The Ledger

60,000 patients: that is how many UHealth patients keep their in-network access after a deal reached today ended a standoff this issue has tracked since July 27. The University of Miami Health System and UnitedHealthcare announced a new multi-year agreement today, July 31, 2026, the exact deadline this issue has covered for four straight days, after what UHealth’s own negotiation page calls “14 months of productive discussions.” The agreement preserves in-network access for more than 60,000 UHealth patients across employer-sponsored commercial plans, individual and family plans, and UnitedHealthcare’s Florida Medicaid product; UHealth said in its announcement that “United saw the value of maintaining access to academic medicine for the thousands of patients who rely on us for their complex care.” Financial terms, including the reimbursement-rate increase UHealth had sought to bring its rates in line with peer South Florida systems, were not disclosed. Confidence: Medium. UHealth’s own negotiation page, updated today, is unambiguous about the agreement, but this run could not independently corroborate the announcement against UnitedHealthcare’s own page, which returned an access block, or against contemporaneous trade press, which had not yet caught up to today’s resolution. Source: UHealth and UnitedHealthcare Negotiation, University of Miami Health System.

882.74 million dollars: that is how much more Medicare will pay the nation’s skilled nursing facilities next year, even after the program’s own advisers told Congress to cut their rates instead. The Centers for Medicare and Medicaid Services finalized its fiscal year 2027 Skilled Nursing Facility Prospective Payment System rule this week, setting a 2.4 percent net payment increase, a 3.3 percent market basket update reduced by a 0.9 percentage point productivity adjustment, for an estimated $882.74 million aggregate increase in Medicare Part A payments to SNFs. The rule lands five months after the Medicare Payment Advisory Commission’s March 2026 Report to Congress recommended the opposite: a 4 percent cut to fiscal year 2027 SNF base rates, citing an aggregate fee-for-service Medicare margin for freestanding nursing facilities of 24.4 percent in 2024, a margin MedPAC projected would climb toward 25 percent in 2026. CMS’s own fact sheet acknowledges commenters raised MedPAC’s recommendation and its margin data during the rulemaking; the agency proceeded with the statutory market-basket update regardless, and also left open, without finalizing, a methodology to address what commenters and MedPAC have both flagged as “case-mix creep” under the current patient-classification system. Confidence: High, since the payment figures come directly from CMS’s own fact sheet and the margin and cut recommendation come directly from MedPAC’s own published report. Sources: Fiscal Year 2027 Skilled Nursing Facility Prospective Payment System Final Rule (CMS-1843-F), CMS, Executive summary, March 2026 Report to the Congress, Medicare Payment Advisory Commission.

95.3 billion dollars: that is how much disclosed capital moved into healthcare deals last quarter, even as the number of transactions kept falling. LevinPro HC, the research platform published by Irving Levin Associates, reported that the second quarter of 2026 produced 459 publicly announced healthcare transactions, down from 553 in the first quarter and down 23 percent from 503 deals in the second quarter of 2025, the second straight quarterly decline in deal count. Dollar volume told the opposite story: disclosed spending reached $95.3 billion across 78 priced transactions, up from $74.7 billion in the first quarter and more than triple the $28.7 billion disclosed in the second quarter of 2025, driven by 21 transactions exceeding $1 billion, up from 13 in the first quarter. Physician medical groups led deal count with 106 transactions, 23 percent of the total and down from 124 in the first quarter, with dental practices the single most active specialty at 54 deals; private equity buyers accounted for 151 deals, 33 percent of total volume, up from 27 percent in the first quarter. Confidence: High, since the deal counts and dollar figures come directly from LevinPro HC’s own published report. Source: Healthcare M&A Deal Volume Drops in Q2:26, According to Acquisition Data from LevinPro HC, GlobeNewswire.

6,673 hospices: that is how many providers Medicare just scored, by name, on a new 0-to-16 scale built to flag which ones are pushing costs onto other parts of the program. CMS finalized its fiscal year 2027 hospice payment rule this week, completing the Service and Spending Variation Index, a composite score built from nine claims-based measures of hospice utilization and non-hospice spending, and for the first time published named, provider-level SSVI scores for 6,673 hospices in fiscal year 2025 and 6,735 in fiscal year 2024, a public download on cms.gov. The rule also finalized data behind the score’s creation: Medicare paid more than 2.8 billion dollars in non-hospice spending, under Parts A, B and D, for patients who had already elected hospice in fiscal year 2024, up from roughly 790 million dollars in Parts A and B alone in fiscal year 2020, a 160 percent increase, and because the existing voluntary disclosure addendum “has not achieved the intended accountability objective,” CMS finalized a requirement that hospices give every Medicare beneficiary a written addendum on non-hospice coverage at the time of election, effective for elections beginning October 1, 2026, rather than only upon request. A high SSVI score, CMS said, “may require additional targeted education or oversight, such as medical review, education, and investigations that could result in payment suspension, and revocation.” Confidence: High on the payment and spending figures, since they come directly from CMS’s own fact sheet and final rule; Medium on how aggressively CMS will act on the published scores, since the rule describes possible oversight responses without committing to specific enforcement. Sources: Fiscal Year 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements Final Rule (CMS-1851-F), CMS, Medicare Program; FY 2027 Hospice Wage Index and Payment Rate Update, Federal Register.

988.3 million dollars: that is the net savings CMS says its flagship Medicare ACO model delivered last year, even as the agency’s own independent evaluation of the same model’s most recently studied year found Medicare spending went up, not down. CMS and the National Association of ACOs jointly released ACO REACH’s performance year 2024 settlement results on July 9, 2026, reporting 2.511 billion dollars in gross savings across the model’s 115 participating ACOs and 988.3 million dollars in net savings returned to CMS, with 96 of 115 ACOs, 83 percent, earning shared savings and 19 taking net losses. Those figures are calculated against a prospective, forecast-based benchmark. CMS’s separately published third evaluation report, also out this July, uses a different yardstick, a comparison group drawn from beneficiaries outside the model, and for the model’s most recently completed performance year, 2023, it found the opposite direction on the bottom line: gross spending fell 1 percent, 126 dollars per beneficiary per year, but net spending rose 0.8 percent, 102 dollars per beneficiary per year, an increase the report says was not statistically significant for New Entrant ACOs and came in below 1 percent for Standard ACOs. The same evaluation credited the model with nearly 200 million dollars in Medicare spending reduced relative to a comparison group across its participating ACOs, and with quality gains including more days at home and fewer avoidable hospitalizations. Confidence: High on both sets of figures, since each comes directly from a CMS-published or CMS-commissioned document; Medium on how to reconcile them, since CMS has not, in the documents reviewed this run, published a side-by-side reconciliation of the two methodologies for the public. Sources: ACO REACH participants generated nearly $1B in 2024 savings: CMS, Fierce Healthcare, CMS Touts ACO REACH Model Results, Alliance of Safety-Net Hospitals, Evaluation of the ACO REACH Model, Evaluation Report 3, CMS Innovation Center.

FRONTIER SCAN. 650 million dollars: that is what investors have poured into platforms trying to run clinical trials without a traditional trial site, a business now getting an artificial intelligence pitch of its own. BCC Research reported July 1, 2026 that leading decentralized clinical trial platforms have raised more than 650 million dollars in recent funding, led by Medable’s 506.6 million dollars in total funding including a 304 million dollar 2021 Series D, with newer entrants such as Lindus Health raising 55 million dollars in a 2025 Series B; the firm sizes the decentralized trials market at 8.5 billion dollars currently, with artificial intelligence tools pitched as fixing an industry where, by the research firm’s account, roughly 80 percent of studies fail to meet enrollment deadlines and delays can cost sponsors on the order of 1 million dollars a month. The business case sits alongside a wave of consolidation among the contract research organizations and trial-technology vendors that decentralized platforms compete against and sell into: Thermo Fisher Scientific’s pending acquisition of trial-technology firm Clario, for up to 9.4 billion dollars, is the largest, and IQVIA and Syneos Health have each built out their own decentralized-trial infrastructure rather than relying solely on point-solution vendors. This is a corner of the drug-development supply chain this issue has not covered before; BCC Research’s ongoing market analysis, and the funding and consolidation activity around named platforms including Medable, Science 37, Lindus Health, Curebase, Castor and Deep 6 AI, becomes this issue’s entry point for tracking it going forward. Confidence: Medium. The funding totals and market-size figures are private market-research estimates rather than audited figures, and this run could not independently verify the enrollment-failure and delay-cost statistics beyond BCC Research’s own characterization. Source: AI Disruption to Transform $8.5 Billion Decentralized Clinical Trials Market as Investment Activity Surges, GlobeNewswire.

THE DEAL SHEET

Target	Acquirer/Investor	Vertical	Value	Source
AllianceHealth Seminole (Seminole, Okla.)	SSM Health Oklahoma (from Community Health Systems)	Hospital divestiture, 32-bed acute care	Undisclosed; deal closed July 1, disclosed in a July 28 SEC filing	CHS sells Oklahoma hospital, Becker’s Hospital Review
Knox Community Hospital (Mount Vernon, Ohio)	Kettering Health (non-binding letter of intent)	Hospital system affiliation	Undisclosed; Kettering commits to capital investment over 10 years post-closing; definitive agreement targeted early fall, closing expected by year-end 2026	Knox Community Hospital signs non-binding letter of intent to join Kettering Health, Knox Pages
Princeton Community Hospital (Princeton, W.Va.)	West Virginia University Health System	Hospital full-membership integration	Undisclosed	Princeton Community Hospital to become full member of the West Virginia University Health System, WVU Medicine

agilon health and Clover Health both report second-quarter results Wednesday, August 5; Privia Health and Oscar Health follow Thursday, August 6.