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The cost of the seat
The weight arrives after the decision is made. Somebody else pays for it.
Sep 13
•
David Wild
1
We've never asked that question
I have spent more weekend hours than I would like building a spreadsheet that should not have needed building.
Sep 6
•
David Wild
1
1
August 2026
I said it was nuanced
I opened with the case mix myself, before the surgeon had to. Longer cases, sicker patients, more transfusion. Every word of it was true, and none of it…
Aug 30
•
David Wild
2
2
No one is ready today
In the same meeting, working the same grid, the administrative seats had two or three names and the clinical seats had none.
Aug 23
•
David Wild
2
The caveat was true. The conclusion was not.
A trustee asked whether the pattern held in other patient populations. I had built the slide that said the question did not matter.
Aug 16
•
David Wild
3
2
The new out-of-network arbitration rule took effect. Almost none of it did.
The effective date was August 3. Three things landed. The provision written for anesthesiology got its date the same day, from a notice rather than the…
Aug 9
•
David Wild
2
1
1
The program pays best where the need is least
Medicare finally measured what hospitals pay for 340B drugs. The number explains why the same program is a growth strategy in one hospital and the…
Aug 2
•
David Wild
1
July 2026
The number is already built
How senior executive pay gets set, and why the architecture pushes it upward no matter who holds the seat.
Jul 26
•
David Wild
1
Who owes the readiness payment?
We know how to pay for standby. We still have to say who owes it.
Jul 19
•
David Wild
2
We settled this in 2009
In 2009 a captured pricing benchmark cost UnitedHealth a $350 million settlement and the database that produced it. Then Congress wrote a version of the…
Jul 12
•
David Wild
What happens when surgery stops subsidizing the hospital?
The subsidy is the thermometer. The fever is the case leaving the building.
Jul 5
•
David Wild
4
3
June 2026
The benchmark is the whole game
A new federal rule just made the fight over out-of-network pay cheaper to enter. It left the number that decides who wins exactly where it was.
Jun 28
•
David Wild
3
3
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