Healthcare · Strategy and product
Margins are thin, coverage is shrinking and AI is moving into every workflow. Here's what I'm watching, and how I'd think about strategy and product in a two-and-a-half-point margin business.
Also on the calendar
Medicare Advantage rate for 2027, about 5% with risk scores. KFF, Apr 2026
of electronic prior-auth requests answered in real time by 2027, pledged by 60+ payers. Health Management Associates, Mar 2026
organizations signed the CMS Aligned Network pledge on data exchange. Health Management Associates, Mar 2026
Medicare telehealth flexibilities extended through Dec 31. American Bar Association, Feb 2026
On the agenda this year
When the margin is two and a half points, a three-year ROI story might as well be fiction. Buyers want savings they can see inside the fiscal year, and they want the labor hours named.
A FIRST STEPRewrite your business case in quarters, not years, and lead with the hours you give back.
Fewer insured patients means more unpaid care and messier payer mix. The first conversation a patient has with you is increasingly about coverage. Care comes second.
A FIRST STEPTreat eligibility, estimates and billing as one patient journey with one owner.
Ambient scribes went mainstream fast, and now the EHR is building its own. That's the moment a feature becomes a commodity. What's left to win is the work around it: the hand-offs, the follow-ups, the pieces no one platform owns.
A FIRST STEPMap the workflow ten minutes before and after your feature. Build there.
Systems are merging by choice now, not only from distress. The deal team closes in months, and the operating team spends years making two cultures, two EHRs and two front doors feel like one.
A FIRST STEPPick the patient-facing journey to unify first, and give it a single product owner across both systems.
Not sure where to start? Neither is anyone, at first.
Send a few lines about your organization and the decision in front of you. I'll reply with how I'd approach it, whether or not we work together.