
Muni Investors Brace for Hospital-Bond Pain From Medicaid Cuts
Trump's $3.4 trillion tax and spending package makes substantial cuts to Medicaid, the public health-insurance program for low-income and disabled people. Republicans are also mulling deeper reductions to Medicaid in a follow-up bill.

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Yahoo
28 minutes ago
- Yahoo
Motherhood at 50 Wasn't the Plan—It Was Better.
Harry Eelman Having a baby as a 50 year old woman wasn't a life experience I ever thought was in the cards. I'd never allowed myself any sort of fantasy about having a child or a partner. For most of my life, my work as a freelance photographer has been my sole focus. I was raised to support myself, to get things done and, through that, find success. I was concerned that I wouldn't be able to have a baby and support myself, and so I approached the idea of family pragmatically and simply let it go. Expending energy on imagining a life I didn't even think I wanted felt like squandering time I didn't have to waste. And so, yes, while I dated a bit in my 20s and 30s, I also spent periods of time single. My biggest focus was work, and my career, and I chose that over fantasizing about motherhood. But then, in life's unpredictable way, things changed. It wasn't so much that I wanted a baby; it was that at 40 I realized I didn't actually have the answers to my life. That it was arrogant and ridiculous to think that I knew exactly what the future would look like, and that I might change my mind one day and want a baby. And although I felt this way, I was avoidant. It took my best friend to push me. I remember she said to me, "Get your eggs frozen right now." At first it seemed ridiculous. I knew 40 was late to freeze my eggs, and even my gynecologist—whom I've had since I was a teenager—laughed and said, "Danielle, you're not having a kid. You're too busy.' But she gave me the referral for the reproductive people anyway, and I went. And it floored me. There with the doctor at my first appointment, where we were discussing the procedure, I was suddenly overcome with emotions and began to cry. Because it suddenly hit me that my body was saying to me, 'This thing that you've been so sure you didn't want, maybe you do.' The reality of seeing this doctor made me very concerned that I had made a choice for myself that was irreversible. Maybe I was too late even then to decide for my future, and I would be relegated to the choices of a 40-year-old. I had never second-guessed myself in my 20s and 30s, but here I was at 40 doing just that. I still get emotional thinking about that day. But even then I couldn't fathom the idea of an actual child. I wasn't looking for a sperm donor. Freezing my eggs was about giving myself the choice, albeit at a large cost financially—$15,000 to be precise, without taking into account annual storage—and emotionally. As with so much in my life, I went back to working at full throttle, traveling and socializing, as soon as it was done. And then out of the blue, a year later I met Harry, the man who would become my husband. This is not, however, the point in the story where we both realized the one thing missing from our lives was a child. We fell for each other hard, but he's a lot younger than me and wasn't ready for kids, so it wasn't even a conversation. What we loved most about the life we were building together was how nomadic it was—we truly traveled the world constantly, something that didn't stop even after we got married in 2018. One time, I think I raised the idea of children with him and said, 'You know, if we're serious, if you want to have a kid, we probably have to start because I'm old,' and in response (while he doesn't remember saying this to me) he was like, 'I don't want to have a kid until I'm like 39.' And I thought (but probably didn't say), 'Well, okay, then. By then I'll be so old, we're never having kids.' I just kind of chucked it away again—and it wasn't hard. I didn't have a great pull to have a baby. But I guess these things creep up on you. Harry's family has lots of kids—he's one of four, he's a twin. His twin has four kids, his sister has three, his brother has two, and I started to think that maybe if we had kids I would be okay with the shift in my life. I wanted to make sure that I was ready to be everything that a potential child would need. I didn't want to still want to do things and think that being a parent was holding me back. It just took me a lot longer than most people to get there. I was 49 when Harry and I decided to start . Did age ever come into it? Not for me. Age isn't why we started IVF. I didn't—and don't—feel old. Age 49 was simply the time at which I finally felt ready to become a mother. At the same time, because of my age, I couldn't get attached to the idea of it. My doctor even said to me that they wouldn't do the transfer at 50—it was now or never. If we were going to do it, we knew we didn't have much time. So we decided to go for it. If my doctor had said to me, 'No, we can't do this at your age,' we would have just abandoned the idea. I honestly believe I would have been okay with that too. Saying that, while I'm usually an all-out-there kind of person, I was very private about the process once we'd decided to move ahead. It wasn't that I held any shame about it. I just didn't want others to make any judgments about me, whether that be my age, no longer being the life of the party, or sidelining me work wise—for nearly 50 years people had known me as a hard-working globetrotter, and my whole life was going to totally shift. IVF is no easy ride. In our case, while I wasn't having to go through the egg-retrieval process, we still had to thaw my eggs, see how many survived, fertilize them, and then sync my cycle and prepare my body for implantation. It's a very physical process; you're shooting yourself with so many hormones every day and also trying not to get too excited while dealing with enormous hormonal fluctuations. The first cycle we did didn't work, and I remember feeling as if I'd expended so much energy on something so unmonumental and unrewarding. It sounds stupid in a way, but in the fakery of what I thought was IVF I presumed that everyone gets pregnant—that I could will a baby into existence through the right doctor, through simply the implantation procedure itself. Of course it doesn't work like that—it's so much more than that, and I know that now. But at the time, when it failed, we just moved on. Now that I have the space, there is a part of me that feels sad that I didn't feel compelled to mourn or be sad. Although I also had such a full life that I knew we'd be okay either way. But there was no doubt we wanted to proceed with a second transfer, which thankfully succeeded. We might have done a third, and maybe even a fourth, if it hadn't worked. However, by the time I had the second implantation, I was also dealing with uterine fibroids—noncancerous tumors that develop in the muscular wall of the uterus, which can affect the successful implantation of embryos. Because of them, it took nearly two hours and three doctors to insert the embryo. So even though I was finally pregnant, it wasn't straightforward. It really was far from ideal medically, because I was a 50-year-old woman by this stage, and my doctors would have preferred me to have a perfect everything. But these were just the cards I was dealt. This was probably the first time I really started to feel my age—pregnancy is hard enough, without this kind of complication—and the whole way through the pregnancy I was being carefully monitored by multiple doctors and health care professionals. As a result of all this, the doctors planned to deliver my daughter by vertical C-section—where they would cut me vertically to try and remove my daughter without disturbing the cysts (which were going to need to be removed safely in a second C-section once I'd healed from the birth). During the birth I lost two liters of blood. But birthing our daughter was a life-altering experience, and one that perhaps is even better coming to it at a more grown-up stage of life. I have nothing to hide about becoming an . It's given me wisdom and patience and a presence with my child that I would not have had when I was younger. I have rethought what's important, how to live my life in a way that is more present, and I do my best to parent her without distractions. Of course I still care about my career, of course I'd love an invite to the Met Gala, but I just feel so grounded with my daughter that I see my work and the perks of my job as a benefit, not the sole focus. I'm 52 now, and my daughter is two, and I think so differently about my life now. For so long I wanted to be there at the center of the action—whether that was socially or workwise—but my center is now my family. I still have so much to achieve in my life, but I equally want so much for her. There's no perfect anything. I'm not the perfect everything, but today I'm a better person. I'm a more thoughtful person, and I'm a more patient person. I'm a more learned person as a 50-something-year-old. The inescapable reality is I'm also an older person, and I wish I were a bit younger only because I just want more time with her. But I wasn't going to be ready until I was ready; that is just the truth. And I regret nothing. Originally Appeared on Glamour More Parenting Parents, you might be too emotionally invested in Bluey Can a $200 Instagram class really make you a better mother? Inside the (annoying?) rise of Cocomelon How Fisher-Price's 'Purple Monkey' Mat Became a viral hit
Yahoo
an hour ago
- Yahoo
Major Health Insurers Slash Prior Authorization Requirements, Transforming the PA Technology Landscape
Black Book Research identifies Cohere Health, Innovaccer, and Waystar among leading vendors rapidly adapting to new industry rules. NEW YORK CITY, NY / / July 26, 2025 / U.S. healthcare is undergoing a pivotal shift as major insurers-led by UnitedHealthcare and Humana-begin to significantly reduce or eliminate prior authorization (PA) requirements for hundreds of routine procedures. Accelerated by federal policy, provider frustration, and consumer demands for timely access to care, these sweeping changes signal a new era in PA technology and operations, according to a July 2025 flash survey conducted by Black Book Research. Industry Drivers: Regulatory Action Meets Provider and Consumer Pressure Insurers covering over 250 million Americans have committed to streamlining or removing PA burdens by the end of 2026. This is partly driven by the Centers for Medicare & Medicaid Services (CMS), which is launching a pilot program in six states in January 2026 requiring faster, more transparent prior authorizations for select Medicare services. CMS has also announced national response time standards for Medicare Advantage plans, further intensifying the need for automation and interoperability in PA processes. Key Survey Insights from the Field Black Book Research's flash survey compiled viewpoints from: 24 IT leaders representing the top 10 PA vendors; 108 managed care and health plan IT and operational decision-makers; 142 healthcare providers and administrative leaders; and 100 healthcare consumers with recent PA experiences. Notable Findings: 84% of managed care executives support reducing PA requirements 96% of healthcare providers report improved workflows and lower administrative burdens 99% of consumers favor eliminating PA for routine care; 83% say they've experienced harmful care delays 67% of health plans expect to reevaluate or end contracts with existing PA vendors by 2026 Additional Observations: 90% of providers foresee broad adoption of interoperable PA tools by 2027 94% of payers plan substantial investment in AI-based PA platforms 100% of consumers prefer providers with automated and transparent PA processes 96% of PA vendor executives acknowledge their current solutions require modernization within two years __________ Vendors Rapidly Adapting and Leading the Innovation Curve: Client Top KPI Scores Black Book highlights the top-performing vendors already making critical advancements to align with industry shifts: Cohere Health - Excels in AI-based automation, payer-provider integration, and CMS-aligned interoperability Innovaccer - Offers strong EHR integration and regulatory compliance dashboards for PA workflows Waystar - Enhancing its Auth Accelerate platform for real-time eligibility checks and exception handling ScribeRunner - Developing dynamic auto-approval rulesets and real-time tracking modules CoverMyMeds - Expanding AI-powered real-time authorizations for both pharmacy and medical benefits Change Healthcare - Transitioning legacy infrastructure with modular FHIR APIs for automated decision-making Availity - Driving advanced API adoption and digital submission channels PriorAuthNow (Rhyme) - Connecting providers and payers through real-time electronic submission with limited manual effort Black Book's Q1-Q2 client satisfaction rankings show these vendors excelled across 18 qualitative KPIs for PA technology. Cohere Health earned the highest overall honors, with MCG Health, eviCore Healthcare, Agadia, Infinx, and Availity also receiving good marks. Onyx led in FHIR-based PA platform innovation. Detailed competitive intelligence reports are available in the Black Book research store. __________ Vendors Facing Existential Threats in the New Era Not all companies are poised for success. Several previously top-rated PA vendors now face considerable risk due to outdated systems and slow adaptability: eviCore Healthcare - Still dependent on manual review processes, with limited AI capabilities HealthHelp (WNS) - Lagging behind in interoperability and modern payer integration PriorAuthNow (Rhyme) - Despite innovation efforts, struggles with scalable real-time API integration threaten its long-term viability _________ Looking Ahead: A Positive Outlook for Adaptive Vendors While legacy vendors must evolve rapidly or risk market exit, the broader outlook for PA tech is optimistic. Companies investing in automated, intelligent, and interoperable systems are well-positioned to thrive. "The future of prior authorization is transparent, automated, and fully integrated into clinical workflows," said Doug Brown, Founder of Black Book Research. "Vendors delivering real-time, AI-powered solutions will define the next generation of care access efficiency for providers, payers, and patients alike." About Black Book Research Black Book Research is a leading healthcare IT research firm known for its independent, vendor-agnostic approach. Over the past 15 years, Black Book has collected over 3 million survey responses from nearly 500,000 healthcare professionals. The firm's flash surveys and long-form evaluations provide real-time, unbiased insights that support strategic decision-making across the healthcare ecosystem. Visit or contact research@ for full survey results and vendor-specific performance details. Contact Information Press Office research@ SOURCE: Black Book Research View the original press release on ACCESS Newswire Error while retrieving data Sign in to access your portfolio Error while retrieving data Error while retrieving data Error while retrieving data Error while retrieving data


Washington Post
an hour ago
- Washington Post
Continuous glucose monitors are in vogue. But do you really need to track your blood sugar?
A quarter-size device that tracks the rise and fall of sugar in your blood is the latest source of hope — and hype — in the growing buzz around wearable health technology. Continuous glucose monitors, small patches that provide 24-hour insight into concentrations of sugar in the blood, could be a tool for Americans to 'take control over their own health,' Health Secretary Robert F. Kennedy Jr. recently told federal lawmakers.