The Michigan Health Council, founded 1944, delivers healthcare workforce research and deep analysis to academic institutions, healthcare organizations, government agencies, and policymakers. The MHC Index is funded by the Michigan Health Endowment Fund.

Trigger warning: MHC utilizes racist themes such as DEI and SDOH in this Index and its work elsewhere.

The benefit of this index is that it goes beyond federal HPSA data. However, AI-skewed job postings, if used to calculate shortages, may produce seriously flawed results. MHC details methodology on pg 5. Another source posted in the comment below may provide contrast. 

The summary as copied below omits insightful graphs that should be viewed in the original.

https://www.mhc.org/index

Michigan Healthcare Workforce Index

The Michigan Healthcare Workforce Index is a comprehensive index that assesses the “health” of 36 healthcare occupations and occupational categories in Michigan. Combining data from Lightcast, the Association of American Medical Colleges (AAMC), and the Accreditation Council for Graduate Medical Education (ACGME), MHC Insight was able to systematically rank healthcare occupations on four inputs - growth, wage, shortage, and turnover - to determine how each occupation is faring in our economy. ​

​The Index is designed to help Michigan stakeholders move from reviewing workforce data to developing an effective workforce strategy.

2026 Index Key Findings

All 36 occupations show lower projected growth compared to the 2025 Index. Lower growth threatens access to care.

Nearly all occupations show significantly higher turnover, reinforcing the need for continued retention strategies and careful interpretation of this year’s turnover data.

Nearly all occupations are projected to face a workforce shortage by 2035. Eight Index occupations are projected to experience a surplus, although statewide surpluses may still mask regional distribution challenges.

An aging workforce and aging population have significant impacts on projected shortages, especially in occupations that care for older adults.

Increasing compensation is an important strategy in growing the overall healthcare workforce, but lowering educational costs may have a greater impact.

The Behavioral Health workforce needs to be strengthened to meet population health needs.

Career pathway expansion for high-growth, low-wage occupations can bolster the overall healthcare workforce.

Occupational Ranking Highlights

The Dentist Group ranks first overall in the 2026 Index.
Pharmacy Technicians rank last overall.
Some Advanced Practitioner occupations now rank in the bottom third, including Optometrists and Pharmacists.
Shifts in job responsibilities (actual or expected) among provider groups are impacting the growth of occupations, especially Nurse Practitioners, Physician Assistants, and Pharmacy Technicians.

How to Use the Index

The Index is designed to help Michigan stakeholders move from reviewing workforce data to developing an effective workforce strategy. Employers can use it to compare retention, demand, and wage pressure across roles to refine staffing strategies and recruitment efforts. Educators can align programs and pathways with projected shortages, helping students prepare for success and meet employer and population health needs. Policymakers and funders can identify where investment may address some of the deficiencies in our healthcare system and offer the greatest opportunity to improve community health. Workforce development organizations can connect regional priorities to statewide trends and identify further opportunities. Professional associations can use the findings to support advocacy, recruitment, and retention strategies.

These are all examples of possible uses of the Index, and the additional benefit of being a data resource to support prioritization decisions and applications for funding, as well as giving recognition to workforce conditions for various occupations, is part of the MHC mission to ensure the future of the healthcare workforce.

Impact of an Aging Workforce

Some of the Index occupations with the highest projected growth, including PTs, PTAs, OTs, OTAs, and HHAs, indicate an increasing need for these professionals as the population ages. According to BLS data, these occupations are all significantly employed by nursing care facilities, continuing care retirement communities/assisted living facilities for the elderly, or home health care services. These occupations, while growing, are also projected to face shortages. HHAs rank last in Shortage on the Index. CNAs rank second-to-last in Shortage and are primarily employed by skilled nursing facilities. These settings all primarily provide healthcare to aging adults, signaling an urgent need for retention and professional development efforts to bolster occupations that are particularly critical for sustaining long-term care.

Further straining the healthcare workforce—beyond the aging population that needs care—are retirements and reduced hours among the aging workforce providing care. Nearly a quarter (23 percent) of healthcare workers in Michigan are 55 and older. The Dentist Group, the Physician Group, HHAs, the Psychologist Group, and Nurse Anesthetists are the “oldest” occupations, with 34.7, 29.9, 28.0, 28.0, and 26.0 percent aged 55 and older, respectively (see below). In the 2025 Michigan Survey of Nurses, 36.6 percent of RNs and 36.3 percent of LPNs reported planning to leave nursing within ten years, citing retirement as their main reason. There is also some evidence that certain healthcare workers, including Physicians, are retiring earlier. This may particularly impact rural areas, where Physicians already tend to be older.

Demographics

While the Michigan labor force is evenly split by sex, females comprise a significantly higher percentage of healthcare occupations, representing 81.4 percent of the industry. Some healthcare occupations with higher earnings, like Optometrists and Pharmacists, are split relatively evenly by sex, while males make up a larger percentage of some of those occupations, including some Physician specialties and dentistry. In Michigan, 41 percent of active Physicians are female. Conversely, in medical schools, female students constitute a larger proportion of total enrollment than males. In the 2024-2025 academic year, active medical residents were split 50-50 between males and females, the first time males were not a larger proportion of residents. The majority of lower-earning occupations have a significantly higher percentage of females.

Racial and ethnic breakdowns between all Michigan occupations and Michigan healthcare occupations are relatively similar, with healthcare occupations having a slightly more diverse workforce. The racial and ethnic diversity of the healthcare workforce overall is similar to Michigan’s racial and ethnic diversity across the state; however, lower-earning occupations are also more racially and ethnically diverse.

Conclusion

Overall, the 2026 Index shows a healthcare workforce under sustained pressure. The healthcare workforce in Michigan is experiencing some improvements, such as continued wage growth, job growth across many occupations, and reduced shortages in some occupations. However, challenges persist. Increased wages can still be relatively low when compared to occupations with similar training; job growth may not align with positions that are needed most to impact care quality and access; projected shortages persist across much of the workforce; and high turnover rates highlight the continued need for retention efforts. With an aging population and an aging healthcare workforce, it is essential for Michigan to continue developing strategies to strengthen healthcare occupation pipelines, recruit new providers to practice in Michigan, and retain existing employees. For additional insight on data-driven solutions to our state's healthcare workforce challenges, see MHC’s Michigan Healthcare Workforce Plan.

​Additional Data & Research

A full data appendix for the 2026 Michigan Healthcare Workforce Index is available upon request, which details the data used to rank each occupation.

The Index presents statewide findings, but workforce conditions can vary considerably across Michigan. Organizations interested in understanding these differences may engage MHC Insight to conduct a customized regional analysis. Depending on your needs, this work can examine specific geographic areas, occupations, or workforce questions to support local planning, investment, and collaboration. Contact MHC to discuss data needs and project scope.

Every.

Single.

Bill.

Billers from solo doctors to mega-hospital systems must use current billing codes, or be denied payment. And the AMA meets quarterly to approve new codes. 

This Patients Rights Advocate v. AMA lawsuit has been a long time coming.

https://www.beckershospitalreview.com/legal-regulatory-issues/ama-sued-over-cpt-billing-code-copyright-8-things-to-know/

AMA sued over CPT billing code copyright: 8 things to know

Paige Twenter    |    August 13, 2026

PatientRightsAdvocate.org sued the American Medical Association on Aug. 13, seeking to void the AMA’s copyright over the CPT code set so the patient advocacy group can republish the codes online for free, according to court documents reviewed by Becker’s.

The Current Procedural Terminology codes dictate how much Medicare, Medicaid and private insurers pay physicians for their services. The lawsuit adds to mounting scrutiny of the AMA’s control over them.

Eight things to know:

1. PatientRightsAdvocate.org filed a declaratory judgment action, asking the court to confirm it can scan and post a purchased 2026 print edition of CPT on its website without infringing the AMA’s copyright. The nonprofit patient advocacy group said it has bought the codebook but has not copied or published it while it awaits a ruling.

The lawsuit was filed in the U.S. District Court for the Northern District of Illinois Eastern Division.

2. CPT is a set of five-digit codes that classify medical procedures and services. Federal law requires their use in nearly every EHR transaction, and the codes underpin how Medicare, Medicaid and at least 45 states set physician reimbursement. Medicare and Medicaid alone cover more than 144 million people and spend over $2 trillion a year.

3. The AMA, the nation’s largest physician association and lobbying group, charges for CPT access — $137.89 for a print edition, plus annual licensing fees for electronic use. It reported $296.4 million in revenue from “Books and Digital Content” in 2025, netting $267.5 million, according to the lawsuit.

The AMA’s annual CPT code royalties generate more than $300 million a year, according to recent data cited by The Washington Post.

4. PatientRightsAdvocate.org argues the AMA has no enforceable copyright on three grounds: that CPT cannot be copyrighted because it has been incorporated into federal and state law, that republishing it is fair use, and that the AMA has engaged in copyright misuse.

The complaint leans on the Supreme Court’s 2020 finding that “no one can own the law.”

“What we are seeking to do is allow them to be freely available, publishable and usable across the healthcare system,” PatientRightsAdvocate.org founder Cynthia Fisher told the Post. She said the AMA’s licensing fees “are adding to the costs of care and coverage.”

5. The lawsuit lands amid growing pressure on the AMA.

In a July 16 proposed rule for 2027 physician payments, CMS sought public comment on the “harms or challenges associated with AMA’s monopoly over CPT-4 licenses for healthcare entities.” The proposal is part of a broader Trump administration effort, outlined in July, to overhaul how Medicare pays physicians.

Sen. Bill Cassidy, MD, R.-La., has accused the AMA of abusing a “government-backed monopoly,” charging “exorbitant fees to anyone using the CPT code set.”

7. The patient advocacy group is not the first challenge to the AMA’s copyright. In 1997, the 9th U.S. Circuit Court of Appeals found the AMA had misused its CPT copyright by licensing the codes to the government only if it agreed not to use a competing coding system.

PatientRightsAdvocate.org is also fighting a related copyright case brought against it by the American Hospital Association over a separate billing manual, the UB-04, which is pending in the same court.

8. In response to questions about the lawsuit and its claims, an AMA spokesperson told Becker’s: “CPT serves as the uniform language of medicine, updated continuously through an open, transparent process that reflects evolving clinical care. The AMA brings expertise and scale to this work, convening collaboration across medicine, government and industry. We will vigorously defend the AMA’s intellectual property rights to ensure the continued access physicians and patients rely on.”

A spokesperson for PatientRightsAdvocate.org said its lawsuit supports efforts made by lawmakers and public officials who have questioned AMA’s control over billing standards.

“Americans should not have to pay a private trade association for permission to see how their medical care is billed and priced,” Ms. Fisher said. “The government made CPT codes part of the operating law of our healthcare system, but the AMA keeps it behind a paywall and charges patients, doctors, hospitals, health plans, employers and tech firms for the privilege of understanding it. These egregious charges ultimately are increasing the costs of healthcare for American patients and employers, unnecessarily. We are asking the court to affirm a basic principle: No one can charge the public to access standards that are incorporated into state and federal law.”

At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.

https://www.freep.com/story/news/health/2026/08/22/blue-cross-blue-shield-michigan-mental-health-coverage-limited-licensed-practitioners-policy/91383390007/

Backlash roils against Blue Cross mental health billing policy change
By Kristen Jordan Shamus - August 22, 2026

• Outside the Blue Cross Blue Shield of Michigan headquarters Aug. 20, protesters said a new company billing policy will hit the mental health workforce hard and limit access to services.
• Starting March 1, Blue Cross says it will no longer cover limited-licensed mental and behavioral health providers in private practice. Only those working in accredited facities will be covered.
• The change, Blue Cross says, is to standardize billing processes across its Michigan health insurance plans and eliminate waste, fraud and abuse.
• Mental and behavioral health providers say, however, that the move will have far-reaching fallout that could cost lives and constrict an already too-narrow pipeline for new clinicians in training.

Blue Cross Blue Shield of Michigan is changing how it covers mental and behavioral health services, saying that as of March 1, it will no longer cover counselors, therapists and social workers with limited or provisional licenses as well as temporary limited licensed psychologists working in private practice in Michigan.

As the state's biggest insurer with about 70% of Michigan's commercial health insurance market, Blue Cross says the change comes as part of an effort to rein in waste, fraud and abuse in medical billing and to ensure its members get high-quality care.

The announcement sparked immediate backlash from people who work in the state's mental and behavioral health field, who call it a corporate cost-cutting strategy that will limit access to care for some of Michigan's most vulnerable people and constrict an already too-narrow pipeline for new clinicians in training.

"This policy, they make it seem harmless and that it's there to protect people, but that's not what it's going to do," said Christopher DeBoer, president of the Michigan Mental Health Counselors Association.

"Limited-licensed practitioners make up roughly 20% of the behavioral health workforce in the state of Michigan. With Blue Cross Blue Shield being the largest payer in the state, that means a large portion of the behavioral/mental health workforce wouldn't be able to bill for those members at all anymore. That's a huge loss of access for thousands and thousands of Michiganders."

DeBoer was among the protesters Friday, Aug. 21, who lined Lafayette Boulevard in Detroit, carrying picket signs and chanting, "Hey, hey! Ho, ho! Corporate greed has got to go!" and "When mental health is under attack, what do we do? Stand up! Fight back!" outside Blue Cross Blue Shield of Michigan's headquarters.

Several politicians, including Dr. Abdul El-Sayed, who is running as the Democratic candidate on the November ballot for the U.S. Senate, joined mental health providers and others to speak out on the change.

Jess Riley, the policy and advocacy manager for the National Association of Social Workers Michigan, held the microphone and told the crowd of more than 100 people that it is going to take a coalition made up of the entire mental health workforce to push Blue Cross to change its policy.

"Not a single profession is affected by this policy, and no single group is going to solve it alone," said Riley, who is macro master social worker and is working toward becoming a limited-licensed master social worker. "Together, what have we done? We've written letters. We have collected data. We've made calls. We've met with policymakers. We've organized and we've protested. And today, all of those different voices have come together here at the Blue Cross headquarters. Let them hear you!"

They heard the voice of Ashley Mosley, 42, of Muskegon, a mother of four whose husband, Brandon Mosley, died unexpectedly about year and a half ago at the age of 36 — leaving her alone to raise their daughters and manage their grief along with her own.

"Our world just kind of flipped," Mosley said. "We found Miss Heather, a limited-licensed therapist who can see us in the evening. Her schedule fits ours.

"All four have built a trusting relationship with her. They have been seeing her for almost a year now, and they can't lose another person in their life that they have built a trusting relationship with after losing their dad so unexpectedly. They cannot lose her," Mosley said through tears.

She held up a poster bearing photos of her girls — who range in age from 4 to 10 years old — and said it was worth the drive to Detroit on Friday to fight for them and do her part to ensure they will have continued access to the limited-licensed therapist who has made such a difference in their lives.

They heard the voice of Samm Heberlein, a limited-licensed professional counselor from Lansing.

"When this takes effect in March, I am potentially losing eight of my eight clients," Heberlein said. "A lot of them are dealing with a lot of trauma. I work with a lot of the queer community and they need support. They need people that look like them and are representative of them. This is going to directly impact them and me. How am I supposed to get my hours to become fully licensed if they're taking away clients for me to work with? That's why I am in this field. It's the clients."

Mental health care crisis could be on horizon

The Blue Cross policy change, DeBoer said, could cost some people their lives — as those with mental and behavioral health disorders who can't afford to pay for therapy or counseling services out of pocket will either have to find new, fully licensed providers amid a workforce shortage — or go without treatment. That could fuel a rise in mental health crises and drive up suicide rates in the state.

"We're talking about people who are among the most vulnerable in the population," said DeBoer, who also works as a licensed professional counselor at Spring Forest Counseling in Lansing. "If they have a depressive disorder or if they have some other mental or behavioral health disorder, and they get this news, it's just like, 'I tried to do everything right. I tried to get better, and then it was taken away from me.'

"Do people end up feeling hopeless from that, from care being taken away based on a bureaucratic decision? ... I would be crushed by that. I would feel as if I don't have a lot of power in my own life and can't even choose my own provider."

For small business owners with private practices or professional offices who employ newly graduated limited-licensed therapists, counselors, social workers and psychologists in training, it could affect their ability to operate.

"It's not just their bottom line, but their viability," DeBoer said.

The association conducted a survey of 2,700 Michigan mental health providers, clients and practice owners, DeBoer said, and found that many private practices would have to undergo major restructuring to remain in business after the policy change, and some would be forced to close.

"There were a few that said they were thinking about just calling it quits," he said.

Other potential downstream effects also worry DeBoer.

"When people go into crises, where do they go for help? They go to the ER. They go to community mental health centers," DeBoer said, noting that both Michigan hospitals and community mental health agencies already report being overtaxed and understaffed. "Neither of those two venues are going to be able to deal with an uptick from that."

Policy change to align Blue Cross plans, billing standards

Blue Cross said it doesn't expect the kind of fallout DeBoer described from the policy change.

If a member is getting treatment through a limited-licensed counselor or therapist and loses coverage with that person in March, Blue Cross can ensure its members can get an appointment with a different, fully licensed behavioral health professional through its network of 22,000 providers "typically within 48 hours" for online appointments and within a week for in-person care, said Julia Isaacs, the company's director of behavioral health strategy and planning.

The company has "worked really diligently over the last five years to expand access ... by over 46%" to mental and behavioral health providers, Isaacs said. It also has "more than 200" outpatient mental and behavioral health facilities in the network. "That's in addition to the hospitals and community mental health spaces that also qualify as these facility-based settings. So, there are hundreds of options for people to either transition care or transition their care to."

She told the Detroit Free Press that this Blue Cross policy change will align all of its commercial health insurance plans with long-standing Blue Care Network policy.

Blue Care Network, she said, has never covered temporary or limited-license mental and behavioral health providers — people who have completed their education but practice under the supervision of fully licensed clinicians to meet the work hours and other requirements needed to become fully licensed — only when they work in accredited, inpatient or outpatient facility-based settings.

The fully licensed supervisors who oversee their work bill Blue Cross for their services using their own National Provider Identification number, a practice called "incident-to" billing.

"This is really making sure that we have more quality standardization across our commercial products," Isaacs said. Incident-to billing for limited-license practitioners can continue after March 1 only in accredited, facility-based settings, according to the new policy. Supervising clinicians in private practices and professional offices will no longer be able to bill in that way.

Isaacs said the shift will provide Blue Cross with more transparency when it comes to claims.

"Currently, we have no line of sight to services that are being delivered incident-to," Isaacs said. "So, when we receive a claim here at Blue Cross that is submitted by one of our behavioral health providers in the network, it could be submitted by that behavioral health provider or it could be submitted by somebody else who is billing under that behavioral health provider and we have no way of knowing that.

"We are trying to balance ensuring quality standards ... oversight and accountability. We have had instances, in response to complaints or other inquiries, where we have found improper coding, lack of documentation and potential fraud for services delivered by incident-to providers. Of course, this is not everybody universally, but in one instance, we did review 176 medical records and 175 failed due to quality or incomplete recordkeeping. So, really, this is about standardizing the way we treat provisionally licensed graduates."

It's also similar to the way Blue Cross handles billing for medical residents who have recently graduated from medical school, Isaacs said.

"They are physicians, but they have to be in an accredited GME (graduate medical education) program," she said. "This is really about treating the behavioral health provider the same. They are able to continue providing those services as long as they are in an accredited facility to ensure that quality and oversight is really consistent across the network."

The company has given providers until March to either find work at an accredited inpatient or outpatient mental health facility or transition their clients to a different therapist who is either fully licensed or working at a facility with accreditation.

"We have provided a lengthy transition time to help those providers and those patients prepare," Isaacs said.

Counselors, therapists form deep bonds

Noel Spring, a licensed master social worker who practices in Detroit and uses somatic therapy as well as trauma center trauma-sensitive yoga, said it won't be easy for everyone who's getting care from a limited-licensed mental health practitioner to just switch to a new provider.

That's especially true for people who need gender-affirming care, for people of color and for those who live in rural communities where there aren't many options.

"I think a lot of people will stop therapy because it's already very difficult to find a therapist you vibe with," Spring said. "Sometimes it's really difficult to find a therapist who has the personal experience or the skills to help you. People spend a lot of time finding the right fit."

If Michiganders with Blue Cross plans are shuffled to just anyone in the company's network of 22,000 providers, Spring said they may drop out of therapy altogether.

"A lot of people, when they lose that right fit, it can be very difficult to want to go out and seek it again. So, I think a lot of people will not continue care. The populations that I'm particularly concerned about are people who hold nondominant identities. Particularly, I'm transgender. I have a supervisee, a limited-licensed social worker who I supervise right now who is a transgender woman. She specializes in gender-affirming care and over half her caseload is people with Blue Cross Blue Shield.

"She is one of a only handful of transgender women therapists in the state of Michigan. All of her people need a very specific type of care. So, where do they go?"

Pushing both limited-licensed providers and their clients toward accredited outpatient and inpatient mental health facilities also feels like a misstep, Spring said.

"Facilities are not made for people of nondominant identities," Spring said. "Those facilities are not made for queer folks. I've worked in them. It was hard for me to work in a facility. It's hard to seek help and treatment in a facility that's not made for you."

For people of color, finding a therapist who understands all of the complexities involved with racial identity also can be challenging. That's especially true in Detroit, Spring said, a majority Black city "where there are very few Black therapists practicing because of the obstacles that exist to become a therapist in the first place. Facilities and therapy in general, have a pretty extensive history of committing harm against people of color, specifically Black folks. And so a lot of Black folks won't trust facilities for very good reasons."

For Blue Cross to suggest people of color, and especially Black Michiganders, are going to receive better care at mental health facilities, Spring said, "is abjectly incorrect."

Isaacs at Blue Cross said that while it isn't ideal to ask members to find new counselors and therapists, the company is giving practitioners and facilities plenty of time to make the transition. It initially issued notice to providers in June, and the change doesn't take effect until March 1.

Noting that, on average, Blue Cross members are in psychotherapy for less than six months, and across all categories of mental and behavioral health, she said it's "somewhere in the realm of 12 to 14 months," a nine-month notice, Isaacs said, is "significant time to either complete treatment or transition care."

"There certainly could be individuals that need continued care, and it is the responsibility of the treating provider to appropriately clinically transition care. ... This happens when people move or change jobs. It is not something that is ever ideal, but it does happen, and it is important in a broader perspective to really make sure that care is being delivered in a more systematically quality-driven way."

David Sniderman, a licensed professional counselor and art therapist who specializes in working with children, teens, and adolescents, bristles when he thinks about the coming change, which feels like a cost-cutting measure to him.

"Mental health is one of their largest expenses," he said of Blue Cross. "These are appointments that you don't just do once a year, twice a year. ... It's something you do every week or every other week.

"I think they saw that people are starting to take care of themselves more often now, especially since the COVID pandemic, and more people have been going to counseling. Blue Cross is trying to create barriers to that because it's a big expense. And so they figure if they can create that barrier, people won't go."

That's an assertion Blue Cross denied, however.

"This policy is not about cutting costs," Isaacs said. "This policy is about protecting our members and ensuring standard of care."

When El-Sayed took the microphone Friday, he accused Blue Cross of putting profits over people and said he's especially concerned about what this policy change will mean for access to mental health care in rural parts of Michigan, where the options are especially limited.

"They are stuck under the health care auspices of one corporation that dominates 70% of the health insurance market in this state. ... I'm not a legislator yet ... but, God willing, with your support, I can be a legislator in just about three months.

"I'm running against a system that says corporations like Blue Cross Blue Shield, which has spent I don't know how much to beat me in the elections I've run in, cannot dictate who your politicians are. Because if they get to pick your politicians, they also get to pick your policy.

"This fight is about sustaining the critical mental health lifeline that you all offer for your patients, but it's also about the kind of politics that protects that lifeline in the first place."

Blue Cross: Private practices can become accredited

Earlier in August, Blue Cross invited mental and behavioral health practitioners to a forum to discuss the policy change, and explained that there is a way for private practice and professional offices to continue to work with limited-licensed providers and get reimbursed by Blue Cross plans after March 1, Isaacs said.

If those private practices work to become accredited outpatient psychiatric care facilities, also known as OPCs, the company said it would extend the deadline until Sept. 1, 2027.

To do so, the practice would need a board-certified or board-eligible psychiatrist on staff or contracted; a fully licensed psychologist, a master's level limited-licensed psychologist, a limited-licensed psychologist with a doctorate with a supervisory or consulting licensed psychologist either on staff or contracted; along with a licensed master's social worker.

That's just the beginning of the requirements, which also include being staffed to handle emergency services 24 hours a day, while also becoming fully accredited through one of the following organizations: the Joint Commission, the American Osteopathic Association, the Council on Accreditation of Services for Families and Children, the Commission on Accreditation of Rehabilitation Facilities or the National Council on Accreditation, or getting a certification letter for community mental health services from the state health department.

"There are certainly some practices that just don't want us to make this change, but back to kind of balancing the network quality across the entire state of Michigan. With what these requirements are and the changes we're making to this reimbursement policy, you know, we continue to think it's the right thing to do," Isaacs said.

"We have modified the outpatient model to allow for part-time, contracted psychiatrists to be part of the care team and oversee the medical care for that practice. I think this really goes back to ensuring that there's consistent quality and oversight, and having a physician as part of that model is really critical, especially for new graduates."

Spring said mental and behavioral health providers running small businesses in private practice aren't likely to be able to jump through all the hoops needed to become accredited outpatient psychiatric centers — nor will most be able to afford it.

Given the shortage of psychiatrists in the state, even if a practice could find one willing to join the staff or become a contractor, the cost would exceed $11,000 a year, Spring said.

"I can't afford that," Spring said. "Small practices can't afford that. ... Does this put small practices out of business? Yes, I absolutely think it will put a lot of small practices at risk of going out of business."

Isaacs said the Blue Cross doesn't have the resources to fully audit the depth of fraud, waste and abuse within the billing practices of mental health providers.

"What I can say is it is something that we routinely see, but I can't give you a specific number," Isaacs said. "My biggest concern is that there is this lack of oversight and established policies and procedures to ensure that clinical care is being delivered and documented properly."

In an early evaluation, funded by the manufacturer, 62% of positive results were false positives where no cancer was found after an extensive workup; 71% of the cancers diagnosed were found not by the Galleri test, but rather traditional screening.  The retail cost of Galleri testing does not consider the 'wild goose chases' triggered by those 62% false positives.

No randomized controlled trial thus far has shown that Galleri testing, on average, reduces cancer mortality.  There is a large Galleri study (150,000 participants) underway in the UK to answer the mortality question.

So the questions before us are: Is Galleri testing worth the cost?  Now or in the future?  Despite a strong marketing campaign by GRAIL, insurance companies and professional societies are not endorsing it, yet:

https://bridgemi.com/michigan-health-watch/blood-test-can-find-cancers-save-michigan-lives-is-that-worth-100b/

https://pubmed.ncbi.nlm.nih.gov/37805216/

https://pubmed.ncbi.nlm.nih.gov/36230741/

• A new blood test could revolutionize cancer treatment, identifying malignancies earlier than ever
• In Michigan, at least one Michigan insurer and one hospital is making the Galleri test available
• But the test, which costs about $950, triggers uncomfortable questions, including: What is a human life worth?

Its promise is extraordinary: A simple blood test that identifies cancers at their earliest stage — long before symptoms or a mammogram or prostate exam detect a problem.

It could reveal dozens of other cancers for which there is no screen at all — ovarian, pancreatic and liver to name a few — giving clinicians a possibly lifesaving head start on treatment.

“Who wouldn’t want that test?” said Leonard Fleck, a medical ethicist at Michigan State University, whose specialty can lead to uncomfortable conversations about medical rationing and the value of human life.

In short, if it delivers on its promise — and there is some question about whether it can — the Galleri blood test could be what one company representative in 2022 called a “new front on the war against cancer.”

But there’s a catch.

That single blood draw costs $950 out of pocket, but it could cost the more than $5.3 trillion US health care system another $55 billion a year if it were made available to everyone under Medicare, Fleck estimates.

Those calculations make the Galleri test an example of how new technology — no matter how big the promise to save lives — must also be measured in dollars. It’s an unsettling, but necessary, cost-benefit analysis at a time when health care costs surge, medical debt hobbles households, and Michiganders shed health insurance they can no longer afford.

“There’s all kinds of things we can do that might save some lives, and the cost at an individual level might be relatively small,” Fleck said.

“But if you’re doing it over tens of millions of individuals, you get very large numbers, and you get very small payback in terms of lives or life years that are saved.”

Large-scale national spending on the Galleri test — at least without clear evidence that it really will save lives — is “socially unaffordable,” Fleck has argued.

Yet a new federal law would extend coverage to at least some Medicare beneficiaries starting in 2028, if the US Food and Drug Administration approves the test. (An FDA committee is scheduled to meet to discuss Galleri’s effectiveness and safety Sept. 23.)

The effort had bipartisan support. Michigan’s US senators, Elissa Slotkin and Gary Peters co-sponsored initial legislation in the Senate, and 11 Congress members from Michigan co-sponsored a similar House bill.

Grail, the California company that makes the test, recommends everyone over 50 be screened with it each year – increased access that would cost $100 billion a year, Fleck estimates.

Dollars and lives

What is very clear is that cancer is costly both in terms of lives and dollars.

As it stands now, more than 1 in 3 people will get cancer eventually, and the disease is expected to kill more than 21,000 Michiganders this year, according to estimates by the American Cancer Society.

Moreover, cancer accounts for 7% of total US health care spending, according to KFF, a nonprofit focused on health care research.

And it’s most deadly and costly in later stages.

The first year of cancer diagnosis costs about $45,063, according to a study published last month in the Journal of the National Cancer Institute. End-of-life cancer care costs more than 2 ½ times that — about $121,746 each year, study authors estimated.

The surging cost of new cancer drugs will drive the cost of medical care in the US from $99 billion in 2023 to a jaw-dropping $180 billion by 2028, according to a study in the peer-reviewed oncology journal by Nature.

Earlier detection

Meanwhile, Americans are routinely screened for just five cancers — breast, cervical, colorectal, prostate and lung. That leaves the lion’s share of cancers without any routine tests.

The Galleri test, and Cancerguard, a similar test that Exact Sciences introduced last year, detect DNA fragments — a genetic fingerprint, of sorts — from cells that tumors shed as they grow.

Cancer detection now often relies on imaging, said Dr. Eric Klein, a scientist with Grail.

“The cancer has to be large enough to see,” he said.

Early detection means more effective treatment and better quality of life as patients avoid pain, disfiguration and other results of late-stage cancer detection, he said.

(Grail insists the Galleri test would supplement, not replace, screenings such as mammograms and prostate exams.)

Arguably the biggest promise in early detection tests is the lives they would save: 24,000 a year in the US, according to Grail.

“The selling point is that this is a non-invasive way to detect cancers early, and some for which there is no screening,” said Dr. Elena Stoffel, a spokesperson for the American Cancer Society, whose focus at Michigan Medicine is in cancer genetics and cancer prevention.

Moreover, in more than 9 in 10 cases, the test can signal where the cancer resides, Grail says.

Henry Ford Health began offering Galleri to patients in 2022 — the first Michigan hospital to do so. Patients have to pay out of pocket, since insurance doesn’t cover the test.

And last month, Grand Rapids-based Priority Health, Michigan’s second-largest health plan, announced that it would offer the Galleri test as an option to employers with self-funded insurance pools. Those employers can add the test to their plan benefits.

How much value, a human life?

According to Galleri, about 1 in 100 people who take the test will get a positive result, indicating that the test has detected a “cancer signal.”

But within those results are false positives, triggering costly follow-up testing and immeasurable stress to rule out cancer.

Even among those whose results are positive, many of the cancers would have been ultimately detected in some other way, and some would have been terminal no matter what stage they were detected, Fleck said.

Moreover, it’s unclear whether liquid biopsies like the Galleri test “overdiagnose,” detecting early cancers that a person’s immune system would seek out and destroy anyway, said Stoffel at U-M.

Given the uncertainty, Fleck pondered in his paper whether the tests such as Galleri are “low-value care” — a phrase that also has been gaining more attention as Americans increasingly are crushed by the weight of health care.

The US spends nearly $340 billion per year on low-value care which is costly on its own, but also can lead to “costly cascades of additional, unnecessary care,” according to the Center for Value-Based Insurance Design at the University of Michigan.

The most glaring uncertainty is this, she said: Does early detection by Galleri really result in longer lives?

‘Worth it’

A recent patient consulted Dr. Najeeb Al Hallak, oncologist at the Barbara Ann Karmanos Cancer Institute after other tests failed to detect cancer cells.

The man, in his early 40s, had a family history of cancer. Uneasy, he consulted Al Hallak, who recommended the Galleri test.

The blood test flagged a “positive” result for colon cancer, and a follow-up PET scan found the early-stage cancer in the patient’s small intestine.

The cells were surgically removed, saving the man from chemotherapy, Al Hallak said.

So is the test worth the cost?

“He will say it’s worth it because we found the cancer,” Al Hallak said of his patient.

But anecdotes can be misleading, Al Hallak said.

It’s unclear what happens when the test is given to millions of patients each year, most of whom will get a “negative” reading, including those for whom the test misses a cancer, he said.

Even Klein, the Grail scientist, acknowledges that it will take another several years to know whether the test’s early detection really extends lives.

As a long-time cancer doctor whose patients include those who are at high risk for cancer, Stoffel at Michigan Medicine hasn’t yet prescribed a single Galleri test.

“The question is do we really see an improvement” in the larger population? she asked. “Do people live longer, better lives? The jury’s still out.”

Klein, the Grail scientist, is also a cancer doctor.

“We are not going to make a dent in cancer without early detection — that’s very clear from every study,” he said.

Certainly, making cancer screening more accessible is a policy decision, Klein said, agreeing with Fleck.

“But I would ask him ‘What problems are more important than addressing that?” he said. “And are we going to look those 600,000 people in the face and say ‘Your life’s not worth it?’”

Any time a new health care laboratory testing methodology is touted, it is always worth reviewing the $ 700 million Theranos fraud.

Aon projects that 2027 employer healthcare costs will rise by 9.5 percent!

The Congressional Budget Office (CBO) forecasts that U.S. Personal Consumption Expenditure (PCE) price index inflation will trend around 2.6% in 2027.  Thus health care costs to employers will rise by almost 4 times the overall rate of inflation:

https://thehill.com/policy/healthcare/6043869-aon-projects-employee-health-costs-rise/

Employer health costs projected to rise 9.5 percent
By Joseph Choi - August 21, 2026

A new risk analysis released by leading insurance broker Aon this week projected that employer health costs in the U.S. will rise by roughly 10 percent in 2027.

Aon, the second largest global insurance broker, projected that at the current status quo, employer healthcare costs will rise by 9.5 percent next year. This would mean spending an added $19,000 per employee on average and would mark a fourth consecutive year of near-double-digit percentage increases.

The firm noted, however, that many employers will likely implement “cost-saving changes or programs” to mitigate expected costs.

Aon identified “rising medical utilization, chronic disease prevalence and growth in drug spending” as factors contributing to the rising costs.

Their projections found that health plan costs will rise across all industries, with the highest spikes anticipated for finance and insurance; technology and communication; and the public sector.

“Employers have now experienced several consecutive years of health care cost increases that are approaching double digits,” said Mike Pasterick, Aon’s North America health solutions leader, in a statement.

“At this level, rising health care costs become much more than a budgeting challenge and influence organizational decisions from benefits strategy and employee affordability to broader workforce and financial planning priorities,” he added. “Leaders are undergoing pressure to maintain affordable benefits while continuing to invest in attracting, supporting and retaining talent.”

https://michiganadvance.com/2026/08/20/violence-against-healthcare-workers-and-staffing-shortages-fuel-hospital-strikes/

Violence against healthcare workers and staffing shortages fuel hospital strikes
By Lynn Arditi of KFF Health News - August 20, 2026

Emergency room nurse Crystal Dhooghe speaks during a rally at the Michigan State Capitol in Lansing on March 17. She is among hundreds of unionized employees at Henry Ford Genesys Hospital who have been on strike since Sept. 1. (Teamsters J.C. 43)

Nurse Crystal Dhooghe is used to dealing with blood and broken bones in the emergency room. But she didn’t expect to witness so much violence against her own colleagues.

“I’ve seen nurses get shoved, pushed, scratched. The biggest one is bitten,” said Dhooghe, who works at Henry Ford Genesys Hospital in Grand Blanc, Michigan.

The prevalence of workplace violence in healthcare has fueled strikes in states such as Louisiana, New York, Pennsylvania, Rhode Island, and Michigan, where Dhooghe and many of her co-workers have been on the picket line since Labor Day last year.

“People will question me and be like, ‘Why are you still working in a place if you’re treated like this?’” said Dhooghe, who gets by on strike benefits and working extra shifts at another hospital. The problem, she said, is that other hospitals aren’t any better. “It’s the same everywhere I go.”

In a statement, Henry Ford Health spokesperson Dana Jay acknowledged violence against healthcare workers is a “national epidemic” and said the health system’s efforts to address the problem include metal detectors, armed security officers trained to make “misdemeanor arrests,” and de-escalation training.

“We have zero tolerance for violence of any kind,” said Jay, asserting the strike is not about safety but is instead “simply an economic strike.”

Nationwide, hospital workers are seven times as likely to be injured on the job due to violent acts as members of the general working population, according to the most recent data available from the Bureau of Labor Statistics. The outcry over workplace violence in healthcare is pitting workers’ demands for better compensation and staffing against hospital operators pressured to cut costs.

‘A Powder Keg’

Violent outbursts are so common that they’ve been dramatized on the popular medical TV series The Pitt. “Emergency rooms right now are like a powder keg,” said Rachel Odes, an assistant professor at the University of Wisconsin-Madison School of Nursing.

In hospitals, a combative or violent patient is known as a “code gray.” Outbursts can be spontaneous and unpredictable, making some almost impossible to prevent. But research shows the risk of violence increases when hospitals are understaffed or employees are insufficiently trained or experienced.

Mental health worker Andrew Kimball-Mirzaie said he got hurt in February 2024 at Butler Hospital in Providence, Rhode Island.

He’d been working at the private psychiatric hospital for about six weeks and said he hadn’t yet worked in the ER. He said he was sent there to “monitor” a man in his 20s who was waiting for an inpatient bed.

The patient was alone in a back room watching a Knicks basketball game on TV, he recalled. Kimball-Mirzaie said he got the patient a drink and a snack. They were watching the game when, suddenly, he said, the patient stood up and punched him in the face. He said the assault left him with a concussion and broken nose. His injuries were documented in the hospital’s incident log.

“I understand that there is an inherent danger with the job,” Kimball-Mirzaie said. He doesn’t blame the patient, who was very ill at the time. “We should have had at least another staff member with us,” he said, “and I should have been adequately trained on the unit.”

The attack emboldened Kimball-Mirzaie to join some 700 other unionized Butler workers last spring and summer in a months-long strike, which forced the hospital to close nearly half of its beds. Service Employees International Union 1199 New England declared the strike a win.

Employees received wage increases that union leaders said would enable the hospital to attract and retain more staff. The hospital also agreed to provide financial support for workers violently injured on the job. And the hospital and union agreed to jointly fund a “time bank” to supplement workers’ compensation for injured workers who need more time to recover.

But five months later, a nurse supervisor at Butler had to call 911 because an unarmed patient in the hospital’s ER was assaulting staff. According to the police report, by the time police arrested the patient, he’d injured two nurses, a security guard, and a police officer.

“Butler recognizes the importance of being proactive in protecting those who provide care,” Mary Marran, Butler’s president and chief operating officer, said in a statement. She added that hospital leadership meets regularly with staff to review safety measures and “identify opportunities to strengthen protection for everyone.”

The patient was charged with four counts of felony assault, including against the two nurses.

The American Hospital Association has said punishment is key to preventing violence. It has been lobbying Congress to make assaulting healthcare workers a federal crime that would carry up to 10 years in prison. At least 45 states, including Michigan and Rhode Island, have enacted similar laws. But workplace safety experts say there is no evidence that such laws have reduced the incidence of violence against healthcare workers.

Calls for ‘Safe Staffing’

Striking healthcare workers around the country often have demanded “safe staffing” instead of stronger punishments for patients who cause injuries.

The rise in violence against healthcare workers has caught the attention of the Joint Commission, the accreditation organization for more than 80% of U.S. hospitals and health systems. The commission released national performance goals that took effect in January and require hospitals to be properly staffed and that staff be trained “to provide safe, quality care.”

But no federal law limits the number of patients in a nurse’s care across healthcare settings, despite the nation’s largest nurses union, National Nurses United, having pressed for a national standard since 2018. Hospitals must “safely staff all units” to enable nurses to “provide the care that patients need before they get agitated or disoriented,” said Jane Thomason, lead industrial hygienist for National Nurses United.

Some states have passed their own staffing laws. Only California has enacted broad mandatory nurse staffing ratios, which research shows were associated with lower mortality rates and likely higher retention. Oregon enacted a staffing law, with exceptions. Legislators in Massachusetts and New Jersey have introduced similar bills, but they have failed to advance to floor votes.

The American Hospital Association opposes mandatory minimum nurse staffing ratios in hospitals, saying they would “remove real-time clinical judgment and flexibility,” compound staffing shortages, and potentially force some hospitals to turn away patients or delay care, spokesperson Colleen Kincaid said. And she pointed to California, whose new emergency nurse staffing ratios for psychiatric hospitals reportedly forced bed closures in at least four counties.

“There are a lot of other things you can do to prevent workplace violence than just increasing staffing levels,” said Jordan Barab, who was a deputy assistant secretary of labor for the Occupational Safety and Health Administration during the Obama administration and helped develop OSHA’s 2016 guidelines for healthcare and social service workers.

Barab said hospitals can, for example, train employees in de-escalation, install metal detectors, or have specially trained security guards on-site so staff don’t have to wait for police to arrive when an incident happens.

Debbie Berkowitz, a worker safety and health policy expert at Georgetown University, said the health provisions in congressional Republicans’ One Big Beautiful Bill Act will squeeze hospitals’ budgets in the next few years.

When funding dries up, she said, “protecting workers is going to be the first thing that gets cut.”

This article is from a partnership that includes NPR and KFF Health News.

Financialization increases prices without providing any benefits beyond those arrogated by the manipulators.  Financialization has been a plague on health care, but has been obscured behind fancy new facilities and swarms of administrators.

A new medical outpatient facility investment platform makes no pretense about strip mining health care revenues through real property management.  As they succeed, your health care costs will increase without any incremental benefit to you.

The press release announcing InfraMed Properties, organized in Southfield:

https://www.prnewswire.com/news-releases/redico-and-one-orchard-launch-inframed-properties--a-medical-outpatient-investment-platform-poised-for-nationwide-growth-302855869.html

REDICO and One Orchard launch InfraMed Properties -- a medical outpatient investment platform poised for nationwide growth
InfraMed Properties Press Release - August 20, 2026

InfraMed is structured to acquire, develop and manage medical outpatient properties across the United States

• New venture seeded with a 25-asset portfolio across 16 states
• Formation of InfraMed combines REDICO's 60 years of experience as a commercial real estate investor with One Orchard's institutional platform-oriented investment track record
• Company is poised to scale as it deploys beyond $1 billion in capital

Costco already has a Medicare Advantage marketplace, called the CBC Health Insurance Marketplace for Costco Members, but Costco is playing market maker there and not actually underwriting Medicare Advantage plans:

https://www.foxbusiness.com/retail/costco-plots-major-expansion-senior-healthcare-medicare-partnership

Costco plots major expansion into senior healthcare with Medicare partnership
The warehouse giant's partnership with SCAN Health Plan could include pharmacy, vision, hearing and other senior-focused benefits
By Bonny Chu - August 19, 2026

Costco will soon offer Medicare plans to certain members as part of a new, first-of-its-kind health insurance venture.

The warehouse giant has teamed up with SCAN Health Plan, one of the nation’s largest nonprofit Medicare Advantage plans focused on senior health care, the insurance company announced Tuesday.

Under the partnership, the companies will launch a "suite of senior-focused" insurance products over the coming years.

Pending regulatory approval, the suite could include a revamped pharmacy experience, Medflex over-the-counter pharmacy benefits, vision care coverage, audiology or hearing benefits and more.

The plans will be sold at Costco stores and also made available through insurance agents and websites, according to The Wall Street Journal.

The companies have not revealed exactly when the plans will become available, as regulatory review and approval are still pending. SCAN currently serves members across 33 counties in California, Arizona, Nevada, Texas, New Mexico and Washington.

SCAN Health said the initiative was designed to address the "disjointed experience that many seniors face accessing care and services" and will "bring more value and better experience to seniors as they navigate their health insurance."

"For the millions of older adults who rely on Medicare Advantage, the future of the program depends on strong partnerships that make healthcare more accessible, more connected and more seamlessly integrated into everyday life," Dr. Sachin Jain, CEO of SCAN Group and SCAN Health Plan, said in a statement.

"Older adults want healthcare that is easier to navigate, more responsive to their needs and rooted in organizations they trust. Our expanded partnership with Costco will give us a strong foundation to explore new ways to help people stay healthy and independent while delivering the quality, value, and service both of our organizations are known for."

Costco CEO Ron Vachris added that the partnership with SCAN serves as an extension of the company’s commitment to providing value to its customers.

"For more than 40 years, Costco has consistently listened to our Members and earned their trust delivering consistent value on essential goods and expanding our health service offerings," Vachris said in a statement.

"Selecting SCAN as our partner to deliver a better healthcare experience for seniors, is an extension of that commitment. We have developed a shared understanding of what matters most to the seniors we serve. Deepening our partnership allows us to build on that foundation and create value for our Members."

The University of Michigan's bureaucrats have selected Vanderbilt Provost C. Cybele Raver as their new President and she is expected to be rubber stamped by the Board of Regents in September.  A sterling academic background, but absolutely no health care background.

Note that Vanderbilt University Medical Center (VUMC) was a component of that university until April 2016, but is now an entirely independent organization.  Raver was not affiliated with Vanderbilt back when they operated VUMC.  This report on the selection of Raver fails to mention a single challenge that Michigan Medicine is facing:

https://bridgemi.com/talent-education/u-m-picks-vanderbilts-c-cybele-raver-as-next-president-what-to-know/

U-M picks Vanderbilt’s C. Cybele Raver as next president: What to know
By Isabel Lohman - August 18, 2026

• U-M is hiring Vanderbilt Provost C. Cybele Raver as its 17th president
• She will be the second female president of Michigan’s largest university
• She will succeed Domenico Grasso

The University of Michigan has selected C. Cybele Raver, the provost and vice chancellor for academic affairs at Vanderbilt University, as its next president.

She will be the second female president of the university.

Raver, who holds a Ph.D. in developmental psychology, is also a professor of psychology and human development at Vanderbilt’s Peabody College, where she has conducted research on children’s development, education policy and poverty.

She will succeed Domenico Grasso, who has been U-M’s president since 2025 when Santa Ono resigned.

Since then, U-M announced Kent Syverud, a U-M alum and president of Syracuse University, would lead the school. But earlier this year, Syverud announced he had brian cancer and U-M resumed its search.

“It is an extraordinary honor to be considered as the University of Michigan’s 17th president at this pivotal moment in higher education,” Raver said in a statement. “Michigan’s scale and impact across research, education, economic growth and public service are unmatched, and I’m eager to build on its remarkable legacy. I look forward to working alongside faculty, staff, students and alumni to lead Michigan forward with clarity and confidence.”

The university’s Board of Regents plans to meet Sept. 1 to approve the hiring. If she is approved, she will start Dec. 1.

“Dr. Raver has a proven record of building strong teams, expanding research excellence and strengthening every institution she has served,” said Michael Behm, chair of the Board of Regents, in a statement. “She understands what it takes to lead a complex, world-class university and she shares our unwavering belief that Michigan has been, is now and must remain the best university in the country. We are confident she is the right leader for this moment and we look forward to the board’s formal vote.”

She previously was the deputy provost at New York University, a faculty member at the University of Chicago and a faculty member at Cornell University. She earned her doctoral degree from Yale.

Vanderbilt is a private research university in Nashville with a total enrollment of 13,575 students in 2024, according to the National Center for Education Statistics. The main U-M campus in Ann Arbor has more than 53,000 students and the Flint and Dearborn campuses add another nearly 15,000 students.

It’s unclear how much Raver will be paid. U-M said it would not have additional details before Sept. 1.

Syerud had been granted a contract with a $2 million annual base pay and total compensation nearing $3 million, according to an expert who analyzes presidential contracts. At the time, George Mason University Professor Emeritus James Finkelstein told Bridge Michigan that Syverud’s contract “breaks new ground for a public university president.”

U-M President Emerita Mary Sue Coleman was the first woman to lead the state’s largest university, serving from 2002 to 2014. She also previously served in 2022.

Raver will inherit a host of challenges at U-M, including selecting a new athletic director as Warde Manuel is set to step down at the end of the year.

U-M is also planning to build a data center near its Ann Arbor campus despite local opposition and is navigating a federal government that has sought to overhaulhigher education, including how student protests are handled, what research should be funded andhow much money students can borrow for school.

Here’s a look at some of the challenges and issues Raver would face as U-M’s new leader:

Data center

U-M plans to build a $1.2 billion data center in Ypsilanti Township in partnership with Los Alamos National Laboratory. But the project faces pushback from local residents. The Ypsilanti township board is expected to consider a six-month delay on Tuesday to determine if local infrastructure can handle the demands of the project.

“We need to examine the impact that these substations are going to have upon the environment, especially when they’re going to build these gigantic monstrosities,” Doug Winters, Ypsilanti Township attorney, told Bridge Michigan Monday.

“What they’re building is already going to produce more energy than what the rest of the township is using right now.”

Athletics

Raver would start the same month Manuel is set to step down.

Manuel agreed to step down following investigations into former football coach Sherrone Moore’s relationship with his executive assistant and a probe into the athletic department.

Manuel will receive a $7 million buyout.

“The broader culture review has identified serious concerns that require immediate action,” Grasso said in a July video. “These include failures in accountability, structural deficiencies, weakness in our reporting and support systems and concerns about retaliation. This is unacceptable.”

Grade changes

In a pilot program slated to begin in fall 2027, first-year students in the College of Literature, Science and the Arts, or LSA, won’t see letter grades on their transcripts for classes they take in the first semester. Instead, the grades will be hidden and students will get a “pass” or “no credit” on their transcript. LSA says hiding letter grades could help students adjust to college and address mental health concerns. LSA is the largest college at U-M.

Critics acknowledge a bad grade can bring discomfort but say that’s not a mental health issue and worry that shielding grades is just “coddling” students and could create a sense of entitlement.

Student protests

U-M has faced criticism from some faculty and students for how it handled protests over the Israel-Hamas war.

Some protestors have faced campus bans and are challenging U-M in court, and in 2025, Grasso announced the school would stop its contract with a private security firm after the Guardian reported the firm had followed and recorded protesters for months.

Vanderbilt has also experienced campus protests over the war and suspended some students, which sparked criticism from faculty. After meeting with Raver in 2024, Vanderbilt faculty members told Raver in a letter that she “deflected our substantive concerns that harsh and selective discipline of student protesters does grave damage to our intellectual and pedagogical community.”

Federal uncertainty

• Research: U-M is one of the nation’s largest research institutions and, like some other US universities, it has faced the prospect of federal funding cuts. U-M spends more than $2 billion a year on research. Vanderbilt lauded Raver’s leadership of research in a statement Tuesday: “Raver set ambitious goals for Vanderbilt’s research enterprise as it reached record heights, surpassing $1 billion in annual research expenditures and $100 million in annual technology transfer revenue,” Vanderbilt said in a news release Tuesday. “She also strengthened the university’s infrastructure for research operations, faculty development and student well-being while advancing efforts to recruit outstanding faculty and students from around the world.”
• Student loans: Meanwhile, the Trump administration’s new rules on federal student loans could limit access for some people to attend graduate school. There are stricter borrowing limits for graduate students and students who attended “professional” programs would have a higher borrowing limit than other graduate students. But those designations are now tied up in legal battles.

Who needs the health and wealth gospel, when Hollywood is ready to fill the gap?

https://www.nbcnews.com/news/us-news/selena-gomez-mom-accused-fraud-mental-health-startup-rcna592411

Selena Gomez and her mom accused of fraud over their mental health startup

In a new lawsuit, investors say they gave $1.2 million to Wondermind to build out the company’s products and expected Gomez to be involved in marketing.

Marlene Lenthang and Joe Kottke   |    Aug. 16, 2026

Superstar Selena Gomez and her mother are accused of defrauding investors of their mental health startup, Wondermind, in a federal lawsuit filed Thursday.

Wondermind, which was co-founded by Gomez; her mother, Mandy Teefey; and Daniella Pierson in November 2021, touts mental fitness practices and tools.

The suit accuses Wondermind and its founders of falsely representing the company’s infrastructure, leadership and partnerships to investors and concealing the alleged fraud for more than three years.

The founders told investors they would build a Wondermind app, boasted advertising deals and secured celebrity cover stories, none of which came to fruition, the complaint says.

Investors poured nearly $1.2 million into Wondermind, but the trio falsely represented the company’s plans to make it profitable, the suit says.

It alleges that investors were kept in the dark until two bombshell media reports portrayed Wondermind as a company in utter disarray.

Gomez’s attorney, Mathew Rosengart, said he will file a motion to dismiss the “baseless claims against her.”

“The allegations that Selena Gomez engaged in any way whatsoever in any purported ‘fraud’ or other wrongdoing are completely meritless, both factually and legally,” he said in a statement.

The suit was filed in federal court in Delaware by Wondermind SRS 44 LLC and Bespoke Wondermind SPV I LLC, limited liability companies that invested in the startup.

They accuse the company and the founding trio of securities fraud, common-law fraud and breach of contract and are seeking rescission — meaning a legal cancellation of the investment contract — as well as damages.

In a statement, Pierson says she categorically denies the allegations and “welcomes the opportunity to present concrete documentation and financial records that establish the facts.”

“To be clear, she has never used investor funds for personal expenses. Quite the opposite: Daniella invested her own money into the business and did not draw a salary from the company,” she said in a statement.

Representatives for Wondermind and Teefey did not immediately respond to requests for comment Thursday.

No products, no updates — and no Selena

Investors say in the suit that they believed the money they gave Wondermind would rapidly scale and build a full suite of company products, including an app, a podcast, an editorial publication and other wellness products.

They also believed that the company’s value lay in Gomez’s involvement as a celebrity with a massive, loyal fan base. The suit alleges that Wondermind had indicated that Gomez would be “intimately involved in the Company” as head of marketing and involved in publicity.

But none of those things happened, the suit says.

“Gomez purported to sign a contract obligating her to perform and then ignored it. The partnerships did not exist. The initiatives never materialized. The app was never built,” it says. “And for three years, while the Company quietly collapsed around them, not one of its founders, officers, or directors said a word to the investors whose money was funding the collapse.”

The investors also allege in the suit that the defendants did not provide timely updates about the status of their investments and the company’s operations unless they were pressed.

In the limited updates they did provide, “they both affirmatively misrepresented the status of the Company’s operations and concealed material information about ongoing issues at the Company,” the complaint says.

Media articles allege a company in disarray
Investors were kept in the dark, the suit alleges, for more than three years.

Then came an August 2025 Forbes article focused on Pierson with the headline “‘Smoke And Mirrors’: How This Entrepreneur Exaggerated And Self-Promoted Her Way Into Turmoil.”

Pierson was described to investors as a millionaire executive whose past business, the daily newsletter The Newsette, of which she was CEO, generated $40 million a year, the suit says. Investors were also told she had secured partnerships with JPMorgan and Fidelity.

But the Forbes report cast scrutiny and said Pierson exaggerated her readership and the valuation of her newsletter.

The suit says that investors contacted Teefey for an explanation after the article published and that she responded that Pierson had allegedly “misappropriated investor funds — including the Plaintiffs’ funds — to fund her lavish lifestyle,” including her $60,000 monthly rent for her New York City apartment and monthly expenses, before she was ousted from the company in January 2023.

Yet Teefey had never informed investors about the alleged misappropriated funds before the article was published, the suit says.

An article in The Cut published Sept. 3 titled “What Happened at Wondermind?” based on interviews with current and former employees, alleged the company was falling apart.

“The accounts in the Cut article collectively show that, from the outset, Wondermind had no plan for its future — much less a plan for achieving a multi-billion dollar valuation,” the suit says.

That article alleged that Teefey had a long-running substance abuse problem that impeded her capacity to helm the company, that Gomez sought to distance herself from Wondermind “based on a long-running family dispute” with Teefey and that Pierson had been ousted from the company based on a dispute with Teefey, the suit says.

The article, the suit claims, proved that the company was “in a state of financial calamity” and that “there was no legitimate enterprise in the works.”

Two months later, in November, investors sent the defendants a notice of rescission, demanding the return of their funds, according to their suit. The defendants did not respond “in substance” to the notice, the suit says, but “continued to lull and mislead the plaintiffs.”

After the notice of rescission was sent, Teefey allegedly contacted Bespoke’s representatives suggesting that investors should not file a suit, claiming the company had an escrow account to return the investments, this week’s lawsuit says. When Andrew Resnick, part of Bespoke, followed up for details of the account and the return of funds, “Teefey disappeared,” the suit says.

“In short, there was no ‘escrow account’ or a plan to return the Plaintiffs’ investments,” the complaint says.

Misleading updates
The suit details several allegations of investors’ being given updates that ended up being misleading or false.

In June 2022, it says, Pierson told the plaintiffs that Wondermind had grown to more than 150,000 subscribers in one month, that she had met with executives at other companies regarding “large advertising deals” and that she anticipated closing “at least $5M in ad revenue this year.” She also said the company had “interest or confirmation for ‘Cover Story’ features from major celebrities including Camila Cabello, Tim Cook, Elton John, Drake, Megan Thee Stallion and more,” the complaint says.

She said the company was starting to build its “online editorial experience” and an ambassador/referral program, the complaint says. She is alleged to have touted that the company had a potential future value of more than $4 billion.

That led the investors to believe the company had the foundation to operationalize, the suit says.

The suit says that from 2022 to 2025, the plaintiffs “proactively” contacted Teefey and Pierson for updates.

“When the Defendants would provide updates — either by email or on a phone call — they concealed the significant operational and financial issues at the Company. Indeed, the Defendants affirmatively misrepresented that the Company was performing well,” the suit says.

Overall, the suit accuses Wondermind and all defendants of securities fraud, alleging they misrepresented the company’s finances, Gomez’s involvement, Pierson’s business background and Teefey’s fitness (as she had never held a similar startup CEO role). They are further accused of common law fraud and equitable fraud.

Pierson in addition is accused in the suit of securities fraud for what it alleges were misstatements to investors, conversion for wrongfully using investment funds and unjust enrichment.

Wondermind is also accused in the suit of breach of contract-use of investor proceeds, rescission-failures to satisfy conditions precedent, and breach of contract-breach of express representations and warranties.