Healthcare Data Guy

Want to know the craziest part about insurance company Pre Authorization Denials ? The insurance company defines the network of providers the patient can use When they deny care, they are effectively saying "we don't trust the judgement of the doctors we require you to use" 🤯🤯🤯

This is a photo I snapped flying over N. Virginia recently. There are currently 685 data centers in Virginia, with many more being built, and a total of 427 Dollar General stores. Virginia has more data centers than any where else in the world. Somehow that ratio doesn't seem right...

Cardiologist wins 3rd place at Anthropic's hackathon. Out of 13,000 applications. Built in 7 days by Michał Nedoszytko MD. Coded day and night - in the hospital, in the cloud, while flying from Brussels to San Francisco. A few years ago, it would have been impossible for a doctor to build this alone in just a couple of days. AI changed that. The project is called postvisit.ai. It is an AI agentic care platform for patients. Including reverse AI scribe it is a companion that guides the patient from the moment they leave the doctor's office. Powered by the massive context window of Opus 4.6, it allows patients to explore their full medical history, connected devices, Evidence Based resources and external data sources — all in one place. Today, the barrier to entry has vanished; even a practicing physician can build an application from scratch.

HHS just open-sourced the largest Medicaid dataset in history. About $1T in claims data, free for anyone to analyze via @DOGE_HHS. Everyone's looking at what was billed. At @MiddeskHQ, we're looking at who's behind the billing. Here's what we found 🧵

An amazing activity teaches children to take risks, build confidence, earn rewards, trust others, and be quick on their feet. So many wonderful lessons 😊

Free use cases eBook: forwardfuture.ai/p/what-people-… Use my prompts: gist.github.com/mberman84/6316…

Count me in. Removing doctors from control of most prescriptions would be a big plus. It's mostly pure bureaucracy, often very poorly handled.

7,000 bureaucrats at @cmsgov. Exposed by DOGE. And not a single one of them was looking out for you. 6,557 employees overseeing $1.52 trillion in spending, 22.5% of the entire federal budget. That’s 0.3% of the federal workforce controlling nearly a quarter of all federal dollars. Where do they come from? Insurance companies. Hospital chains. Consulting firms. Where do they go when they leave? Right back. 53% of CMS appointees exit to private industry after their government stint. Only 15% came from industry. The pipeline flows one direction, toward the money. Marilyn Tavenner ran CMS, then became CEO of AHIP, the insurance lobby, for $4.6 million over three years. Before CMS? 25 years at HCA. Seema Verma left CMS for Oracle. Thomas Scully was previously a scum bag for the Federation of American Hospitals, became CMS administrator, then landed at a private equity firm. This isn’t public service. It’s a résumé builder with a $1.5 trillion sandbox. And when DOGE finally came knocking? CMS was largely spared. Only 300 positions cut out of 6,500. Rumor has it, the DOGE lead for HHS was a healthcare entrepreneur himself and reportedly shielded CMS from deeper cuts. Let’s see what the DOGE has to tell us about that. The fox isn’t guarding the henhouse. The fox built the henhouse, staffed the henhouse, and owns the henhouse. Premiums are too high! Fraud and “improper payments” appear rampant. And now that the HHS data is public, every American deserves to know what’s been driving those prices. The $9 billion Minnesota Medicaid scam that X went after? The deeper we dig into the HHS data, the more that looks like child’s play. It’s as if a giant piggy bank was cracked open for a select few and the hard-working Americans who fund this system were never invited. Link to article in replies.

The HHS Medicaid Provider Spending dataset is now publicly available for the first time. I pulled every organization in the country that bills under code T1019, Personal Care Services. That's bathing, dressing, and meal prep for Medicaid beneficiaries. Non-medical. Delivered by home health aides. The national spend on this single code from 2018 to 2024: $122.7 billion. 98 entities collected 42.5% of it. Nine of them crossed the $1 billion mark. Seven are in Brooklyn. Some share the same block. Some share the same authorized official. Some share the same address, four doors apart. Physicians face prior authorization, peer review, board certification, malpractice exposure, and utilization review to practice medicine. These entities operate under the lightest regulatory classification in healthcare while processing more dollars exponentially. The oversight infrastructure for the largest Medicaid spending category is either absent or non-functional. The data is now public. Part 1 of the investigation is live. dutchrojas.substack.com/p/the-billion-…

I heard from an administrative colleague about a meeting that made his jaw drop. He was summoned to an “emergency summit” to discuss his health system’s decline in heart failure admissions. The cardiology department had been focused on reducing heart failure admissions and readmissions The focus of the “summit” would make anyone with a consicence blush: How do we increase our heart failure admissions? The most benign view is that the system wanted to get a larger share of a shrinking pie of admissions in the community. But the subtext of the meeting was unmistakeable: when patients win, hospitals lose. In many ways, outpatient management of heart failure was “too effective.” High margin heart failure admissions and ICU stays were shrinking in number. And, yet, rather than declaring victory and the stunning success of the cardiology team, the hospital was in a panic. Revenue was declining—and the hospital’s finances were suddenly in disarray. They needed more admissions—and fast. Said another way, they needed more sick people to need their services. Traditional administrators would say the dynamic is an outgrowth of our broken fee-for-service health systems. That incentives from value-based care do not make up for loss of volume. But there’s something more nefarious in this short vignette: it’s the unquestioned institutional focus on finance over health. “No margin, no mission,” some might glibly say. But has the mission been fundamentally corrupted? 
Is our mission: Keeping our beds full? Our margins high? Our doors open? 
Our teams employed at all costs? Or is our mission to promote the health and well-being of the community? We have clearly lost our way in important respects. For if it was the latter, the emergency heart failure admissions meeting would not be an institutional crisis, but a celebration. Celebration of community health. 
Celebration that patients were able to spend more time at home than in the hospital. Celebration that patients were healthier and so needed services less, not more. But, yet, health service organizations too often measure themselves by traditional business metrics: Volume. Revenue.
 Profit. Which of course are the wrong metrics for (mostly not-for-profit) health systems and hospitals who are chartered to serve the public good. It is the (hard) work of hospital administration to work proactively with payers to ensure that they are financially rewarded for doing the right thing. Not to blame the system and perverse incentives. forbes.com/sites/sachinja…

NEW: The HHS DOGE team just open sourced the largest Medicaid dataset in department history. This dataset contains aggregated, provider-level claims data for a specific billing code over time. $1T in Medicaid provider spending data released here: opendata.hhs.gov.

Be Dr Elisabeth Potter > Princeton molecular bio > crush Emory med school > match into the most competitive plastics residency at UT Southwestern > fellowship at MD Anderson learning to rebuild breasts with a woman’s own tissue > graduate top of the game, DIEP flap queen, 1,000+ cases deep > join big hospital systems in Austin > watch insurance companies nickel-and-dime cancer patients for years > see OR fees hit $30k+ before the surgeon even picks up a scalpel > get the infamous @UHC call *while patient is under anesthesia* asking if she really needs to stay overnight after mastectomy + reconstruction > step out of the OR, fight on the phone, they deny her anyway > posts the video > it explodes > millions of people finally see what doctors have been screaming about for a decade > United sends the lawyers > “delete the videos or else” > she laughs, posts the letter instead, and goes harder > they cut her brand-new surgery center out of network > Redbud Surgery Center, the one she poured millions into so women wouldn’t get crushed by hospital bills > suddenly staring at bankruptcy while still trying to operate > double down on cash-pay transparency > same elite surgeons, same microsurgery expertise > do the $100k+ hospital case for a fraction of the price > same day, same quality, zero corporate middlemen bleeding the patient dry > keep posting, keep fighting, keep winning small battles (Aetna in-network, Cigna in-network, one patient at a time) > turn the whole thing into a movement > be the surgeon who said “if I want healthcare to be different, I have to practice differently” > actually do it > still in the arena > still taking on the biggest insurers in America > still rebuilding women after cancer I’m inspired! The Elizabeth Potter arc is what I hope for all my physician colleagues @EPotterMD @DutchRojas

Many people face high deductibles and out-of-pocket expenses with their Healthcare plans. My guy uses OWN YOUR LABS for his medical lab tests. Here is the website and a few examples of tests and their costs. They are a FRACTION of what you pay, even WITH insurance. And you don't need a doctor to order the tests for you. ownyourlabs.com/shop

@thejobchick that sounds like S&P 500... what's remaining? Russell 2000?

Layoff Watchlist: Feb 6, 2026: Dick’s Sporting Goods EY Fidelity KPMG MLS Unilever AWS Siemens Healthineers Sysco Santander Ashley Furniture Goldman Sachs Stanford University Dartmouth College Android NBCUniversal Blue Cross Blue Shield Emerson Blue Owl Capital The Ladders Robert Half Westinghouse Electric Company Chewy J.Crew BioSpace New York Life Warner Bros. Discovery SharkNinja Barclays JPMorgan Chase BlackRock Kaiser Permanente Citi Salesforce S&P Global Korn Ferry Evercore Lionsgate Saks Global USAA Ford – Greenfield Site Strategy Stripe Meta Volvo Google Lyft Royal Caribbean Group Blue Origin Coca-Cola Cargill Okta Voyager Walmart Autodesk DocuSign Aon Activision Blizzard Qualtrics Adobe HelloFresh Disney Visa Flock Safety L3Harris Workday (2/5/26) Empower Pharmacy Pep Boys Merck CLEAResult SanDisk Supermicro Bain & Company The Cheesecake Factory Affirm Local, State, & Government Positions I will start putting out overviews for each including timing, divisions and estimated totals in the coming days.

100% Correct. Consumer payments at point-of-service will bring transparency to an opaque pricing system and promote competition. It is, however, unlikely to happen in the near future.

Started a week ago, not knowing how to write a single line of code I wanted to read the Bhagavad Gita daily, but couldn't find an app that felt right. So I built one. Ended with a full iOS app live @10minutegita on the App Store: → 239 daily readings of the Bhagavad Gita → Original Sanskrit shlokas + transliteration → Verse-by-verse translations & commentary → Personal daily reflections → Streak tracking with calendar heatmap → Shareable verse cards with 8 gradient themes → Hindi & English bilingual support → Light/dark mode, adjustable fonts → Completely offline after download Total cost: $200 Claude Max Subscription + $20 ChatGPT Pro Subscription + $99 Apple Developer fee Lines of code I wrote: 0 Claude Code wrote everything. I just described what I wanted in plain English (non-technical background). Codex reviewed it. Now it's live on the App Store. The barrier to building isn't coding anymore. It's just knowing what problem you want solved. Links & Full Process in 🧵↓ Built with @AnthropicAI's Claude Code

Fairfax County pays $403K/year for a health director who is NOT a physician and literally follows WHO/CDC protocols and sends propaganda emails like this👇🤬Why doesn't Virginia have a Surgeon General? @VAMEDFREEDOM @feds4freedomusa content.govdelivery.com/accounts/VAFAI…

@wesmckinn @jenstirrup I thought Outlook could do this since Gmail was invented using POP3 or IMAP

I've used Gmail for 20 years. Almost 2M emails, 150K attachments. Rather than let Google hold my data hostage, I built msgvault: local-first email archive with a terminal UI and MCP server, powered by DuckDB. Open source, single Go binary. wesmckinney.com/blog/announcin…