Improper payments across federal healthcare programs continue to absorb tens of billions of taxpayer dollars each year, posing a persistent operational risk that too often escapes strategic scrutiny. The Centers for Medicare & Medicaid Services (CMS) has released its Fiscal Year 2025 estimates, revealing a complex and often misunderstood picture of payment accuracy, documentation failures, and structural compliance breakdowns.

The Centers for Medicare & Medicaid Services (CMS) recently announced that more than 22.8 million individuals have enrolled in 2026 health insurance coverage through Affordable Care Act (ACA) Marketplaces, a record-breaking figure that surpasses all previous enrollment periods. This national snapshot captures signups from both the federal HealthCare.gov platform and state-based exchanges (SBEs), marking a clear high point in the ACA’s implementation. But behind the headline growth lies a more nuanced, and increasingly urgent, set of questions for healthcare leaders tasked with navigating cost structures, compliance shifts, and continuity of care.

The launch of Mount Sinai Tisch Cancer Center’s AI-powered clinical trial matching platform, PRISM, marks a decisive shift in how large health systems may approach research participation at scale. While artificial intelligence continues to draw headlines across diagnostics, imaging, and documentation, this initiative surfaces a quieter transformation: the operational integration of trial eligibility into real-time care workflows.

The lawsuit fallout from the TriZetto data breach has accelerated a reckoning long overdue in healthcare IT governance: vendor partnerships are not cybersecurity strategies. As Cognizant Technology Solutions now faces multiple U.S. class-action suits over its handling of a 2020 breach affecting its TriZetto Provider Solutions platform, the liability spotlight is shifting upstream. In a sector increasingly dependent on outsourced infrastructure, cloud-based platforms, and revenue cycle management automation, enterprise buyers can no longer separate procurement from risk management.