Healthcare Brew covers pharmaceutical developments, health startups, the latest tech, and how it impacts hospitals and providers to keep administrators and providers informed.

Healthcare Brew

Amanda Eisenberg

Healthcare Brew delivers the latest news and trends in healthcare.

healthcare-brew.com

A female medical professional conducts a pelvic exam

HHS, CMS update informed consent guidance

The guidance comes as more than a dozen states have moved to ban non-consensual pelvic exams.

Maia Anderson

Positive arrows pointing upward above healthcare symbols

Health systems turn to internal VC arms to bring in additional revenue 

At least 23 health systems are operating venture capital arms. 

Will Peischel

Clinicians see increased understaffing and want protections, per survey

Almost half of respondents reported a higher patient ratio than the year prior.

A medical cross and circle denoting hospitals

Hospitals & Facilities

Cassie McGrath

Welcome back to Signed and Scrubbed, a monthly roundup of hospital deals, developments, and bankruptcies.

This month, there were at least seven deals and closures on July 1 alone. But don’t fret, there was more news from the rest of the month as well.

We compiled noteworthy provider transactions from July. Here’s what you need to know.

Providence, Rhode Island-based physician group Anchor Medical Associates permanently closed all three of its locations on July 1, leaving a 

On July 1, St. Louis-based health system Ascension subsidiary Ascension Seton acquired 

 of Texas-based Cedar Park Regional Medical Center, a 126-bed facility, for $436 million.

. Alhambra, California-based Astrana Health acquired Los Angeles’s Prospect Health System, which includes the 177-bed Foothill Regional Medical Center, for $708 million on July 1.

Baystate Health, which has 900 beds across five hospitals, is allegedly considering acquiring 182-bed Mercy Medical Center, which would bring together the two biggest hospitals in Springfield, Massachusetts, 

Beacon Health System finalized its acquisition of Ascension Southwest Michigan on July 1, adding four hospitals to the South Bend, Indiana-based system. The hospitals include 422-bed acute care hospital Beacon Kalamazoo, 25-bed Beacon Allegan, 25-bed Beacon Dowagiac, and 43-bed Beacon Plainwell. The deal also includes 35 outpatient clinics and an ambulatory surgery center.

Chippewa Valley Health Cooperative (CVHC).

 Chippewa Falls, Wisconsin-based Chippewa Valley Health Cooperative bought the former St. Joseph’s Hospital from Hospital Sisters Health System on July 1. Now called the Chippewa Valley Cooperative Hospital, the facility will serve patients while CVHC builds a new hospital in Lake Hallie, which is set to open in the beginning of 2028.

On July 8, Hugh Chatham Health, which includes an 81-bed facility and is based in Elkin, North Carolina, announced a merger with Winston-Salem, North Carolina-based Atrium Health Wake Forest Baptist. Under the partnership, Atrium pledged a $100 million investment in Hugh Chatham Health, which has 25 locations and 70 providers.

Rockford, Illinois-based system Mercyhealth announced a “temporary suspension” of services at its main 195-bed hospital Javon Bea Hospital-Rockton on July 1.

 Bedford, New Hampshire-based SolutionHealth filed a “disaffiliation agreement” to return to two independent systems. In 2018, Manchester-based Elliot Health System and Nashua-based Southern New Hampshire Health had signed an affiliation agreement to become one health system, but 

 July 16 they’re looking to separate again.

 Bethlehem, Pennsylvania-based St. Luke’s University Health Network finalized the acquisition of its 16th hospital on July 1: the 207-bed Grand View Health in Sellersville, Pennsylvania.

 Marlton, New Jersey-based Virtua Health and Wilmington, Delaware-based ChristianaCare signed a letter of intent on July 16 to co-found a “regional not-for-profit health system” across New Jersey, Delaware, Pennsylvania, and Maryland. The plan would include 600 care sites and 30,000 employees.

Hospital building split in half collaged with briefcase and $100 bill. Credit: Illustration: Anna Kim, Photos: Adobe Stock.

Signed and Scrubbed: July 2025 hospital M&A

July 1 alone saw seven deals and closures. 

US News and World Report has released its 

 of the best hospitals for 2025–2026 in the country, breaking down the top providers in different regions and specialities.

There’s also an honor roll list highlighting the top 20 hospitals in the country out of 4,400+ evaluated facilities, and US News ranked the top hospitals in 15 specialties.

Hackensack University Medical Center at Hackensack Meridian Health, Hackensack, New Jersey

Hospitals of the University of Pennsylvania-Penn Presbyterian, Philadelphia

New York-Presbyterian Hospital-Columbia and Cornell

Northwestern Medicine-Northwestern Memorial Hospital, Chicago

Stanford Health Care-Stanford Hospital, Palo Alto, California

UCSF Health-UCSF Medical Center, San Francisco

University of Texas MD Anderson Cancer Center, Houston

Cardiology, heart, and vascular surgery: 

University of Texas MD Anderson Cancer Center

Bascom Palmer Eye Institute-University of Miami Hospital and Clinics

Nurses or scientist women walking with syringe in their pocket and carrying five golden stars.

Here are the year’s best hospitals in the country, via US News

The list also ranks for best hospitals in different specialities. 

The One Big Beautiful Bill is expected to bring numerous changes to healthcare, including 

 in cuts to federal spending in the Affordable Care Act (ACA) marketplace and Medicaid over the next 10 years.

There’s one community that’s expected to see a particularly big impact from these changes: rural patients. 

 already faces unique challenges, like staff shortages, lower salaries, and less specialty care. While the bill allocated $50 billion for a “rural health transformation program,” experts still fear the money will not be enough to keep these 

 afloat and may even lead to facility closures.

“Something is going to collapse,” Lora Sparkman—a partner and VP of clinical solutions, patient safety, and quality for workforce management company Relias—told Healthcare Brew. “It’s going to be the already fragile and underserved, and that’s rural healthcare.”

Cuts to public insurance funding are a particularly big concern, as KFF reported almost 

 people in rural areas rely on Medicaid and 

 uninsured US children and adults as of 2023) could lose insurance due to the changes.

Some insurance loss will also likely occur due to new Medicaid work requirements (effective Dec. 31, 2026) in 40 states, requiring some enrollees to prove they have employment to get public health insurance unless they have a disability, are in school, or have children. 

 this kind of policy is more likely to remove patients from insurance than actually push people to work.

Katherine Hempstead, senior policy officer at healthcare research organization the Robert Wood Johnson Foundation, told us work requirements will “make it harder” for people to access Medicaid “even if they’re eligible.”

, which are credits designed to make care through the ACA marketplace more affordable. The credits are now set to expire at the end of 2025, which will mean higher healthcare costs for US residents—specifically, a $313 increase in premiums and a $900 rise in out-of-pocket maximum for a household of four with an annual income of $85,000 in 2026, nonpartisan research and policy institute the Center on Budget and Policy Priorities projected in April.

 in June the bill’s cuts to Medicaid and SNAP benefits, a federal food assistance program administered by states, could cause a $154 billion loss for state revenues by 2029 and cut 1.2 million jobs mostly in healthcare and food-related businesses.

Sparkman said she’s concerned rural hospitals may close as a result of these cuts. Rural providers already operate at a loss or “razor-thin margins,” she said, and cutting Medicaid will only make that worse.

Compared to metropolitan hospitals, where operating margins average 5.4%, operating margins for rural hospitals averaged 3.1% in 2023. For hospitals not near “any substantial population center,” the margins are even lower at 1.7%, 

“Rural areas are poorer, and rural areas have less employer-sponsored insurance, so the hospitals are really depending on these more public programs to give them revenue,” Hempstead said.

As for the $50 billion rural health fund meant to address some of these challenges, Hempstead said the money is “not enough,” especially considering it’s a one-time fund.

 to dole out $25 billion “equally” to states that apply with a “detailed rural health transformation plan over five years.” Centers for Medicare and Medicaid Services (CMS) Administrator Mehmet Oz will decide which states receive the other $25 billion, depending on how many people live in a rural area, the number of rural hospitals compared to nationwide rates, as well as other issues that “the administrator deems appropriate.”

CMS did not respond to a request for comment by publication.

Sparkman said adopting artificial intelligence could help rural hospitals respond to these challenges, as could using telemedicine and enhancing education and training.

Hempstead, meanwhile, remains skeptical of the fund’s effectiveness.

“I don’t think [the rural health fund is] an adequate response,” she said. “It’s not like everything was fine till you passed this bill. I don’t think this hospital fund is going to solve the problems created by this bill, nor is it going to solve the deeper problems with rural health.”

Illustration of a hospital with a "sorry we're closed" sign in front of it

Rural healthcare may ‘collapse’ from effects of One Big Beautiful Bill, expert says 

Rural healthcare is already challenged. Now it’s seeing new federal funding cuts. 

Homelessness was declared a public health emergency in Los Angeles in late 2022, with an 

 43,699 people who are unhoused in the city and 72,308 people unhoused in LA County.

 to end up in the emergency department compared to people with housing, according to one 2023 study. But emergency departments are 

 across the country, and appointments are expensive for both the patient and the hospital due to frequent and complex medical care that’s often further complicated by mental health issues within this population.

At the same time, it’s difficult to provide consistent care for people experiencing homelessness.

“There has been a demonstrated need…for this specific population to get some stabilizing healthcare in a way that’s more affordable than getting it in the hospital,” Brittnee Hill, director of interim housing and enriched residential care for LA County’s Housing for Health, told Healthcare Brew.

Opened in July 2022, the 96-bed Restorative Care Village provides free short-term housing for patients discharged from the hospital to continue their recovery while gaining access to stabilizing and housing resources. The program is a county partnership between Los Angeles General Medical Center and the Housing for Health effort within the LA County Department of Health Services.

Within the Restorative Care Village, buildings and tables

The idea is to have one medical campus that can treat everything from mental health to substance use disorder to emergency and inpatient care, Brad Spellberg, chief medical officer at the Los Angeles General Medical Center, said.

“And no matter what level of care you need, you move up or down that ladder to get to where you need to be until ultimately, you’re reintegrated into the community,” he added.

Something that sets the program apart from the 

 respite programs in the US, Heidi Behforouz, chief medical officer at Housing for Health said, is patients are also allowed to stay in the facility for longer periods. While some programs last only a few weeks, Hill said the average stay for recuperative care center patients is 180 days. (For comparison, the average respite stay in the US is 31 to 45 days, according to the National Institute for Medical Respite Care.)

“Sometimes it just takes two to three weeks to even unpack who are they underneath all of this immediate trauma and then start to work on recovery and rehabilitation,” Behforouz said.

The center, which also treats victims of domestic violence and substance use, additionally helps patients prepare for treatment that requires prep, like a colonoscopy.

In an attempt to build long-term solutions, the staff also works to connect patients with housing. In 2019–2020 in LA County, there were more than 186,167 

 from unhoused patients, according to the California Department of Health Care Access and Information.

The recuperative care center is just the first phase of a three-part plan. The campus will also include a residential treatment program for mental health, a sobriety center to help with substance use, and permanent housing support.

Since the program is still in its early stages, Spellberg said it’s still too early to understand its effects on the hospital and county.

But that doesn’t mean the program isn’t already affecting individuals.

Moises Alvarado has been homeless in Los Angeles for eight years.

In April, the 56-year-old was taken to Los Angeles County Hospital for the seventh time for the same affliction: ulcers in his feet. He was there for 12 days receiving antibiotics.

It’s a cycle for Alvarado. “Pretty much every year” his feet get infected, he said, and he’d be brought to the hospital before getting sent to a local respite center. But the treatment didn’t stick because he’d get discharged and lose access to social services. As a result, he wasn’t able to recover enough to get healthy or find a job and permanent housing.

But this time, he was sent to the Los Angeles General Restorative Care Village.

“Being on the street, it makes it a little hard to keep up with the appointments and for them to contact you,” Alvarado, who doesn’t have a cell phone, said, adding it’s challenging to keep paperwork.

Alvarado’s wounds are healing and he can walk better now. He’s also spoken with staff about finding permanent housing and connecting with agencies that can help with his condition.

“This is the best [facility] that I’ve been to,” he told us.

LA hospital Restorative Care Village, county partner to address unhoused crisis 

The program is still in its early stages, with more mental health and substance use treatment and housing support to come. 

LA hospital, county partner to address unhoused crisis 

Nicole Ortiz

Though Medicaid cuts in the Trump administration’s budget bill 

 hospitals, providers may start singing its praises after learning they’re due for a pay bump next year.

On Monday, the Centers for Medicare and Medicaid Services (CMS) shared its proposed 2026 physician fee schedule, which determines Medicare payments based on the amount of resources in provider services like office visits, hospice, diagnostic testing, ambulance care, and more.

The budget bill calls for a 2.5% raise, and this also accounts for a 0.55% adjustment in proposed changes to certain services, according to a CMS fact sheet. Last year, Medicare paid $32.35 per relative value unit for qualifying physician services; next year’s rate is set at $33.59. For nonqualifying services, it’ll grow from $32.35 to $33.42.

Put simply? Physicians will get a more than 3.6% increase to this year’s salaries.

This was just one element of Monday’s announcement, which also highlighted initiatives for improving care for things like chronic conditions, calculating more accurate payment rates, and establishing a new payment model for beneficiaries with heart failure and lower back pain (both of which see 

“We’re advancing technical improvements that reward high-quality, efficient care,” Chris Klomp, deputy administrator and director at CMS, said in a press release.

Adjustments can be made to the proposed rule until September before it goes into effect next year.

A 2D animation of a hospital with a bunch of pharma pills and dollar bill signs coming out of the top of it

CMS proposes 3.6+% pay increase for providers

The physician fee schedule would set Medicare payments at $33.42 for certain services.

illustrated headshot of caroline catherman, healthcare brew reporter

Caroline Catherman

There are about 90,000 people in the US waiting for kidneys, and nearly one out of every 20 dies each year, according to an estimate by the United Network for Organ Sharing, a nonprofit that manages organ donations nationwide.

 are getting creative in their quests to bridge this gap, going so far as to genetically engineer 

 for human transplantation, for instance, though only a handful of those procedures have been performed so far.

On July 1, the federal government rolled out a new solution: the Increasing Organ Transplant Access (IOTA) model. Over six years, the model will test whether performance-based payments can increase kidney transplants without hurting care quality.

The Centers for Medicare and Medicaid Services (CMS) has selected 103 hospitals across the US to participate in the model, including big names like New York’s Mount Sinai Medical Center and Baltimore’s Johns Hopkins Hospital.

Under the model, CMS will vary hospital payments for each adult Medicare fee-for-service kidney transplant based on that hospital’s number of adult kidney transplants per year, organ-offer acceptance rate ratios, and survival rates.

During the first year, CMS will give out bonus payments up to $15,000 per transplant to centers doing more procedures with higher organ-offer acceptance ratios and survival rates based on comparisons to that hospital’s historical benchmarks and national benchmarks. But from year two on, some hospitals will also be charged up to $2,000 a transplant by CMS for low performance based on similar benchmarks.

Multiplied, that adds up. Participating hospitals performed a range of 12 to 394 kidney transplants in 2023, according to CMS data. That could mean a bonus ranging between $180,000 to $5.9 million or a penalty of $24,000 to $788,000.

Trade group the American Hospital Association (AHA) is concerned because participation in the model isn’t optional for the selected hospitals. It’s also arguing the model may be incentivizing volume at the expense of quality.

It “could have an immediate detrimental impact on the quality of care or on patients’ access to care by overburdening their providers,” Jennifer Holloman, AHA senior associate director of policy, told Healthcare Brew over email.

CMS told us patient safety is “paramount” and performance will be “closely” monitored, with the model tweaked as needed.

“The model is specifically designed to reward appropriate, high-quality transplant activity, not simply volume,” a CMS spokesperson said in an email.

LaVarne Burton, president and CEO of the nonprofit American Kidney Fund (AKF), told Healthcare Brew in an email AKF understands where AHA is coming from, but the country needs to test better approaches to care.

“Given the number of people in need of a transplant and the better health and quality of life outcomes associated with a transplant, we need to find ways to improve the status quo,” she said. 

That said, however, Burton said AKF didn’t get everything it would have wanted out of this model. An earlier proposal from CMS included a health equity performance adjustment that would have given more weight to transplants performed on low-income patients. Its removal left AKF “disappointed,” she said. 

“The health equity performance adjustment would have been an important tool to ensure IOTA participants are not unfairly penalized if they serve a high number of low-income populations,” Burton said.

Gavel inside an empty human organ transplant box.

CMS’s kidney transplant overhaul has begun

Could financial incentive be the secret ingredient to solving the kidney crisis?

On June 10, Bobby Mukkamala was inaugurated as the 180th president of the American Medical Association (AMA).

An otolaryngologist from Flint, Michigan, Mukkamal chairs the organization’s substance use and pain care task force, won the AMA Foundation’s Excellence in Medicine Leadership Award last June, and served on the AMA board of trustees in 2017 and 2021.

He spoke with Healthcare Brew about how his recent brain tumor diagnosis has informed his leadership at AMA and his plans for the new role.

This interview has been edited for length and clarity.

Why did you want to become president of the AMA? What are your goals?

I have a slightly different answer than before. Up until I became a patient, it was all about my practice of medicine and just the hassles around trying to take good care of patients. Hassles like 

…That hassle factor was something that bothered me, and it bothered my patients.

Now, I’m a patient with something that puts me on death’s door. As far as having a big brain tumor and navigating the system, nobody’s going to have it better than me as far as access to the neurosurgeons that do exactly this kind of operation. That is unique. Inequity exists in our country…As a patient, I experienced the difference between what I have and what everybody else has.

What should people be paying attention to with the AMA? 

What I love about the AMA is that when we come up with our policies, it involves every state and every specialty in the country. It’s a room of almost 1,000 doctors who share the stories behind why they want to add something to our policies through a resolution. So when we approve something as a House of Delegates, it’s because it’s important to the majority of physicians in this country.

Another thing I became very passionate about was I became board certified in lifestyle medicine. The goal of lifestyle medicine is to prevent disease. Working on keeping people healthy and out of the hospital by eating the right things, by sleeping the right amount, by getting the right amount of exercise, by avoiding things like smoking and minimizing alcohol, by being social. The more we focus on prevention of disease—keeping people healthy—the less it’s going to cost us in the long run.

What do you expect will change in the industry in the next five or 10 years?

I predict that things will improve. I think the pendulum from when my parents were in practice and loving it to where we are now, this other end of the pendulum where physicians are just like, “You know what? I don’t want to deal with this anymore.” I predict that in five years, we’ll move a little bit back in that direction.

When we share stories with the people who are in a position to change the direction that we’re going, by things like regulation and who can do what, I’m optimistic we can at least move in the right direction.

American Medical Association president Bobby Mukkamala