Medicare is a government-run insurance program, so this is one of the few cases where a private insurance company wouldn't receive data.
(There is such a thing as Medicare advantage, where a patient can choose to put their Medicare dollars toward private insurance, but it's not part of the initial launch of this program.)
Isn't the first em dash taken from an interview that the writer did with the subject over Zoom? I think using an em dash to punctuate a broken or partial sentence like that is pretty standard journalistic practice when you don't want to modify the original quotation (e.g, denote a paraphrase with brackets), and definitely not an AI tell.
The other uses are honestly pretty standard rhetorical patterns; they do not seem especially AI-flavored to me.
I run a YC startup that was accepted to Medicare ACCESS.
Historically, insurance has paid for activity: time spent in visits, RVUs generated, and minutes logged. This was a reasonable starting point, but the flaw is that there's no strong incentives to be efficient.
ACCESS is explicitly a "deflationary" approach. Medicare has set the payment rates high enough to be viable for startups, but low enough that you have to use software (including AI) to deliver a large part of your program.
So Medicare has basically created economic incentives to reward software without prescribing the exact shape of the programs. I thought it was a really interesting approach and builds on 15 years of lessons from CMMI (Medicare's innovation group).
I would maybe modify this to say - there is a strong incentive to be efficient - you only make so much money per encounter, DRG visit to the hospital, etc. So the pressure from "management" on a lot of us clinicians is to see more people per day, make each hospital visit as short as possible, etc. Medicaid providers now see something like 50-60 patients a day because the per-patient visit is relatively low. But there isn't as much incentive for outcomes. I think CMS has tried it in the past, but with varying success. Whether this new mousetrap will work, who knows.
The existing CPT codes (roughly) pay proportionately to physician time (RVUs). So I wouldn't say there's an an incentive toward delivering care efficiently, but rather hospital management wants to maximize billable hours.
Oh no, there's both. At least for consultations, there's only 3 inpatient / 5 outpatient levels of CPT codes which work for both complexity and/or time. And patients tend to be pretty complex, so it'd not hard to justify a level 4 or 5 CPT code; any less than that and the patient usually has absolutely nothing wrong with them. And at best, max complexity, Medicare pays, something like $227 per CPT code. So to keep the lights on, you'd better figure out a way to see 14, 16, 20 patients a day...a practice cannot stay afloat if you take 45 mins to an hour to see a level 5 CPT code.
For hospital stays, I may be outdated in this, but Medicare pays a lump sum DRG which doesn't tend to go up much, so the longer the patient is in the hospital, the less money the hospital makes.
Short story is the biggest pressures from the higher-ups is for us to see more volume outpatient, and cut duration of stays inpatient....
There are a million doctors in the U.S. so if they're each seeing 60 patients per day that would mean that 17% of the population needs to be seen by a doctor daily.
That would put hospitals somewhere between churches and offices in terms of the impact they have attracting attendance.
That's not what the post you're replying to said, at all.
I'm not in a position to evaluate whether they were right, but you've presented this as if it proves them wrong when it's barely related to what they said.
MA upcoding survives because insurers profit from risk-coding patients sicker. if this breaks that link, watch how insurer Medical Loss Ratios shift in 10-K filings over the next 2-3 years
Lipoprotein(a) is the strongest hereditary risk factor for heart disease. Each Lp(a) particle is basically an LDL cholesterol particle with an extra wrapper protein.
This statement is from lipidologists (basically, people who study cholesterol), but the American Heart Association released similar guidelines in Mar 2026 which recommend Lp(a) testing for everybody.
Previous generations might have said the same thing about Ableton itself, vs playing a physical instrument. In that regard, AI might become just another power tool for creative expression.
I’ve always said that the more divergent the input is from the resulting output, then the less personal expression you have. For me, in order of moving away from meaningful control in generative models, it goes: “text → code,” “text → picture,” and, at the very bottom, “text → music.”
For me personally, music composition begins and ends with the motif - the melody itself. It’s the part I enjoy the most, and it’s also the part I have the most individual control over since I can sing.
Everybody makes music differently, but if you lack the ability to play an instrument and you also can’t whistle or sing, it’s hard for me to imagine how you’d have any meaningful control over the melody.
How would a non‑musician express an actual melody that they came up with (beyond simple things like instrumentation and general “feelings”) in text? RED RED RED BLUE. (Sorry couldn't resist a Mission Hill reference here.)
With all that out of the way, there's still lots of room for using AI in music. I’ve used it to take some of my existing songs, mostly pianistic in nature, and swap out instrumentation and arrangements just to play around with different soundscapes. It's like BIAB on steroids.
Agree to some extent. At some point though we jump the thin line between creative expression and… magic?
Like if at some point I can just say “Generate a song similar to Smooth Criminal, different enough to not trigger copyright claims” and it just works, and everyone loves it… well is that creative thinking?
I think you can quantify the amount of creative expression you engage in by looking at all the decision points in the creative process where you are directly involved in making the decision. For an LLM prompt, that is going to be fairly limited by definition. I suppose the quality can be measured then by how novel and effective the output/approach of each decision is then, how much impact is made.
The amount of creative expression does not necessarily correlate with impact. Something can be created with nearly zero creative expression, that ends up making a significant impact. In that case you are more of a director than an artist I suppose, in that you direct the high-level process and only make decisions there. You can call it creative thinking in the same way a good businessman makes smart high-level decisions and then delegates what is downstream to others, with decisions being optimized for impact.
I think you can be creative "within a frame" in that sense, e.g. creative in the way you wield an LLM for instance, which is on a different scale compared to being creative on the piano roll with how you organize and brainstorm your melodies. It's just a different skill set at a different granularity altogether. But the one thing that I think holds, is that higher level methods have less creative expression by definition, because you are delegating more decisions to other faculties; you are seeing less of the "creator" in the work.
I think there is something to it. First, it would still need to be different enough from Smooth Criminal to avoid listeners just going back to the original. Then, if anyone could just type a simple prompt like that and get a hit, wouldn't we be flooded with 'sounds like' singles, which would turn the audience off of those, and now, you're not making hits...
I think there will always be more to it then just a simple prompt, but having the vision to make a song that sounds pleasing, and unique enough is certainly creative to me.
Of course, there's also a huge demand for generic, inoffensive music (think theme/intro songs, waiting room and elevator music). If we could make that more enjoyable to listen to, would anyone care if that's not creative thinking?
You could make (and many do) the same arguments over covers of songs, even when the covers end up eclipsing the original. Where was the creative thinking in that?
> AI might become just another power tool for creative expression
It is NOT a digital tool to create art. Yes, people used to be snobbish about digital art. Some still are. This doesn't say anything about generative AI because that isn't a tool.
The closest equivalent is hiring someone on fiverr to create music for you and claiming you created the music because you wrote the "prompt".
There is nothing creative about using generative AI. Is is a form of management. The difference is that instead of extracting labor directly your are extracting dead labor from the million of artists whose work was stolen to train the AI.
I don't disagree if its building the whole song, but given that this is tooling within the DAW, if an artist went in and said 'give me 5 alternative reverb sounds on this track', is that not using AI as a tool? Yes, the AI is creating the sound profile, but is that any different then using presets, or samples?
I used to play around for days just making sounds on my synth. The process of creating them was often just turning random knobs and dials. If the AI is turning those for me, thats not a tool?
This study tested a relatively new drug, PCSK9 inhibitors, which lower LDL cholesterol/ApoB above and beyond what's possible with statins and ezetimibe.
The patient population was 3600 people with high-risk diabetes, but not atherosclerosis. So they're at elevated risk compared to the average person.
PCSK9 inhibitors are still expensive (about $1,800 per year), with pretty limited insurance coverage. But this will likely change as the evidence builds.
It includes both mathematical formulas and PyTorch code.
I found it a bit more practical than the Sutton & Barto book, which is a classic but doesn't cover some of the more modern methods used in deep reinforcement learning.
It's also nice that Sutton & Barto belabors a lot of old stuff that is no longer obsessed over, and this skims through that and gets to the stuff that is much more relevant today.
The basic principal behind this shift is that exposure to bad cholesterol acts like radiation dose. Both the intensity (how high LDL/ApoB is) and the time exposed (how many years) matter.
These newest guidelines from the AHA/ACC, released yesterday, operationalize this partly by using a new set of equations that predict cardiovascular risk over a 30-year period (rather than 10 years).
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