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

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Hospitals

Nicole Ortiz

Healthcare Brew delivers the latest news and trends in healthcare.

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Dani Bowie, SVP of workforce AI at travel nursing agency Aya Healthcare, began her career as a nurse and has moved into “helping hospitals run more efficiently.” With Aya specifically, she’s in a role where she taps into how AI and predictive analytics can ensure nurses are scheduled “in ways that support their well-being and help hospitals manage labor costs,” she said.

We spoke with Bowie about how her work has evolved and how the tech she works with factors in.

This interview has been edited for length and clarity.

What’s the best change you’ve made or seen at a place you’ve worked?

 remains one of the most complex challenges for hospitals and health systems. Where efficiency and automation are lacking, and resources are misaligned, that’s where technology can make the largest impact: by transforming scheduling. What previously took hospital nurse leaders hours and days can now take less than five minutes with the right technology.

What’s the biggest misconception people might have about your job?

, there are a lot of misconceptions about AI in healthcare. AI isn’t intended to replace clinicians but rather enhance their work and help them practice to the top of their licensure. The tools we’re developing are built to save nurse managers hours per week of manual effort—that kind of time savings is invaluable.

What’s the most fulfilling aspect of your job?

As a former health system executive, seeing the technology I designed and created implemented in hospitals across the country is so rewarding. It’s ensuring nurses like me are caring for patients at the bedside rather than being 

, staring at a computer screen covered in sticky notes, buried deep in spreadsheets until they’re cross-eyed.

What healthcare trend are you most optimistic about?

I’m really optimistic about how technology will 

 streamline processes, better utilize their resources, and improve alignment between previously siloed units. Technology is helping frontline leaders get away from mundane and tedious work so they can focus on what’s most important: patient care.

How this healthcare exec is helping make health systems more efficient with AI

Dani Bowie oversees how Aya Healthcare implements the tech, with hopes of reducing burnout.

Cassie McGrath

Apples are ripening, and football season has officially kicked off. But with temperatures dropping, that also means cold and flu season is right around the corner.

Cold and flu season is typically the busiest time of year for hospitals, as respiratory diseases like Covid-19 and RSV spread, and hospitals are forced to grapple with 

For decades, health experts have recommended vaccines as the best way to protect against these viruses. But on Sept. 9, the Make America Healthy Again Commission released a new strategy that includes investigating “vaccine injuries” and potentially making changes to the childhood vaccine schedule.

Some Trump officials are also trying to link vaccines to children’s deaths, the 

Previously, most adults who wanted a Covid vaccine could go to a local pharmacy to get it. But on Aug. 27, the FDA approved the next round of Covid vaccines with new limitations that only allow people over age 65 or people who are at higher 

Mary Turner, president of the National Nurses Union, expressed concern about the public health effects in a statement on Aug. 28 and said the decision presents a “major risk with the ongoing threat of Covid and further mutations of the virus.”

Experts have also told us the move could place a greater burden on providers.

“Restricting [vaccine] access will likely mean more Covid cases in the broader population, which in turn could drive additional strain on emergency departments and urgent care centers,” Tyler Evans, a physician as well as co-founder and CEO of the Wellness Equity Alliance, an organization that addresses health inequities, said in an emailed statement.

 than normal, with one major Oregon university hospital reportedly treating 1,101 cases of flu in November and December, compared to 251 during the same months in 2023, 

“Based on the current regulatory environment,” CVS 

 in a statement, it and Walgreens are cutting down vaccination efforts, 

, by either requiring prescriptions or stopping vaccinations in certain states. In a statement, Walgreens reportedly said it “is prepared to offer the vaccine in states where we are able to do so.”

 90% of Covid vaccines were performed at those two pharmacy chains in 2024.

As a result, clinicians who work with providers administering the vaccine could see an increase in workload, Evans said.

“As pharmacies scale back vaccination programs, the responsibility will fall more heavily on frontline providers such as nurses, pharmacists, and community health staff during an already demanding season. That added workload raises the 

 and missed opportunities to protect patients,” Evans said.

 found that some clinicians can, per adult patient, spend an average of 5–29 minutes on vaccine services—but many patients end up electing to not get inoculated.

 Some states are taking matters into their own hands.

Massachusetts’s Department of Public Health, for example, issued a standing order on Sept. 3 to allow most people over the age of five who want a Covid vaccine in the state to get one. California, Oregon, and Washington formed a West Coast Health Alliance, also on Sept. 3, to share trusted health information, including “coordinating health guidelines” based on immunization recommendations from national medical organizations, according to a press release.

Sandra Adamson Fryhofer, a trustee for the American Medical Association, said in a Sept. 3 statement the industry group “strongly opposes” the state’s plan.

“This unprecedented rollback would undermine decades of public health progress and place children and communities at increased risk for diseases,” the statement read.

injecting injection vaccine vaccination medicine flu man doctor insulin health drug influenza concept - stock image

How Trump administration Covid vaccine limitations could affect hospitals 

Experts say vaccine limitations may place burdens on providers. 

Maia Anderson

Ever wonder what entices an executive to jump ship and join a new health system? For Amy Perry, Banner Health’s insurance arm caught her eye.

Perry joined the Arizona-based nonprofit health system as president and COO in November 2021 and took the reins as president and CEO in July 2024. Before joining Banner, she was SVP of integrated care delivery and CEO of New Jersey-based Atlantic Health’s hospital division for four years.

Banner is Arizona’s largest health system and consists of 33 hospitals that handle roughly 6.4 million clinic visits per year and have more than 55,000 employees. The system brought in $15.6 billion in revenue in 2024.

Perry told Healthcare Brew the fact that Banner has its own health plan with about 1.2 million members was a big part of the reason she took the job, as she sees provider-sponsored health plans, or PSHPs, as a “really important approach to healthcare.”

PSHPs are health insurance companies that are owned, either partially or fully, by a health system, hospital, or other provider group. The largest example is the Kaiser Foundation Health Plan, which has more than 12.6 million members and is run by Kaiser Permanente, a California-based health system.

As of 2022, 197 health systems in the US (or 31%) have PSHPs, according to healthcare analytics firm Trilliant Health.

PSHPs help health systems move away from a 

Healthcare’s reliance on sick people to generate revenue is a primary reason costs keep rising, according to Perry.

“When we are able, as health systems, to get premium revenue, we can actually save money when people stay well. It’s almost a completely shifted paradigm,” she said.

About 74% of Banner’s revenue came from the fee-for-service side of the health system and about one-quarter (or about $4 billion) came from premiums in 2024, Perry said.

“I’m just a fervent believer that we’ve got to find a way to migrate, as health systems, toward more of this at-risk, premium-based care,” she said.

However, it’s not easy to be both insurer and provider, according to Katherine Hempstead, a senior policy officer at healthcare research organization Robert Wood Johnson Foundation.

That’s because providers are typically incentivized to do more higher-cost procedures while payers try to keep costs down.

“When you’re trying to do both jobs, it can create a conflict,” Hempstead said.

Some large hospitals, including Northwell Health, the largest health system in New York, have 

 to create PSHPs. Northwell blamed high risk adjustment payments for why it shuttered its PSHP, CareConnect Insurance Company, in 2017, Fierce Healthcare reported. 

Perry acknowledged how hard it is to run both a health system and an insurer, saying “it’s very difficult to live in both worlds.”

However, despite the challenges, there are also upsides, she added, such as premium revenue that allows the health system to invest in chronic disease management and other things “you wouldn’t even consider on the fee-for-service side because there’s simply not enough funding.”

But premium revenue hasn’t shielded Banner from broader industry headwinds like Medicaid funding cuts and 

President Trump’s One Big Beautiful Bill Act, which was signed into law on July 4, is set to 

 by about $1 trillion over the next 10 years. Perry said Banner is bracing for a reality in which some services may have to be cut.

“We have a significant commitment to Medicaid patients and the service lines, but at the same time, there’s only so much we can do if we are scaled back,” Perry said. “Access will be affected, not only in clinics but in emergency rooms.”

To prepare for the cuts, which will take effect 

 over the coming years, Banner is “battening down the hatches like most health systems and trying to reduce our expenses as much as possible,” she said.

Tariffs on products like aluminum and steel already cost Banner roughly $23 million as of September, according to Banner’s SVP of Finance Adrienne Moore, and the health system expects that figure to be less than $35 million by the end of 2025.

In addition to navigating Medicaid cuts and tariffs, one of Perry’s top goals as CEO involves a $1 billion investment in technology the health system plans to pay over the course of five years, she said.

As part of that initiative, Banner created its own ChatGPT-like program called BannerWise via a 

 with AI company Anthropic to analyze data from things like physician notes and pathology results, Modern Healthcare reported earlier this month. Perry told Healthcare Brew this will help providers use the health system’s data “in a more strategic and analytical way.”

Beyond investing in technology, Perry said she’s very focused on connecting with the communities the health system serves in the near term.

“If we’re able to do that and we do it successfully over the next five years, I’m going to be one happy CEO,” Perry said. 

A woman, Amy Perry, Banner Health CEO, cutout and contained in an abstract shape while breaking the frame.

Banner Health CEO Amy Perry on running a health system with an insurance business

From health insurance to Medicaid cuts, Perry dishes on her first year leading Banner Health.  

Banner Health CEO on running a health system with an insurance business

illustrated headshot of caroline catherman, healthcare brew reporter

Caroline Catherman

As some in the medical field know too well, it can be hard to leave a healthcare job.

Sure, patient relationships and coworker bonds are difficult to sever, but one of the top things keeping many from branching off on their own just might be their contracts.

Between 37% to 45% of US physicians are in employer agreements that limit where they can work after they leave or how long they must stay in their current position, according to professional group the American Medical Association (AMA), compared to about 18% of the overall workforce nationwide, per a 2021 

On Sept. 10, the Federal Trade Commission (FTC) announced it had sent warning letters to several healthcare and staffing companies with potentially “unreasonable noncompete agreements in employment contracts.” A few days earlier, it had 

 for public comment to inform “case-by-case” enforcement of noncompetes going forward.

This comes shortly after the commission announced Sept. 5 it’s officially abandoning attempts to defend a 

 on all noncompetes that it passed in April 2024.

It’s all left providers and hospitals alike asking: What’s next for noncompetes?

“Even though [the FTC ban] legally did not go through, that has caused a lot of professional societies, state governments, and regulators to take a look at the issue,” Joseph Marine, a professor of medicine at Johns Hopkins University School of Medicine, told us.

 Chances for a nationwide ban on noncompetes are “slim,” but restrictions are growing state by state, Daniel Gilman, a senior scholar of competition policy at nonprofit research organization International Center for Law & Economics, told us.

There have been more than 60 state bills introduced in 2025 to establish or expand restrictions on noncompete agreements, according to bipartisan public policy organization the Economic Innovation Group. As of June, the group counted four states (California, Oklahoma, Minnesota, and North Dakota) that have totally banned noncompetes and 34 plus Washington, DC, that have restricted their use.

Whether restricting noncompetes is a good thing depends on the market and who you ask.

Marine believes that while these agreements can be a tool for smaller practices to ensure they recoup their investment in new hires, it’s possible they could also be “abused” by big health systems and groups to dominate a local market, as has been previously 

“Noncompetes are being written in a way by these large health systems that physicians who wish to leave and do something differently are virtually always forced to move, sometimes out of the state, in order to practice,” he said.

In 2023, hospital lobbyist group the American Hospital Association opposed the FTC’s ban on noncompetes, arguing 

 to the commission it could disrupt the healthcare labor market and exacerbate healthcare worker shortages.

AMA, which lobbies for physicians, largely opposes noncompetes in its code of ethics. It argues they “restrict competition, can disrupt continuity of care, and may limit access to care,” though it 

 a complete ban, either, the organization said last year.

Gilman said whether noncompete agreements illegally restrict competition likely depends on the market and factors like how many competitors there are.

He said there’s not enough research to conclude how noncompetes impact physicians or healthcare costs.

“​​We have very few studies of the effects of noncompetes in the healthcare sector specifically, or even more specifically, with regard to particular healthcare occupations,” he said.

 in the Journal of Human Resources found noncompetes to be linked to lower physician job turnover. The study also noted, however, that this is a “relatively understudied topic” and more research is needed.

What is the future of healthcare noncompete agreements?

Breaking up is hard to do.

The healthcare industry has seen an increasing number of 

 in recent years, and time is running out for Congress to renew legislation that experts say is key to detecting threats before an attack takes place.

Deemed the Cybersecurity Information Sharing Act of 2015, or CISA, the legislation makes it possible for organizations that scan for cyber threats to share information about potential bad actors before a cyberattack occurs and without potential legal liability. But the act is set to expire on Sept. 30, and experts told Healthcare Brew that without it, the healthcare system would be more vulnerable. 

“When information is not shared, it gives an upper hand to the attackers because they go undetected,” Mike Nelson, VP of digital trust at cybersecurity firm DigiCert, said. “The unfortunate result is that, as less information is shared, attacks will certainly go up.”

Before the legislation was passed, if an organization detected a threat for a potential cyberattack, it might have been hesitant to share that information for fear of legal liability, according to George Pappas, CEO of healthcare cybersecurity compliance company Intraprise Health.

“You’re really asking parties to share [information] before they have a solution,” he said.

What CISA did was remove that liability component so organizations were protected when sharing information about potential bad actors.

“Information sharing around cybersecurity is a critical aspect of protection,” Nelson said. “For example, if one hospital gets hit from ransomware, they can rapidly share how they were attacked, the details of that attack, and it can arm the rest of the industry to say, ‘Hey, we can now prevent that.’”

If CISA is allowed to lapse at the end of September, hospitals and healthcare organizations at large will likely see more successful cyberattacks “because organizations would be less prepared to respond to those attacks,” Jon Moore, chief risk officer and SVP of consulting services at healthcare cybersecurity company Clearwater Security, said.

Cyberattacks are already a huge problem in healthcare. The industry had the most cyber threats last year among all critical infrastructure industries, according to the FBI’s 2024 Internet Crime Report, which listed a total of 444 ransomware and data breach incidents in healthcare. The same year, the Change Healthcare cyberattack 

Without CISA, organizations will likely return to sharing less information on potential cyber threats because their legal teams will advise caution without the protections the act offers, Nelson said.

Two senators—Mike Rounds, a Republican from South Dakota, and Gary Peters, a Democrat from Michigan—introduced a bill in April to extend CISA by another 10 years. 

In a press release announcing the bill, Rounds said allowing CISA to lapse could “significantly weaken” cybersecurity ecosystems, “removing vital liability protections and hampering defensive operations across both the defense industrial base and critical infrastructure sectors.”

No progress has been made on advancing the bill, but 

 reported on Aug. 19 the House Homeland Security Committee confirmed plans to mark up the bill when Congress comes back from its August recess.

Since CISA was passed, the healthcare industry has seen “tremendous improvement” in keeping organizations protected from cyber threats, Nelson said, adding, “I just hope that progress continues.”

Red folders in the shape of a hospital cross with a mouse pointer

How hospitals may be affected if 10-year-old CISA cybersecurity law is allowed to lapse

Congress has until the end of September to renew the law, which allows organizations to share information about potential cyber threats.

How hospitals may be affected if a 10-year-old cybersecurity law is allowed to lapse

 to rise 9% in 2026, it seems employers and patients alike can’t expect a slowdown in spending anytime soon.

 have been proposed to establish price transparency about healthcare costs, so patients can know what they’re expected to pay up front.

Now, Trillium Health is giving a look into the numbers.

The healthcare analytics company published last month a 

 (2,659 hospitals and 3,491 ambulatory surgery centers across the nation) that provides some insight into these rising costs.

The report used data provided through the Centers for Medicaid and Medicare Services (CMS) 

, a 2020 regulation that requires health plans to share out-of-pocket cost information and negotiated rates. The idea was to give patients information about how much they’re expected to pay before care is delivered.

But when payers started reporting this information in July 2022, the data was hard to sort through due to the “complexity and extremely large” files, 

, which monitors health spending, reported in February. Trillium Health sorted through the data, and ultimately found great variation in what hospitals, payers, and patients spend on the same care.

While patients who are publicly insured pay rates set by CMS, commercially insured patients’ rates are individually negotiated between insurance companies and providers. As a result, patients with different health plans get billed different amounts for the same procedure.

For example, the report looked at negotiated rates for six inpatient treatments like coronary bypass, bowel movement procedures, and hip, knee, and ankle surgeries. Among 101 hospitals in Pennsylvania, UnitedHealthcare’s negotiated rates for a bowel procedure involving a complication or comorbidity could cost anywhere from $18,066 to $87,457.

There was even price variation within some hospitals, the report found. At Tufts Medical Center in Boston, the negotiated rates for a coronary bypass involving major complications or comorbidities were $95,989 with Aetna and $144,204 with United, according to the report.

The report also found care largely costs less at ambulatory surgery centers compared to outpatient hospital departments (e.g., $1,179 compared to $3,633, respectively, for a colonoscopy). This difference in price presents an annual $4.5 billion in “potential savings” for colonoscopies at ambulatory centers, according to the researchers.

Here are a few other things worth noting:

US health spending in 2023 was $4.9 trillion, or $14,570 per person.

Spend in the US is 139% higher than Switzerland, which has the next-highest spend per person.

The report found “no observable correlation” between cost and quality of care at 10 providers featured on three 

Large scale pill with a price tag attached lays on top of the US map. (Credit: Anna Kim)

Report: Healthcare costs could vary greatly depending on the health plan

Trillium Health pored over CMS data and found great variation in what patients pay for care, depending on their insurer. 

 (EHR), you likely think of Epic, as the healthcare software company has records for 325 million patients and is the largest in the US.

And when you think of the modernization of the EHR, you may think of AI scribes like 

, the note-taking assistants designed to speed up clinical documentation.

Scribes can save physicians 15,000+ hours in work per year, 

 published in the journal NEJM Catalyst Innovations in Care Delivery reported, and between $200 billion to $360 billion in annual healthcare spending, 

But this month, the inevitable happened: 

 it was developing its own AI tools, including Art, an AI scribe that will, like other apps, share medical information with clinicians in real time. It’s part of Epic’s “native AI charting” developed in partnership with Microsoft, and is expected to launch for “limited use” early next year, a spokesperson from the company told Healthcare Brew and other outlets.

So what will happen to the scribe startups when the EHR giant releases its own AI tools?

Experts told Healthcare Brew they expect some market shift, but think their technologies provide strong value to providers.

“I wouldn’t be a very good founder if I didn’t think this was already going to happen,” Tom Kelly, co-founder and CEO at AI scribe developer Heidi Health, said.

You may have noticed, but Epic isn’t only releasing an AI scribe. It’s looking to build a suite of AI tools to help everywhere from the patient room to the back office, according to the company.

This highlights a bit of a trend in the health tech industry: Execs don’t want to just make scribes; they’re instead hoping to automate the entire healthcare workflow.

In fact, Ambience Healthcare—one of the leading AI scribe developers in the US, with at least 40 clients like the Cleveland Clinic and the Houston-based Memorial Hermann Health System—made its own expansion announcement, entering a $243 million Series C fundraising round on July 29.

Then on Aug. 19, Ambience released an AI copilot tool, Chart Chat, which works within Epic to provide real-time health information to clinicians, like lab results and prior treatments.

“We still feel like we’re 5% of the way through everything we possibly want to build,” Nikhil Buduma, Ambience’s co-founder and chief scientist, told us.

AI healthcare company leaders are also confident in their technologies.

The two co-founders said they think Epic will provide an accessible—and possibly cheaper—internal solution, which may be better suited for an outpatient facility. But Buduma said academic medical centers may want something more high tech since they tend to care for more patients and handle more complex cases that require added clinical integration.

It’s also important to differentiate between competitors.

For example, Kelly said Heidi Health is focused on building a tool that can be used in Epic but isn’t necessarily 

 to be. This means it can also complete tasks, like helping with forms outside of the medical record, in addition to its note-taking capabilities, Kelly said.

AI scribe companies also have existing contracts with providers. Ambience and Cleveland Clinic signed an agreement for five years back in February, for instance.

Just because Epic has its own scribe now doesn’t mean these partnerships will disintegrate, the two co-founders said. Buduma said Ambience plans to work with the Cleveland Clinic while further developing its products.

Still, Kelly said he “would never want to let an agreement be the thing that keeps [Heidi’s] customers” adding it’s the health tech company’s responsibility to build an integrated product “that makes it really hard to swap” for another tool.

Where he could see companies running into problems, though, is when their value proposition is their integration with Epic. If Epic is cheaper, doesn’t require additional authentication, and there’s no data-sharing risk, “then it probably will be actually quite easy for [health systems] to swap,” Kelly said.

When contract renewals come around, he expects to see some lower prices because of this. There could also be more 

With this competitive market and increasingly high-tech products, Epic’s announcement "definitely will heat up the market,” Kelly said.

Robot typing text on a typewriter. Artificial intelligence generated text and future of journalism concept. Vector illustration.