The Layoff Tracker, Cigna's GLP-1 Cut & What Happens When Compliance Fails

June 8th, 2026. Bo and Luke break down three stories connected by the same thread: what happens when organizations wait too long to act.

📉 The Layoff Tracker Keeps Growing — the Pattern Is Now Structural Becker's and Fierce Healthcare updated their 2026 trackers again this week. Care New England, ECU Health, Intermountain Health, and dozens more added to the list. The Mississippi rural hospital we covered in March officially filed for Chapter 9 in April. The pattern: almost all of these are administrative and billing positions tied to Medicaid and Medicare reimbursement cuts. Clinical roles are largely protected — and organizations cutting are simultaneously posting hundreds of open positions. Action: Run succession planning for the bottom 75% of your organization — especially non-clinical roles. Map skills to open positions now. Pull four quarters of margin data, compare your trend line to the tracker profiles, and take that to your CFO this week as a planning conversation — not a crisis response.

💊 Cigna Cut GLP-1 Coverage for 68,000 of Its Own Employees — Effective July 1 Cigna will stop covering Wegovy and Zepbound for weight loss beginning July 1st — the same day CMS launches its Medicare GLP-1 bridge program at a $50 monthly copay. Employees have until June 30th to refill. Coverage for type 2 diabetes remains. GLP-1 coverage has become a benefits differentiator candidates weigh when choosing employers. Action: Confirm your organization's GLP-1 position today and communicate it directly to employees before July 1st. Don't let them find out from the news on the same day Medicare expands access.

🚨 648 Jobs Gone: What a CMS Provider Agreement Termination Looks Like Laurel Ridge Treatment Center in San Antonio laid off all 648 employees after CMS terminated its Medicare and Medicaid provider agreement for failure to comply with federal health and safety requirements — effective June 26th, no grace period. Roles affected span the full workforce: DON, RNs, therapists, pharmacy techs, HR managers, and more. Action: Meet with compliance and quality leadership this week. Know your CMS survey history, open plans of correction, and active investigations. Find out whether HR has a defined role in your regulatory response plan.

Be the source of communication. Even when you have nothing new to share — tell your people that. That is still information.

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Three Things That Escaped the Savannah Convention Center

Luke Carignan and ASHHRA Executive Director Jeremy Sadlier are back from ASHHRA26 — and the sessions were too good to leave at the convention center. Bo is out this week, but the content more than covers for it. Three themes from the conference floor that every healthcare HR leader needs on their radar right now.

🤖 AI Hit the Bedside and the Org Chart — Simultaneously Four out of five physicians are already using AI for documentation and admin. Nursing schools are rethinking curricula to train AI-augmented clinicians. But the session that landed hardest: AI voice cloning needs only 10 seconds of audio, and threat actors are already targeting executives for wire transfer fraud. Shadow AI is a real liability — vendors are switching AI features on by default inside tools you bought for other reasons. When an AI tool causes harm, it lands as a people problem. That is HR's desk. Action: Build your AI tool inventory — not a policy, an actual list. Know what is on, who turned it on, and what decisions it is influencing.

🚨 Workplace Violence Is Now a Retention Problem With a Badge ASHHRA26 keynote speaker Brian Euridge, Senior Director of Public Safety at University of Michigan and Michigan Medicine, delivered one of the most practical sessions of the conference. His community policing model — security staff required to log two short non-medical conversations daily — drove a 46% reduction in nurse assaults in nine months. The stat that should stop every HR leader: six in ten nurses who experience violence have considered leaving the profession. You cannot prevent what you cannot see — and most incidents are never reported. Action: Treat under-reporting like a safety journey. Drive reporting up first. Reduction follows.

📋 The Layoff Wave Is Really a Skills Pivot Read the cuts as reallocation, not contraction. Administrative and billing layers are absorbing the risk; direct clinical roles stay protected. The organizations winning are hiring for competencies instead of titles and building talent through apprenticeships. ASHHRA's partnership with Dallas College now has national models in 26 states. Wellstar's ChangeWell program trained 100 change champions with zero projects delayed more than 30 days. Action: Reach out to Jeremy, Amy McEnroth at Dallas College, or Mark Sherry at Baylor Scott and White. The apprenticeship blueprint already exists. You do not have to build it from scratch.

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This episode is brought to you by AP3 — the ASHHRA Preferred Partner Program.

Healthcare HR leaders are navigating rising costs, workforce shortages, and an overwhelming vendor landscape. AP3 cuts through the noise.

Managed in collaboration with Lockton and backed by ASHHRA, AP3 is a governed ecosystem of vetted, healthcare-aligned solution providers across talent acquisition, benefits administration, workforce compliance, financial wellness, and employee engagement. Every partner is rigorously vetted. Every relationship is governed. Every solution is built for healthcare.

No directories. No bidding wars. Just trusted partners proven to perform.

Visit AP3.info to learn more and get connected with a partner.

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10,000 Nurses on the Edge, a Union Decertification & the GLP-1 Benefit Bomb Landing July 1

Three stories in one week that cut across labor relations, trust, and total compensation strategy. Bo, Luke, and ASHHRA Executive Director Jeremy Sadlier break down what every healthcare HR leader needs to act on before July 1st — with ASHHRA26 in Savannah just days away.

🔥 Corewell Health: 90% Strike Authorization Nearly 10,000 registered nurses across nine Corewell Health East hospitals voted 90% to authorize a strike — the clearest possible signal that trust has collapsed. Nurses voted to unionize in November 2024, defeating a $1.7M anti-union campaign. Nearly a year into first-contract negotiations, management terminated the nurse student loan repayment program and eliminated pool pay. The union calls it retaliation. The vote confirms it landed that way. HR Takeaway: A 90% authorization vote doesn't mean 90% of nurses want to walk. It means 90% are frustrated enough to use the most powerful tool they have. Culture is what happens when the lawyers aren't in the room. The time to build credibility is every day before negotiations start — not during them.

🔄 GWU Nurses Try to Vote Their Union Out On the opposite end: nurses at George Washington University Hospital filed a decertification petition with the NLRB just two years after voting the union in 310-207. The nurses leading the effort say promises weren't kept and the union drove a wedge between coworkers. Decertifications are exceedingly rare — employees must self-fund and self-organize with zero employer support while the union retains full resources. That 30% got there at all is telling.

💊 Medicare GLP-1 Coverage at $50/Month Starts July 1 CMS announced Medicare Part D will cover GLP-1 weight loss medications for a $50 monthly copay beginning July 1st. Qualifying criteria: BMI of 27+ with a cardiovascular condition, or BMI of 35+. The bridge program runs through December 31st, 2027. GLP-1 spending has risen 500% since 2018 and now represents 14% of all US prescription drug spending. Your Medicare-eligible employees are already reading about this. Your non-Medicare employees will ask why their plan charges $300. Action: Pull your current GLP-1 coverage language. Ask your broker for a cost exposure analysis. Build a one-page FAQ for your HR team before July 1 — the questions are coming.

See you in Savannah.

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How Parkland Health Grows Its Own Workforce — And Why You Should Too

Featuring Stephanie Speights, PhD, SHRM-SCP, Senior Vice President of Talent Development, Parkland Health

What if the answer to your most pressing workforce shortage is already inside your building? Stephanie Speights has been proving that thesis for nearly seven years at Parkland Health — one of the most respected health systems in the country — by building a talent development engine that grows clinical staff from the inside out.

🌱 Start With Your Highest Turnover Role Stephanie's counterintuitive advice: don't start with your hardest-to-fill clinical role. Start with the role that churns the fastest. Identify the volume you hire annually, calculate first-year turnover, and build your apprenticeship pipeline there. The transporters, PCAs, and dietary staff cycling through your revolving door are often your best candidates for the next clinical role they never knew existed. But first — address why they're leaving. Drop people into a broken environment and they will still leave.

🤝 Commit Operations Before You Launch The most common failure point: workforce development teams that build great programs but can't get operations to hire the graduates. Stephanie is direct — before you build the cohort, get the commitment. Leaders must agree to hire from the program and to be active participants in shaping the experience, the clinical rotations, and the matchmaking that puts the right person in the right service line.

🎓 Day One Is Not Too Early Parkland starts the development conversation at orientation with a gallery walk — posters on ERG leadership opportunities, tuition programs active on day one, and career navigator resources for anyone who wants to explore what's next. The message is clear: you don't have to wait, and you don't have to leave to grow.

🤖 AI Won't Replace the Heart — It'll Require More of It Ambient documentation, predictive scheduling, and clinical AI are already reshaping what healthcare workers do. Stephanie's response isn't a technology roadmap — it's a human one. Build agility. Develop leaders who create psychological safety around change. And make sure your senior leaders are wise enough not to chase every shiny object at the expense of core mission.

The pipeline you need is already in your building. Your job is to open the door.

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HealthCare Associates Credit Union partners with healthcare organizations to offer a no-cost financial wellness benefit for employees. Built specifically for healthcare professionals, HACU provides everyday banking, loans, mortgages, and financial education - all with no added administrative burden for HR teams.

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What a VP of Clinical Efficiency Needs HR to Understand

Featuring Katie Abebe, Vice President of Clinical Efficiency, Upstream Rehabilitation

If you have ever wondered what it feels like to run clinical operations across 800 clinics in 25 states — and what that VP actually needs from HR to make it work — this is the episode. Katie Abebe took an unconventional path from construction to community college to a doctorate in physical therapy from Chatham University, and now builds systems for clinical quality and efficiency at one of the top five largest outpatient rehab providers in the country.

⚙️ What Clinical Efficiency Actually Means Clinical efficiency is not just operational throughput. It is eliminating waste, aligning what payers require with what is best for the patient, and delivering high-quality care within insurance-constrained reimbursement models where margins are already thin. One missed clinician can eliminate an entire week's margin at a single clinic. The math is not forgiving.

🧑‍⚕️ What HR Can Do for a Clinical Workforce Right Now Katie's direct answer: flexibility and compensation. Clinical staff carry a unique burden — when they cannot show up, real patients go without care and real revenue disappears. Systems that have built flex clinician pools are absorbing that risk. For PT specifically, reimbursement has not kept pace with inflation, meaning highly credentialed clinicians are often financially stressed. Performance-based earning opportunities — not just productivity bonuses — are a meaningful retention lever.

🤖 AI in the PT Space: The Promise and the Guardrails Upstream is already using AI to reduce documentation burden — the number one reason Katie says she left the clinic. On the horizon: AI-assisted triage at the front of the funnel, helping route patients to providers most likely to deliver results. But Katie draws a clear line. AI for notes and scheduling? Embrace it. AI making the final clinical call without a human in the lead? Not yet.

🔎 The HR Takeaway Build the flex pool. Create performance-based earning paths. And when a clinician's attendance pattern shifts, don't go straight to corrective action — go to the conversation. It is almost never a work problem.

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HealthCare Associates Credit Union partners with healthcare organizations to offer a no-cost financial wellness benefit for employees. Built specifically for healthcare professionals, HACU provides everyday banking, loans, mortgages, and financial education - all with no added administrative burden for HR teams.

Learn more at HACU's Human Resource Benefit or email directly at busdev@hacu.org and we are happy to take you through the process whether it's opening a membership for yourself or bringing us on as your employee benefits partner.

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April 27th, 2026. Three policy hits in the same week, all with direct workforce consequences. Bo, Luke, and ASHHRA Executive Director Jeremy Sadlier break down what HR leaders need to do before July 1st.

💉 RFK Jr. Defends $15.8B in HHS Cuts — His Own Word: Painful After seven congressional hearings, HHS Secretary Kennedy called the FY27 cuts painful and acknowledged his department does not want them: $5B in NIH funding, elimination of the National Institute on Minority Health, $923M in HIV/AIDS reductions, and deep cuts to the Agency for Healthcare Research and Quality. Bipartisan pushback was visible — Republican Senator Tom Tillis called the NIH cuts handing China our lunch. These are not Washington cuts. They flow directly to hospitals, universities, and health systems. Action: Identify every federal grant, research partnership, and workforce development program your organization depends on through NIH, HRSA, or HHS. Build that list this week. Contingency planning starts now, before FY27 makes the cuts real.

🩺 Nursing Was Excluded From the Definition of a Profession Effective July 1st, graduate nursing students lose access to $50,000/year in federal loans — capped instead at $20,500 — because nursing was excluded from the Department of Education's professional degree definition. Law, medicine, and dentistry made the list. Nursing, PT, OT, PA, and social work did not. 59% of nurses say they are now less likely to pursue a graduate degree. Action: Audit your advanced practice nursing vacancies. Evaluate whether your tuition assistance and loan repayment programs can close the new gap. Connect with academic partners now before fall enrollment is affected.

📋 Medicaid Work Requirements: 80 Hours a Month, Starting Late 2026 HR1 Medicaid work requirements are becoming operational — 80 hours per month of documented work, school, or community service or enrollees lose coverage. 65% of Medicaid recipients already work. Those most at risk are the low-wage frontline workers staffing your EVS, food service, PCA, and security roles. Action: Map your lowest-wage workforce against Medicaid thresholds in your state. Brief your CHRO on your exposure before a coverage gap destabilizes the frontline workforce you cannot afford to lose.

Every story this week lands on HR's desk. High five to every practitioner still standing.

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HealthCare Associates Credit Union partners with healthcare organizations to offer a no-cost financial wellness benefit for employees. Built specifically for healthcare professionals, HACU provides everyday banking, loans, mortgages, and financial education - all with no added administrative burden for HR teams.

Learn more at HACU's Human Resource Benefit or email directly at busdev@hacu.org and we are happy to take you through the process whether it's opening a membership for yourself or bringing us on as your employee benefits partner.

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Featuring Ricky Price, Founder, Game Ready Skills & Development | McDonald's All-American | Duke University | NBA Veteran

Healthcare HR professionals spend their days building cultures where people can do their best work under extraordinary pressure. Ricky Price has lived that challenge at the highest level — growing up in Compton, earning a spot under Coach K at Duke, competing professionally for nearly a decade in the NBA, and now translating every lesson from that journey into leadership development for organizations that refuse to settle for average.

This one hits different.

🏀 Visualize First, Then Do the Work Ricky's number one pillar: visualize and imagine your success before it happens. He visualized game-winning shots, big-time college basketball, and a professional career — and when those moments arrived, they felt like deja vu. For healthcare leaders, the application is direct: if you cannot see where your team is going, you cannot build the culture to get there.

⏭️ The Next Play Mentality Coach K's most transferable lesson: when you make a mistake, you cannot wallow in it. Get to the next play. For clinicians who carry the weight of high-stakes errors, this is not a dismissal of accountability — it is the framework that makes continued high performance possible. The leaders who model this give their teams permission to recover and keep moving.

🏆 Assign Roles. Build the Team. When Ricky arrived at Duke, every player was the number one recruit in their state. Coach K's solution: assign clear roles and hold everyone accountable to theirs. High-performing healthcare teams fail the same way athletic teams do — when stars refuse to subordinate individual brilliance to collective purpose. Role clarity is not a limitation. It is the architecture of a championship culture.

🎉 Celebrate Your Wins — Strategically The goal is not the only moment worth celebrating. Daily discipline, weekly consistency, small process wins — these compound. Teams that only celebrate outcomes miss the habits that produce them.

📖 Resource Celebrate Your Wins by Ricky Price (Foreword by Coach K): https://amzn.to/4mCr874 Connect with Ricky: https://www.linkedin.com/in/ricky-price-1a242438

You do not need a wicked jump shot. You need the mindset behind it.

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HealthCare Associates Credit Union partners with healthcare organizations to offer a no-cost financial wellness benefit for employees. Built specifically for healthcare professionals, HACU provides everyday banking, loans, mortgages, and financial education - all with no added administrative burden for HR teams.

Learn more at HACU's Human Resource Benefit or email directly at busdev@hacu.org and we are happy to take you through the process whether it's opening a membership for yourself or bringing us on as your employee benefits partner.

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Hospital M&A Hits a 6-Year High, a 42,000-Worker Strike Looms & a Rural Hospital Has 56 Days

April 20th, 2026. More than 1,000 hospital leaders are in Washington, DC for the AHA Annual Meeting. The urgency they are carrying into that building has never been higher. Bo, Luke, and ASHHRA Executive Director Jeremy Sadlier break down three stories hitting simultaneously.

📉 Hospital M&A Is Back — But It's a Survival Story Kaufman Hall's Q1 2026 report: 22 hospital transactions, highest Q1 total since 2020, $14.5B in transacted revenue. The marquee deal is Sutter Health's proposed acquisition of Allina Health, creating a $26B nonprofit spanning 39 hospitals. But 68% of Q1 deals were divestitures — systems shedding underperforming assets before distress makes them less attractive. HR 1 Medicaid cuts are explicitly driving independent hospitals to seek partners now. Action: Share the Kaufman Hall Q1 report with your CHRO. Know where your organization sits on the risk-to-resilient spectrum. Build your M&A integration playbook if one doesn't exist. If your board is in partnership discussions, HR should already be at the table.

🏠 UC's 42,000-Worker Strike Is About Housing, Not Wages Local 3299 representing 42,000 UC service and patient care technical workers announced an open-ended strike beginning May 14th. The central grievance: UC refused to bargain over housing aid and unilaterally imposed higher health premium rates during negotiations. Workers are being priced out of the communities they serve — many commuting two hours each way. This is not a California story. The affordability gap exists in every major market. Action: Assess your own affordability exposure. What your lowest-paid workers spend just to get to work is a labor risk hiding in plain sight.

🏚️ A Mississippi Rural Hospital Has 56 Days A rural Mississippi hospital announced possible closure by June 15th after laying off 86 employees and eliminating service lines. The driver: a Medicaid clawback — $2.5M already recouped, another $5M in dispute. This hospital is not one option for its community. It is the only option. And it is not alone. Action: If you operate or support rural or critical access facilities, conduct a billing documentation audit now — not after a clawback notice arrives.

When the whole system is under pressure simultaneously, HR leaders already at the table make the difference.

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Learn More here - https://rxbene.fit/3ZaurZN

HealthCare Associates Credit Union partners with healthcare organizations to offer a no-cost financial wellness benefit for employees. Built specifically for healthcare professionals, HACU provides everyday banking, loans, mortgages, and financial education - all with no added administrative burden for HR teams.

Learn more at HACU's Human Resource Benefit or email directly at busdev@hacu.org and we are happy to take you through the process whether it's opening a membership for yourself or bringing us on as your employee benefits partner.

HealthCare Associates Credit Union — a healthier benefit for healthcare HR leaders and their teams.

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