Healthcare Finance & Policy, From the Inside

The business of American medicine, explained by someone who practices it.

I am a PA-C. I write plain-language analysis of the money, rules, and paperwork standing between patients and their care, for the clinicians, administrators, and billing teams who keep medicine running.

13 hrs
spent by physicians and staff on prior authorization every single week
53M
prior authorization decisions made by Medicare Advantage insurers in 2024
80.7%
of appealed denials were overturned, yet most are never challenged
94%
of physicians say prior authorization contributes to burnout

The Latest

What is changing right now, and what to do about it
Featured Medicare

Medicare Is Now Using Artificial Intelligence to Review Prior Authorizations. Here Is What Providers Need to Know.

In six states, private technology companies now review Medicare prior authorizations using artificial intelligence, and they earn a share of every dollar of denied care. The full breakdown: the 15 services, the vendors, the lawsuit, and the playbook for providers.

Benjamin Hillman, PA-C  ·  June 2026  ·  10 min read
Read the Analysis

All Articles

The prior authorization files, practice finance, and provider policy
Practice Finance

The 2026 Medicare Fee Schedule Gave a Raise on Paper. Many Will Still See a Cut.

The conversion factor went up, but an efficiency adjustment and a facility cut quietly offset it. Who actually gains and who loses in 2026.

June 2026 · 7 min Read →
Medicare

Medicare Telehealth Survived the 2026 Cliff. Here Is Where Things Stand.

The flexibilities lapsed, then got a two-year reprieve through 2027. What is covered now, what is permanent, and the new deadline to watch.

June 2026 · 7 min Read →
Prior Authorization

Only About 3 Percent of Texas Providers Earned a Gold Card

Five states let high-performing providers skip prior authorization entirely. Almost nobody qualifies. The playbook for joining the few who do.

June 2026 · 9 min Read →
Prior Authorization

New Federal Prior Authorization Rules Took Effect in January

Insurers now face 72-hour deadlines and must explain every denial. What the new federal rules actually change for your practice, and what they leave untouched.

June 2026 · 9 min Read →
Prior Authorization

The Peer-to-Peer Review Is a Game Nobody Teaches You

Word-for-word scripts and tactics for the ten-minute phone call that decides whether your patient's care gets approved.

June 2026 · 8 min Read →
Prior Authorization

Your Prior Authorization Was Denied. The Next 72 Hours Decide Whether It Stays That Way.

Most denials are never appealed. Most appeals win. The hour-by-hour playbook, the appeal letter skeleton, and the external review step almost nobody uses.

May 2026 · 8 min Read →
Provider Rights

When Providers Speak Out, Who Has Their Back?

Clinicians who challenge insurers publicly often pay for it. Inside the Healthcare Professional Speak FREE Act and the push for real whistleblower protections.

May 2026 · 9 min Read →
Practice Finance

Running an Independent Practice Has Never Been Harder

Closures keep climbing, margins keep shrinking, and yet some clinics are figuring it out anyway. What the survivors are doing differently.

May 2026 · 12 min Read →
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