Business coach for PT, OT & SLP clinic owners. PT for 30 years, built and sold my own practice.
Atlanta, GA
Joined September 2009
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Ron Tester | Coach for PT, OT & SLP owners retweeted
“700 rural hospitals are at risk of closing!”
Then why the hell are we still restricting physicians from opening and owning hospitals?
The AHA warns about losing rural access while fighting physician-owned hospitals that could offer an alternative.
That’s the part missing from the fear porn: we’re supposed to believe the options are disappearing while the hospital lobby works to keep alternatives out.
If the current operators can’t make it work, let physicians own, build, and run competing hospitals.
How desperate does the situation have to become before protecting patients takes priority over protecting the incumbents?
Nearly 700 rural hospitals (ONE in THREE in the country) are at risk of closing.
A new report says private insurers paying below cost is the biggest reason. Keeping every one of them open would cost about $4 billion a year. Meanwhile, UnitedHealth made $4.1 billion in profit in Q3 2026 alone.
Read about the report here: healthcareuncovered.substack…
Ron Tester | Coach for PT, OT & SLP owners retweeted
People are angry because they pay $28,000 a year for something they can't price, can't compare and can't understand. Then the pharmacy charges them less if they pay cash than it does if they use the insurance they paid $28,000 for. Broken is an understatement.
Ron Tester | Coach for PT, OT & SLP owners retweeted
Paying $900/m for health insurance just to owe another $5,000 when you finally need a doctor doesn't feel like healthcare.
Ron Tester | Coach for PT, OT & SLP owners retweeted
Over $28,000 a year for family health insurance premiums, up from $6,000 in 1999.
And that’s before deductibles, copays, and surprise bills.
The system is fundamentally broken.
Ron Tester | Coach for PT, OT & SLP owners retweeted
Let’s compare Arch to the talking heads of ESPN…
Ron Tester | Coach for PT, OT & SLP owners retweeted
Frank Pallone thinks a surgeon who owns the operating room is a conflict of interest.
A hospital that owns the surgeon is apparently a business model.
In 2007, Pallone took the gavel of the House health subcommittee and cosponsored CHAMP, which would have frozen physician-owned hospitals in place.
In 2008, he called those hospitals "overutilized." In 2010, Section 6001 of the ACA shut the door on new ones and froze the beds and operating rooms of the ones already built.
Meanwhile, hospital systems kept buying physician practices. Prices for services from acquired physicians rose an average of 14.1%. Nobody in Washington froze anything.
Ownership in one direction met a federal barrier; ownership in the other remained an ordinary business strategy.
The conflict of interest Pallone described never disappeared.
A hospital that employs the surgeon, owns the operating room and collects the facility payment holds every incentive he accused physicians of having. The difference is who gets to keep the money.
New in The Rojas Report. Link below.
Ron Tester | Coach for PT, OT & SLP owners retweeted
Let me start with screw the @washingtonpost they are crap journalists.
These are hospital-owned clinics. The hospital controls the billing and collects the facility fee.
Yet the Washington Post puts “doctors’ offices” in the headline, leaving readers with the impression that their physician is behind the markup.
Misleading BS
Patients deserve to know who sets these charges and who collects the money.
If the hospital is charging the fee, put the hospital in the headline. Physicians shouldn’t have to answer for a billing policy their employer controls.
washingtonpost.com/business/…
Ron Tester | Coach for PT, OT & SLP owners retweeted
New study in @JAMAHealthForum: Profitability of Nonprofit and For-Profit Ambulatory Surgery Centers
jamanetwork.com/journals/jam…
h/t Elizabeth Plummer & Kahler Doyle
@JHUCarey @JohnsHopkinsSPH @NeeleySchoolTCU
Ron Tester | Coach for PT, OT & SLP owners retweeted
I was standing behind a guy at the pharmacy counter on a Friday at 5:15 PM.
He was trying to pick up daily heart medication for his mother, who had just been discharged from the hospital that morning.
The technician scanned the bottle, frowned at the screen, and said:
"Your insurance rejected the claim. It says 'Prior Authorization Required.'"
The guy said, "She’s been on this exact prescription for four years. The cardiologist literally signed her discharge orders three hours ago."
The tech sighed: "Their insurance software ran an automated formulary update on the first of the month. The algorithm flags maintenance drugs to see if the doctor will switch to a cheaper tier.
Her doctor has to submit a formal electronic appeal."
"The doctor's office closed at 5:00 PM," the guy said, his voice shaking. "It’s Friday. She will run out of medication by tomorrow morning."
The tech looked down and whispered: "You can pay out-of-pocket cash for a three-day emergency supply."
An automated algorithm denied an elderly woman’s heart medication at 5:01 PM before a weekend, banking entirely on the chance that the family gives up and covers the cost out of pocket.
It’s not administrative red tape. It’s calculated financial extortion engineered into healthcare software.
Ron Tester | Coach for PT, OT & SLP owners retweeted
Telling an eighty-year-old woman to "check the portal" for serious biopsy results is cruelty disguised as digital efficiency.
My 82-year-old aunt had a lung biopsy done two weeks ago.
The doctor told her they’d have the pathology report ready within five business days.
Friday afternoon rolled around. No call.
She dialed the clinic’s main desk, her voice shaking with anxiety.
The receptionist cut her off before she could finish explaining:
“Doctor doesn’t give results over the phone anymore. All lab findings are automatically released to your MyChart patient portal.”
My aunt said, “Sweetheart, I don’t have a computer. I have a landline on my kitchen wall. Can the doctor just tell me if I have cancer?”
The receptionist sighed into the receiver:
“It’s hospital network policy. We can’t bypass the portal. You’ll have to have a family member create an account and view the file.”
My aunt spent an entire seventy-two-hour weekend sitting in her recliner, gripping her reading glasses, convinced she was dying.
I drove out to her house on Monday morning, set up a profile on my laptop, and pulled up the records.
The result was benign.
The pathology report had been uploaded four days earlier.
A doctor spent three minutes clicking an upload button, and an elderly woman endured four days of sheer psychological terror because the hospital decided a phone call was too expensive.
Since when did delivering medical news become a self-service task?
Ron Tester | Coach for PT, OT & SLP owners retweeted
This is extremely dark
🦔The Blue Cross Blue Shield Association says insurers paid out nearly $1 billion more than usual from AI-assisted hospital documentation in 2024-2025. Hospitals use AI to scan records and find secondary diagnoses that human reviewers missed. More diagnoses means higher reimbursements. But treatment levels haven't gone up.
BCBSA's SVP of data science said AI is "identifying more billable conditions, not sicker patients." Insurers now deploy their own AI to deny those same claims. Patients pay for both through higher premiums.
My Take
This might be the most American healthcare story I've ever read. Hospitals bought AI to find more things to bill for. Insurers bought AI to deny those bills. The technology cost money on each end and the tab went straight to patients through higher premiums. A billion dollars moved and no one got any healthier. The only thing that changed was the size of the invoices.
Two sides of a trillion-dollar industry found a new tool to fight over the same pool of money and the person in the hospital bed pays for all of it. Premiums go up, denials go up, and the AI vendors collect from everyone. If you want to know who AI works for, stop reading the press releases and look at where the money goes. In healthcare it went straight into the billing department.
Hedgie🤗
Ron Tester | Coach for PT, OT & SLP owners retweeted
So… your friend has Parkinson’s.
Harrison Ford and Michael J. Fox share advice on how best to be there for someone with Parkinson’s, from navigating changes in handwriting to staying connected and helping counter social isolation.
Learn more about how you can help find a cure for Parkinson’s on our website. bit.ly/4xuz8M4
Ron Tester | Coach for PT, OT & SLP owners retweeted
Be a reason someone marvels at the kindness in the world.
Be the reason someone believes in the goodness of strangers.
Be the reason someone remembers that people still stop, still help, still care.
Multiple strangers. One lost earring. No obligation to help. Nothing to gain.
And yet, they joined the search.
Sometimes the smallest moments reveal the biggest truths about who we are.
There is goodness all around.
May we see it.
May we join it.
May we be it.
op: @mainelyemma
Ron Tester | Coach for PT, OT & SLP owners retweeted
US airlines- protected by law from foreign competition on domestic routes, bailed out twice by taxpayers since 2001- are using AI to squeeze even more money out of customers-
Not to increase on-time stats. Not to improve experience.
But to more efficiently screw customers!
Ron Tester | Coach for PT, OT & SLP owners retweeted
Hey @SecDuffy put a stop to this!
🦔Delta's CEO said AI will boost profits by 50% by setting a different ticket price for every passenger in real time. The airline uses an AI system called Fetcherr that generates a unique price for each shopping request. Delta told Congress last year it was not using personal data for individualized pricing. Its investor presentation described building toward offers for "you, the individual." Airlines are exempt from FTC pricing oversight.
My Take
This is what AI does for a company like Delta. It doesn't make your flight better or your bag show up faster. It watches how you shop and figures out the most you'll pay before you close the tab. Consumer Reports found Uber and Lyft charging 42% different prices for the same ride at the same time, and the House Oversight Committee found one case where two people got quoted $76 and $24 for the same trip. Delta is building the airline version of that, and every carrier will follow because the economics are too good to pass up.
Walmart told us this week that families are choosing between gas and groceries at $4 a gallon. Delta's answer to those same families is an algorithm that squeezes them for every dollar they have left. Airlines are exempt from FTC pricing rules, state laws are preempted by federal deregulation, and the CEO told Congress one thing while telling investors another. When people ask me where the trillions going into AI actually end up, I think Delta just gave us one of the most honest answers we've gotten.
Hedgie🤗
Ron Tester | Coach for PT, OT & SLP owners retweeted
Reminder: the datacenter discourse is a documented psyop and they’re winning
Two reports from @SamLyman33 and @bitcoinpolicy document a coordinated foreign influence campaign against American AI — running through CCP state media, a Shanghai-based Marxist's nonprofit network, and foreign billionaire dark money that has funneled $2B+ into US advocacy infrastructure.
AI doomerism isn't as organic as it looks.
Ron Tester | Coach for PT, OT & SLP owners retweeted
The absence of an em-dash key on the standard keyboard is a disgrace of extraordinary proportions.
Ron Tester | Coach for PT, OT & SLP owners retweeted
If you haven’t ever seen this, watch it. It is devastating. Thing is, Milton was routinely this devastating in debates. Always with a smile. Only James Q Wison could rival him (in my acquaintance) for extemporaneous fluency.
En 1979, un presentador de TV le preguntó a Milton Friedman si no le daba vergüenza defender un sistema basado en la codicia.
La respuesta se estudia hasta hoy:
«—Cuando ves la mala distribución de la riqueza, tan pocos que tienen tanto y tantos que no tienen nada… ¿nunca has dudado del capitalismo, de si la codicia es una buena idea?
—Primero dime: ¿conoces alguna sociedad que NO funcione con codicia? ¿Crees que Rusia no funciona con codicia? ¿Que China no?
¿Y qué es la codicia? Ninguno de nosotros es codicioso, claro. El codicioso siempre es el otro.
Los grandes logros de la civilización no salieron de despachos del gobierno. Einstein no construyó su teoría por orden de un burócrata. Ford no revolucionó el automóvil así.
Los únicos casos en la historia en los que las masas escaparon de la pobreza son aquellos donde hubo capitalismo y libre comercio.
—Pero parece premiar la habilidad de manipular el sistema, no la virtud.
—¿Y qué premia la virtud? ¿Crees que un comisario comunista premia la virtud? ¿Un Hitler? ¿Crees que los presidentes americanos eligen sus cargos por virtud… o por peso político?
Dime: ¿dónde están esos ángeles que van a organizar la sociedad por nosotros?
Yo ni siquiera confío en ti para hacerlo.»
