomes so relevant. CMS is moving quickly in this direction, and hospital outpatient departments (HOPDs) are squarely in the crosshairs. The shift will undoubtedly clamp down further on hospital margins, but it shouldn’t be surprising. We’ve been talking about the demise of HOPD reimbursement for years, and the health systems that will fare best are the ones who are working towards aligning their approach with where patients can be treated safely, efficiently, and at lower cost, rather than relying on legacy reimbursement structures to fill the gap. And just like it doesn’t make sense to try to replicate a hospital or nursing home environment in a patient’s home, we also shouldn’t try to carry the same clinical staffing model into every care setting. Yes, there are non-negotiables when it comes to patient safety and clinical expertise, but there’s also a meaningful opportunity to rethink how teams are built. That means clinicians at every level working at the top of their licenses, thoughtfully involving family members and community resources, and using technology to surround these sites of care with non-clinical operational support. From my health system days, I understand why rising costs, margin pressure, and site-neutral payments feel like threats. While painful, I’m hopeful they can also serve as a positive forcing function, pushing us toward care models that are better aligned with our aging population and the realities of today’s workforce.
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