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CMS proposes updates to home health payments for CY 2027, updates to provider enrollment and quality and value-based purchasing programs
The Centers for Medicare & Medicaid Services July 1 issued its calendar year 2027 proposed rule for the home health prospective payment system. The rule proposes a 2.4% update, which includes a 3.1% market basket update, reduced by a 1.0 percentage point cut for productivity, as well as an 0.3 percentage point increase related to outlier payments. In addition, the agency proposes a temporary cut of 3.0% that it states is necessary to achieve budget-neutral implementation of the Patient-driven Groupings Model.
Bates lifts what matters in healthcare leadership
East Carolina University College of Nursing student Sandra Bates is driven by a passion for improving healthcare systems.
Uber Shakes Up AI Data Labeling Business, Dismissing Top Leaders
Uber Technologies Inc. has dismissed two tech leaders at its nascent AI data labeling business, shaking up a key division that the ride-hail company has positioned as a key growth driver.
The Case for Performance-First Management
What began as a crisis-driven response to the Covid pandemic laid the foundation for today’s dominant management paradigm: people-first management. But today’s business demands a different approach, as performance and productivity have replaced engagement and retention atop the CEO agenda. Performance-first management represents a gentle shift toward an approach where managers empower their teams to deliver high-impact results within a complex and evolving reality. It keeps people at the center, but reorients the manager’s role around enabling performance, not just supporting satisfaction. Gartner research shows that managers who shift toward a performance-first approach are up to 21% more likely to deliver the business results that are expected of them. And employees who say that their managers are performance-first report higher overall satisfaction with their employee experience.
Sony will cease production of discs for new PlayStation games in 2028
New games sold for PlayStation consoles will only be available digitally and won’t be sold on discs effective January 2028, Sony has announced. The move applies to all PlayStation games released from that point on, including those made by Sony and those released by third parties. The PlayStation group calls the change “a natural direction for Sony Interactive Entertainment to adapt to consumer trends as the general preference for digital media significantly outpaces physical discs,” according to a PlayStation blog post reviewed by Game File in advance of its publication. As movies, TV and music have shifted from physical media to an age of downloads and streaming, Sony’s move could speed the demise of physical media in a gaming. The industry has offered consumers games via cartridges, cassettes, floppy discs, CDs, DVDs and Blu-Rays across a 50-year stretch. Sony has been reporting to investors in recent years that PlayStation games have been increasingly purchased as downloads, not as discs. The most recent figures show nearly four in five purchases of full games for PlayStation 4 and PlayStation 5 were purchased digitally in the past year. Stats like that may cause today’s news to carry an air of the inevitable. But Sony’s declaration for 2028 is still likely to produce a shock, as the biggest gaming platform on the planet that uses game discs leaves them behind. Discs going away, but the fate of game boxes is unknown Sony is committing to still selling games in physical retailers even after they drop discs in 2028. Just how those games will be sold—in boxes with codes inside, as cards marked with digital redemption codes—is unclear. Digital games will also continue to be sold in the online PlayStation Store. New games released for PlayStation consoles prior to January 2028 will be unaffected by the policy change, Sony says. That means the PS5 games of 2027, be they a new Madden, a new God of War, a new Call of Duty, a new Sly Cooper (one can dream?), would still potentially be offered on disc. PlayStation 6 implications Sony’s timeline for a transition to a no-disc era will also spin up more speculation about the timing and configuration of Sony’s next-generation console, the probable PlayStation 6. “This pretty much guarantees that PS6 won’t arrive until 2028 at the earliest,” Piers Harding-Rolls, senior games research analyst at Ampere Analysis tells Game File. Harding-Rolls also concludes from today’s news that “the base version of a PS6 will not include a physical media drive,” as Sony looks to keep costs down on the device. Sony itself is saying nothing about the PS6 today: not its timing, nor how it might or might not support internal or external disc drives in order to run disc-based PS4 and PS5 games, should the console be backwards compatible. The many signs this was coming Industry support for games being released on physical media has been waning. As has consumer interest in them. PC games effectively went all-digital years ago, thanks to the popularity of playing games through Steam and other digital storefronts. The Covid-19 pandemic and the lockdowns that kept much of the global population home helped shift shopping patterns toward downloads. Sony’s own data shows PlayStation game downloads being an uncommon consumer choice a decade ago and now becoming the norm. On consoles, physical media has been in such decline that Sony and Microsoft both launched their current gen Xbox Series and PS5 consoles in 2020 with cheaper versions that lacked disc drives. In early 2024, Phil Spencer, then head of Xbox, told me that ““[w]e ship games physically and digitally, and we’re really just following what the customers are doing.” He added that the game industry had become an outlier in still supporting disc-based entertainment, even as movies and TV have bailed on discs in favor of downloads and steaming: “Gaming consoles themselves have kind of become the last consumer electronic device that has a drive. And this is a real issue, just in terms of the number of manufacturers that are actually building drives and the cost associated with those. And when you think about cogs that we’re going to go put in a console—and as you have fewer suppliers and fewer buyers—the cost of the drive does have an impact.” Last year, the Nintendo’s Switch 2, which uses cartridges rather than discs, introduced the concept of game-key cards, which are physical media that contain no game, just a prompt for a download. Even disc-based games aren’t what they once were, now frequently containing just stubs of games rather than the whole thing. The website Does It Play has tested over 3000 games and found that, for example, that the disc version of this year’s hit 007: First Light, only contained the game’s first mission, with the rest needing to be downloaded. Beyond all that, last week brought the news that Grand Theft Auto VI, likely the biggest game launch this decade, will debut for PS5 and Xbox Series without a disc-based version. Today’s big news comes to you for free. Game File is a reader-supported publication. To receive new posts and ensure more of my work is possible, please consider becoming a free or paid subscriber. Subscribe Discs helped define PlayStation However the trends in entertainment may be going, it is still remarkable to see PlayStation ditch discs given their importance in PlayStation history: In the late 1990s, the first PlayStation’s support for games on relatively cheap CD-ROMs instead of traditional game cartridges allowed the upstart console to outmaneuver cartridge-based systems from Nintendo and Sega, as it drove down game prices down in the process. (The cheaper disc format even prompted Final Fantasy VII maker Square to taunt Nintendo in a magazine ad, saying that if the game was “available on cartridge, it’d retail for around $1200.”) PlayStation devices often doubled as machines for watching movies and TV on the latest disc-based formats. In the late 2000s, for example, Sony’s pricy PS3 gained traction as a go-to device for playing then-novel Blu-Ray discs. In 2013, Sony effectively roasted the digital game-sharing restrictions proposed by rival Microsoft for its upcoming Xbox One console by showing how games could be shared for the then-upcoming PS4. In a 21-second clip that has over 20 million views on YouTube, one PlayStation executive simply handed a game box—presumably with disc inside—to another, who said “thanks.” Sony’s possible motivations The PlayStation announcement today cites “consumer preferences” and a shift away from discs among “the broader entertainment industry,” but does not delve into the decision-making process that brought Sony to this point. Sony is not discussing the economics of this move (I asked!), but there are a number of potential factors: Abandoning discs will spare Sony the cost of manufacturing and shipping them, which analysts and industry veterans I spoke to said could account for $1 or so of a game’s retail price. For first-party games, that’s direct savings for Sony, though the amount is limited by the winnowing percentage of people who were even buying the disc-based versions. For third-party games, Sony could pass the savings on to partners or just retain the better profit margin for themselves. As the 2024 comments from Phil Spencer alluded to, leaving discs behind could mean leaving disc-drives behind, allowing Sony to produce consoles more cheaply. Switching to digital-only for games could diminish the risks of copies of new games leaking. It would also seemingly make second-hand sales of used games impossible, pushing more people to buy their own copies of games. These economic benefits for Sony could be boons for the games industry overall, Ampere analyst Piers Harding-Rolls tells Game File. Among other things, it could free publishers and retailers from having to worry about securing an inventory of game discs when trying to sell games, he noted. “If there is a way to streamline the business of games retail, I generally think it’s a good thing for the industry as it removes unnecessary costs,” Harding-Rolls said. “This will help offset pressure on margins from other directions – development and staffing costs for example.” Should the industry shift from game boxes that contain discs to smaller, cheaper game cards, Harding-Rolls said, that reduces pressure on publishers and retailers. “The advantage of everything going digital for the industry is that sales can be tracked much more easily and there is less commercial risk for publishers wanting to continue selling via retail,” he said. The shift to no discs will also likely impact game development timelines, as developers will no longer face the same urgency to have a build ready to submit to PlayStation for the production of a disc, as industry experts noted around GTA VI’s no-disc news last week. Instead, projects may gain weeks of development time, in the event delivery deadlines for platform approval move closer to release date. Preservationists’ likely worries While millions of gamers have shifted to digital, there are still people who associate game discs—and only game discs—with actual ownership of PlayStation games. That portion of the gaming community spoke up last week about wanting to buy a version of GTA VI that they could hold in their hands, could lend to a friend and could potentially pop into a well-preserved PS5 console three decades from now and still see it run. Such gamers didn’t want to worry that they’d merely purchased a digital copy that could lose access to the game if, say, the company behind the game someday turns of the servers that transmit downloadable copies. Digital copies of games are inherently less long-lasting, because consumers aren’t actually buying a game (on a disc), just buying access to the game. The fine print in online gaming shops notes this, as does a recent law that went on the books in California in 2025. That lasw requires game publishers doing business in the state to refrain from words like “sell” when offering digital copies of games, unless they explicitly tell consumers that what’s being sold isn’t the game itself but a potentially revocable license to access it. A Sony spokesperson noted to Game File that “[w]ith all digital content, including games, movies, and music, players are purchasing a personal license for non-commercial use.” Regarding the fears of PlayStation games being lost to time in an all-digital era, the rep also noted that Sony remains “committed to delivering experiences from past generations to the new platforms our players are using.” They noted that PlayStation has used emulation and remasters to keep offering its classic games to modern gamers. It’s true that many consumers have become accustomed to not having physical copies of new music albums or movies, but the relative precariousness of digital copies of games is in fact being highlighted today by…. Sony’s other big announcement: the upcoming closure of the PS3 and PS Vita online stores Sony said today that it will be closing the online marketplaces for its PlayStation 3 console and PS Vita handheld in most countries in July 2027 (sooner elsewhere: August 2026 for the PS3 store Mexico, Honduras and Nicaragua; late 2026 for PS3 in other Latin American countries and the Middle East). “We know this news may be disappointing to PS3 and PS Vita players who hold a special place in their hearts for this generation of gaming,” Sony said in its announcement, saying the move “was not an easy decision for us to make.” Sony said that PS3 and Vita marketplaces “are no longer able” to support modern commerce systems, prompting a “need” to close the shops and focus on more modern PlayStation platform stores. The news may spark some deja vu. Sony announced back in March 2021 that it planned to take the PS3, Vita and PlayStation Portable marketplaces offline that summer. The move would have caused some 2,000 digital-only games to become unavailable for new purchasers, according to a VGC analysis at the time. Fans complained loudly. By April 2021, Sony walked back the PS3 and Vita shop closures, with then PlayStation boss Jim Ryan saying “it’s clear that we made the wrong decision here.” This time around, Sony is giving a longer notice period in most regions. The closure of those stores is still likely to cut off access to new purchases of digital-only PS3 and Vita games. The current PlayStation 5 marketplace sells PS5 and PS4 games, as well as a selection of PS1 and PS2 games. It does not sell PS3 games, because games for that platform can’t run on the system (some are offered via a PlayStation Plus streaming option). Vita games also aren’t sold via PS5. Sony says digitally purchased PS3 and Vita games will be downloadable after the stores’ shutdowns “for the foreseeable future.” Sony’s move contrasts with Microsoft’s Xbox platform, which continues to sell and support games from all four Xbox console generations. But it puts it in line with Nintendo, which disabled purchases in the marketplace for its Wii console (a contemporary of the PS3) in 2019. Nintendo discontinued purchases in the online shop for its 3DS portable (a contemporary of the Vita) in 2023. The big questions about Sony’s 2028 post-disc era Will Microsoft follow suit, ending support for new disc-based games on Xbox platforms and therefore all game consoles, too? Whether Microsoft does or not, will third-parties that can no longer release games on discs for PlayStation, simply ditch the disc options across the board? Given the GTA VI no-disc experiment launching this November, will more game publishers decide to forgo disc-based offerings even in 2027? How will no-disc PS5/6 games be packaged and sold in brick-and-mortar retail stores? What becomes of game sharing in an all-digital era? Will Sony modify its current set-up, which currently allows some sharing of digital games across a pair of consoles, to allow more casual lending? (See for example, Nintendo’s year-old system of letting players lend a digital game to another player in a “family group” for up to 14 days.) Will there be a version of a PS6 with a disc drive? Or will a drive be offered as an add-on? And how will gamers who want to retain access to PS4/PS5 disc-based games react to whichever configurations Sony chooses to offer? What will the final disc-based PlayStation game be?
Corona maker Constellation Brands tops forecasts as beer business drives earnings growth
Strong beer performance lifts quarterly resultsConstellation Brands Inc Class A (NYSE:STZ) reported first-quarter results ahead of Wall Street expectations, supported by continued strength in its beer division. Adjusted earnings came in at $3.
Anthropic debuts AI-driven pharma R&D tool, Claude Science
Anthropic launches Claude Science as big tech companies increasingly eye expansion in the wider healthcare and life sciences space.
Unisun Sports Commences, Kicking Off 2026-27 Season
JACKSONVILLE, Fla. - Unisun Sports, the groundbreaking strategic alliance between the Atlantic Sun Conference (ASUN) and the United Athletic Conference (UAC), has officially commenced as of July 1, 2026. Unisun Sports will serve both conferences, designed to significantly enhance operational efficiency, foster deeper collaboration, and drive innovation across both NCAA Division I organizations.
Unisun Sports Commences, Kicking Off 2026-27 Season
Unisun Sports, the groundbreaking strategic alliance between the Atlantic Sun Conference (ASUN) and the United Athletic Conference (UAC), has officially commenced as of July 1, 2026. Unisun Sports will serve both conferences, designed to significantly enhance operational efficiency, foster deeper collaboration, and drive innovation across both NCAA Division I organizations.
AI, Data Centers, and the New Politics of Power Demand
Artificial intelligence (AI) has overturned the long-stable trajectory of U.S. electricity demand. After decades of flat growth, planners and regulators now face a surge driven by hyperscale data
AI-Driven Restructuring Accelerates Layoffs Across U.S. Technology Sector
Artificial intelligence is rapidly reshaping the U.S. technology industry, with major companies accelerating workforce reductions.
The End of Independent Federal Agencies Will Change Your Business
For executives, the U.S. Supreme Court’s decision in Slaughter v. Trump will likely lead to less certainty and consistency for the regulated aspects of their businesses, with federal rules and their enforcement increasingly determined by political expediency rather than expert analysis. Specifically, there are five ways in which all U.S. businesses will be affected: regulation will become more informal and less transparent; consistency across administrations will disappear; oversight by Congress and the federal courts will be diminished; expert advice will be devalued; and politically-connected lobbyists will drive decision-making. In this environment, business leaders will need to plan accordingly, honing their ability to shift strategy, perhaps dramatically, after every election—and perhaps even during administrations.
Weird Dresses
Schiaparelli deigns shows strong business potential with celebrity-driven virality, replaces ad spend, while surrealist shock value.
Dale Jr. Fires Back At Criticism Of NASCAR Broadcast
Dale Earnhardt Jr. has been involved in the NASCAR media space for a while now, so the legendary driver is used to criticism. Over the weekend, some NASCAR fans expressed frustration with the TNT broadcast, as some believed that the analysts were underestimating the chances of Shane van Gisbergen ...
Nokia, SAP and Microsoft Enter Strategic Multi-Year Agreement to Advance Cloud- and AI-Driven Business Transformation
Nokia will accelerate its enterprise transformation using RISE with SAP Methodology, with SAP S/4HANA hosted on Microsoft Azure.
Fast food, fries and science: Inside U-M's lab studying cravings
The experiment starts before anyone takes a bite. There's no drive-thru. No cashier calling the next order. No glowing sign announcing the restaurant is open.
How the Improved Shell App Drives Business Success
The app creates a unified experience to support ‘future growth across the retail network.’
Conduent Announces Agreement to Sell Its Tolling Business to Quarterhill Inc. for $70 Million
FLORHAM PARK, N.J., June 30, 2026 — Conduent Incorporated (Nasdaq: CNDT), a global technology-driven business solutions and services provider, today announced that it has entered into a definitive agreement to sell its Tolling business (a division of...
Building the Valley: Young Springdale man keeping lawns at bay as business grows
When Justin Burrell started landscaping in 2022, the then-14-year-old wasn’t old enough to drive himself to clients’ houses so he enlisted help from his parents. At first, he mowed lawns for some extra pocket change. Now, at 18, Burrell is working toward turn his Burrell Grounds and Services business into
Ozempic Might Be Making Your Team Less Driven. Here’s the Science
New reports on GLP-1 drugs and the brain’s “wanting” system have direct implications for how leaders motivate, reward, build teams, and sustain culture.
A New Playbook: State-Driven Solutions for Resilient Health Data
Health equity depends on data equity: the representation of communities in the data used to identify disparities, target interventions, and hold systems accountable.
AI is rewriting the political competitive landscape
Artificial intelligence is rapidly becoming a central infrastructure layer in political campaigns, reshaping how elections are financed, contested and influenced, The New York Times reports. Campaigns and affiliated political groups are increasingly investing in AI-driven tools for voter targeting, message optimization and large-scale content generation, turning modern elections into capital-intensive, technology-enabled competition. This shift is […]
Apple says it is releasing updates early in response to AI cybersecurity concerns
Apple said it is pushing forward a series of software updates that would previously have been bundled with a new version of its iOS operating system, making them available earlier than in previous cycles in response to AI-driven security concerns.
Science Says Driving A Stick Shift Is Good For Your Brain
The manual transmission may have another argument in its favor beyond driver engagement.
West Palm Beach business collecting items for Venezuela
Across the region, donation drives are collecting baby formula, medical supplies, nonperishable food and other essentials for families affected by the disaster.
How a Brain Messenger Protein Drives Progression of Alzheimer’s Disease
In mice, a brain protein called Arc helps spread toxic molecules from sick brain cells to healthy ones. If therapies could be designed to target the spread, they could be a powerful tool to stop disease progression.
Expert: Tennessee Redistricting Plan Driven by Politics, Not Race
An expert defends Tennessee's congressional redistricting plan, arguing racial consequences stem from partisan aims, not racial discrimination.
Has the McLaren W1 redefined the supercar?
A first drive of the Formula One team’s latest take
Driven: The McLaren W1 Has Earned Its Suffix
The rear-wheel-driven 1258-hp hypercar is a worthy successor to the F1 and P1.
Cleveland Clinic Tackles Hunger, Housing and Maternal Health
In 2025, our teams continued to address critical social drivers of health, expand access to care and resources, and build stronger, healthier communities.
South Korean tech giants to build a $518 billion chipmaking hub to serve soaring AI demand
South Korean tech giants Samsung Electronics and SK Hynix plan to invest a combined $518 billion in a new computer chip manufacturing hub, capitalizing on surging artificial intelligence-driven demand.
It’s Linux, On A Sega Megadrive
If you were in the market for a games console in 1990, the chances are that the object of your desire was either a Super Nintendo with its 16-bit 6502 derivative, or the Sega Megadrive, sold as the…
Andretti linked to young rising IndyCar driver for 2027 season
Andretti Global has been linked to a young rising IndyCar driver for the 2027 NTT IndyCar Series season.
Life Science Reagent Market Forecast Points Higher Toward 2035, Driven by Biopharma Scale-Up and Cell Therapy Expansion
World life science reagent market forecast 2026-2035: CAGR 6-8%, index 2035=185. Bioprocessing, cell therapy, and QC drive growth. Key players: Thermo Fisher, Merck, Danaher.
Anxiety drives child mental health referrals past one million
Demand is soaring beyond capacity, meaning children in England wait years for help with various conditions.
How did EBS science show reach Netflix's top 10?
For years, South Korea’s public Educational Broadcasting System has struggled to rival the massive budgets of global streaming originals and star-driven mainstr
I started using Projects in Google Drive; it instantly boosted my productivity
Google Drive finally feels smarter
El Niño Is Back—and It Could Cost Businesses Trillions. What Smart Leaders Are to Prepare
Dartmouth research makes the duration of the damage clear: economic losses from major El Niño events persist for five years after the event itself.
Linux 7.3 To Introduce DRM "Color Format" Property With AMD GPU Driver Support
While the Linux 7.2 kernel merge window is only ending later today to cap off the feature work on this next version of the Linux kernel, already for the Linux 7.3 kernel cycle later in the year there is one notable feature on the way: the DRM color format property is being introduced and being first supported by the AMDGPU kernel graphics driver.
The Politics of the Instagram Story
Drive yourself crazy for the low price of $3.99 a month!
The AI Politics of 2028 Are Starting Now
Gina Raimondo and Eric Holcomb are not running for president. They might drive the 2028 agenda on artificial intelligence anyway.
Rooted in Flagstaff, Driven by Community
Flagstaff Business News Rooted in Flagstaff, Driven by Community
Your health insurer shouldn’t decide your treatment plan. That’s what your doctor (and possibly AI) should be doing.
With a digital health record, clinicians and AI-driven diagnostic tools would be able to see your full health history — and then make better decisions.
Scientists discover what triggers belly fat as we age
Aging may trigger the appearance of specialized stem cells that supercharge the body's ability to create new belly fat. The discovery reveals a potential biological driver of middle-age weight gain and a promising target for future anti-obesity treatments.
The Most Expensive AC Setting to Use During a Heat Wave, Experts Say
Trying to stay cool during a heat wave? Experts reveal the AC setting that can drive up energy costs the most—and what to use instead to save money.
ACES hosts event looking at health impacts of climate change
Dr. Mark Gladwin, the dean of University of Maryland School of Medicine and the vice president of Medical Affairs, is slated to speak with Aspen Center for Environmental Studies from 6 to 7 p.m. July 2 on the worsening health impacts in the face of human-driven climate change.
Tourism tax dollars to drive $25M makeover of John R. Jones Sports Complex in Pensacola
PENSACOLA, Fla. -- The John R. Jones Sports Complex will soon undergo a makeover. When it's complete, it is expected to be one of the premiere athletic fields i
The Best Prime Day SSD and HDD Deals Are Almost Gone: Save Big With Drives From Samsung, Seagate, WD, and More
After months of RAM-related price hikes, Amazon Prime Day is the best time to score deep discounts on SSDs and hard drives. But today is your last chance!
Walton Arts Center to host blood drive with free entertainment July 1
The Walton Arts Center will host a blood drive in partnership with the American Red Cross from 10 a.m. until 4 p.m. on Wednesday, July 1. The center will provide live entertainment for blood donors in attendance that day, including performances by cellist Carrington Truehart, and guitarists Ben Harris and William Reyes. SUBSCRIBE: Get our
CSUF Report Finds Family Businesses Drive Jobs and Revenue in Fullerton
The city of Fullerton is home to a vibrant entrepreneurial community, with family-owned businesses serving as a cornerstone of the local economy. The family business sector in Fullerton is the subject of a new report researched and published by Tim Schultz, the head of Cal State Fullerton’s Center for Family Business. Chethan Srikant, associate professor […]
Weather drives cowherd size, not broken markets
Data shows weather, not broken markets, drives cowherd decisions. Producers cite grazing concerns and drought as top barriers to expansion.
Should “Success” in Science Be Measured Differently?
Publication volumes are one of the main ways that success is measured for researchers today. From mentorship to real-world impact, scientists argue that “publish or perish” pressures overlook many of the contributions that drive discovery forward.
The Science Of Speed: How Mizuno’s Nanoalloy Face Changes What’s Possible In Driver Design
Mizuno is the first company to put a functional polymer layer in front of a driver face. The implications go well beyond ball speed. For most of the
Ohio Black-owned businesses, payroll has increased, bringing bigger share of economy to group
According to analysis of national census data, black-owned businesses in Ohio continue to increase payroll, and drive jobs and income in the state.
Intel’s Chip Business Shows Signs of Life After Years of Struggle
It is the centerpiece of President Trump’s drive to make more chips in the United States, but the company still has a long way to go before it can be called a complete turnaround.
Why Vrancken marks fresh start at data-driven Hearts
As Belgian head coach Wouter Vranckin takes charge at Hearts, it marks a strengthening of the club's data-driven vision, writes Thomas Duncan.
Making Our Own Luck
We are cross-posting a piece that former NIH official Kris Willis wrote for Macroscience. Kris is now the President and Founder of the Woodley Park Institute, for which I’m a board member. Picking winners or hedging bets? Federal science agencies have long wrestled with the question of how to ensure their billions of dollars of grants and contracts result in maximum benefits for Americans. On the surface, it might seem that a goal-oriented, interventionist style of management would be the best policy: prioritize our most pressing problems and distribute funding accordingly.This top-down strategy creates a unique hazard, though: bad choices can send resources in the wrong direction, resulting in slow progress that impedes the delivery of tangible benefits to citizens. Moreover, if decision makers pursue an applied advance when the underlying scientific principles remain poorly understood, they risk costly failures and a loss of support for the research enterprise at large. Examples include Nixon’s 1971 War on Cancer, undertaken on the premise that a cure could be achieved in less than a decade, the drive to build an operational commercial fusion plant by the mid-1990s, and the National Plan to Address Alzheimer’s Disease, which failed to produce the effective treatments and prevention strategies promised by 2025. The contrasting laissez-faire approach is to hedge your bets. If the path to an advance is impossible to predict, then the wisest choice might be to distribute funding to as widely as possible. The main risk of this strategy is that spreading funding thinly may limit the resources available to the most promising research, resulting in the same negative outcomes as the interventionist approach: limited support for the most promising topics, slow progress, and delayed returns. In reality, at science agencies like the National Science Foundation and National Institutes of Health, program managers navigate between these two extremes, setting some funds aside to target high-priority areas and using the rest to cover the widest possible range of meritorious proposals. This middle path seems like the most rational way to proceed, but it still requires making choices. How much should be set aside for high priority topics? What should those topics be? How should we define merit? Expert opinion can provide a helpful guide, but leading experts can have remarkably different opinions about what matters and what should be prioritized. Moreover, experts and administrators alike can be risk averse, giving an edge to high-profile, well-established concepts. What’s really needed is a data-driven framework to help guide decision-making, one that doesn’t simply repackage prestige or incumbency. Recognizing breakthroughs years in advance Many breakthroughs fail to attract funding or recognition at the earliest stages of development. Katalin Karikó, for example, spent years struggling to win grants for work on mRNA that would eventually win her and Drew Weissman a Nobel Prize. Similar stories can be told about Jim Allison’s groundbreaking studies leading to the development of cancer immunotherapy, Stan Pruisner’s demonstration that prions can self-replicate without DNA, or Robin Warren and Barry Marshall’s proof that Helicobacter pylori, not stress, causes ulcers. Yet at some point, the scientific community recognizes and responds to transformative breakthroughs like these. How does that change happen? And what if science funders could identify the areas that are on the cusp of a breakthrough? Those questions led my collaborators and me to study how scientists responded to past breakthroughs. Based on patterns in that data, we developed a means of predicting future breakthroughs, using biomedicine as a proof of concept. It’s worth taking a moment to describe how our approach works. Briefly, our prediction process begins by grouping the 18 million or so peer-reviewed papers in PubMed, the authoritative database of biomedical research, into roughly 50,000 unique topics. A small subset of these topics are so widely acclaimed as breakthroughs that they have been recognized with a major prize like a Nobel or a Lasker Award. We theorized that studying the development of these outliers over time, especially before they gained acclaim, was the key to identifying future instances of them. After defining topics, we chose 21 representative breakthroughs and asked what they looked like before they won prestigious prizes. To answer that question, we re-ran our topic-mapping algorithm repeatedly, winding back the clock one year each time, stringing together the years to follow the progress of each field as it grew and advanced. We found that in each case, the years leading up to a discovery followed a pattern: a burst of papers on a new, rapidly evolving topic, many of which quickly became influential. These characteristics—the percent of papers that are new, the percentage of papers that are brought in from other topics, and the influence of each individual paper—can all be measured separately for any given topic. Together, they act as a predictive signal that is detectable an average of five years before a transformative discovery is made, and up to thirty years before the discovery receives a major prize. Scanning the current research landscape for topics that display this signal allows us to predict what work will likely produce a future breakthrough. Each year we analyzed includes four or five signals, a number that appears to have remained constant across a twenty year time frame. In their classic work on the sociology of science, Bruno Latour and Steve Woolgar established that the desire to participate in a major discovery is an important motivator for scientists as they consider whether they should take up (or abandon) a research problem. Although further work is needed, the simplest explanation for our results is that this behavior is widespread enough to detect at scale. A foundational advance, or something like it, draws the attention of scientists and causes them to change the direction of their research. They vote with their feet, staking their own reputation and careers by publishing on and citing the new idea. That upswell of interest is the foundation of our breakthrough signal. What kind of research does our model identify as a breakthrough? After building a model based on the patterns in our 21 preselected breakthroughs, we tested it by identifying all early signals of discovery from 1994 through 1997. Of the 18 signals we found in that time period, 17 can be traced forward in time to a breakthrough. Examples include super-resolution fluorescence microscopy (see the image above), the directed evolution of proteins and enzymes (Chemistry Nobel, 2018), and sequencing the human genome (National Medal of Science, 2008). The discovery of the role of leptin signaling in obesity is a particularly interesting case study. Around 1950, scientists noticed the existence of a type of lab mouse that suffered from a unique inherited form of obesity. When given the freedom to choose their own diet, these mice ate more than normal and preferred food that was high in fat. Researchers had few clues as to why the animals overate; early experiments pointed to the existence of a soluble ob factor found circulating in the bloodstream that regulated appetite, but its identity was unknown. In 1994, Jeffrey Friedman and colleagues identified and sequenced the ob gene, noting that the protein it encoded appeared to fit the profile of a circulating factor. A year later, a trio of high-profile publications demonstrated that ob was a hormone that regulated body weight and fat deposition by regulating appetite. One of these was co-authored by Friedman, who christened it leptin from the ancient Greek word for thin. Using our model, the data from 1996 make it clear this advance would become a breakthrough. Scientists had flocked to study the biology of the new hormone, generating the flurry of new papers and citations required to produce a signal. One of these demonstrated that serum leptin concentrations reflected the amount of adipose tissue in the human body, providing clinical validation of the earlier mouse studies. Before the identification of leptin, scientists were unable to point to a specific molecule that controlled appetite and adiposity, so that it was impossible to rule out non-physiological causes of obesity; its characterization fundamentally changed our concept of weight gain. In 2010, Friedman and fellow pioneer Douglas Coleman were awarded a Lasker for the discovery. Our work also identifies breakthroughs in clinical practice and behavioral and social sciences, even though these areas are less likely to draw the attention of major prize committees. One example that falls into this category is the introduction of endovascular aneurysm repair, a minimally invasive surgical procedure for the treatment of abdominal aortic aneurysm, a leading cause of death among Americans over the age of 65. Relative to the previous standard of care, it reduces in-hospital mortality by almost four-fold. In 2017, Timothy Chuter received the American College of Surgeons’ prestigious Jacobsen Innovation award for his multiple refinements to the technique. Another under-recognized breakthrough identified by our model is the development of standardized survey instruments to assess the quality of life for HIV+ patients. The antiretroviral cocktails introduced in the mid-1990s reduced AIDS mortality, but treatment came with serious side effects. The new evaluations showed that patients whose disease progressed had worse physical functioning than Americans with other chronic diseases, while those who were asymptomatic maintained a health-related quality of life on par with the overall US population. This evidence made it possible for patients and activists to argue that even in the absence of a total cure, and in spite of the side effects, alleviation of symptoms was a worthwhile priority for clinicians. My colleagues and I have failed to identify any significant recognition for the physicians and health policy experts who pioneered this advance, although in 2016, researchers called for the World Health Organization to set targets for good health-related quality of life as part of its framework to end the AIDS pandemic. From forecasting to funding How should science funders use our predictions? Any serious discussion of what we should do with this new capability needs to begin with an understanding of its limitations. We can’t (and shouldn’t) invest all of our resources in the small number of topics predicted to produce breakthroughs. Innovative new fields are born from existing ones; they rarely arise de novo. If funders don’t maintain a diverse portfolio, the breakthroughs of tomorrow will have no antecedents. Think of this as eating the seed corn, or killing the goose that lays the golden egg. There are also multiple goals of funding beyond basic scientific discovery, including translating discoveries into clinical practice, developing new technologies, supporting economic development, and training new scientists. The investments needed to accomplish these goals are likely different from those required to support emerging breakthroughs. Finally, we must be aware that we may not capture every instance of a breakthrough. The concept is fuzzy, and not every significant discovery is recognized with a major award. Further, breakthroughs are rare, meaning that our dataset is, by necessity, small. This makes formal estimates of accuracy challenging. Although our overall success rate appears to be high, any one signal may turn out to be a false positive. We found one apparent example: the development of the third generation COX-2 inhibitors, Vioxx and Celebrex, which were much celebrated in the early 2000s as effective but non-addictive pain relievers, meets all the algorithmic criteria of a breakthrough. Five years after it received FDA approval, researchers demonstrated that Vioxx was associated with serious cardiovascular complications, and the manufacturer voluntarily pulled the drug from the market. Celebrex remains available, although like other NSAIDs, it carries an FDA warning for increased cardiovascular risk. Decision makers who were overly focused on the breakthrough potential of this research might have wasted substantial resources nurturing an area that ultimately proved to be a failure—but so would those who relied on expert opinion at the time. That said, the potential benefits of funding the next mRNA vaccine or cancer immunotherapy years earlier than we might have are large. When we can’t assume the outcome of an action, it’s worth conducting an experiment. Can targeted support for areas that are poised to produce a breakthrough increase the return on scientific investment without cannibalizing future advances? With the necessary administrative infrastructure in place, conducting this experiment would be straightforward. First, identify all the breakthrough signals between 2018 and 2023, select half at random, and commit to a decade of investment. For biomedicine, a six year window should yield about 30 topics with the potential to produce a breakthrough. Providing strong support to half of these might be accomplished for $300 million a year. That’s roughly half of the recent annual budget of the NIH Common Fund or around 20% of the fiscal year 2025 budget for ARPA-H. After five years, then again at ten, compare to see which group — the one that was actively managed, or the control — produced more breakthroughs, and on what timescale. Although we used biomedicine as an example, the same experiment could just as well be run for physics, materials science, or any other discipline. Any attempt to undertake such an experiment should keep three points top of mind. First, we can predict the topic of future breakthroughs, but the people and vision for how to move the work forward are still important. In practice, this means success requires active program managers with the expertise to develop the science and the authority to do so, including by recruiting investigators. Second, we would be wise to learn from the failures of past attempts to fund transformative research. High among these are funding modestly repackaged work, confusing the genuinely novel with the merely unfamiliar, and relying too much on incumbent investigators. All of these risks can be mitigated by thoroughly and intelligently integrating high quality data into portfolio management. Finally, we need to have patience. Even with strong funding support, producing a breakthrough takes time. If supporting breakthroughs is the best way to nurture the birth of new fields, we also need to accurately describe and properly manage the other two stages, so that we invest wisely throughout the productive lifetime of ideas and divest once they reach the point of diminishing returns. We would benefit from more study of all of these phases, especially the transition from one to another. More research could answer questions like: When does a breakthrough become an established field? How do the availability of funding, the size and characteristics of the available workforce, and the accumulation of evidence that disagrees with prevailing models affect a field’s decline? Exactly how do old ideas give birth to new ones, and can we speed up the process? The more we understand about the dynamics of scientific progress, the better we can maximize the odds that our curiosity leads to results. I’d call that finding a way to make our own luck.
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(Welcome to the “Most Important Story of the Week”, my bi-weekly strategy column analyzing the most important (but often not buzziest) news story of the last two weeks. I’m the Entertainment Strategy Guy, a former streaming executive who now analyzes business strategy in the entertainment industry. Please subscribe.) Scrolling through links over the last week, I stumbled across this fun headline: Wow. Formula 1 (the sport, not the docu-series) is the perfect “dog not barking”. As a reminder, each week in my Streaming Ratings Report, I call out the shows that miss every viewership chart. I dub them “dogs not barking”—like the Sherlock Holmes mystery—because without any data, we forget they even exist. This is in contrast to something like, say, a film flop—cough The Mandalorian and Grogu cough—where even underperforming at the box office is widely discussed here, there and everywhere. In the US, Formula 1 is now in “no public viewership data, so not discussed” territory. After moving to Apple TV from its former home of ESPN, basically no one talks about it. Apple did publish an initial, unsourced, unsubstantiated, (dare I say unserious) datecdote claiming more folks are watching Formula 1 on Apple than ESPN, but we haven’t gotten any updates since. This stands in contrast to when the sport streamed on ESPN, and ESPN PR provided weekly viewership figures. Formula 1 was, at best, a niche sport in America—averaging 1.3 million viewers in the Big Data Plus era—but now it’s basically anonymous. (And yeah, after moving to Apple, I very, very, very much doubt its ratings increased.) Unfortunately, that story isn’t quite big enough to warrant a section in today’s “Most Important Story of the Week” column, but I wanted to call it out, because otherwise, no one else will! Certainly, no one will write articles about the silence/ratings decline, unlike when they wrote breathless articles connecting the rise in viewership to Netflix’s Drive to Survive, including Reuters just last month. (This is a topic I’ve tried to provide a moderate/nuanced/non-hyped take since 2022.) Anyway, on to this week’s issue. I was a bit worried I didn’t have a juicy topic, then the Murdochs went out and did their Murdoch thing: buying Roku. So that’s the story of the week, and it happens to touch on quite a few themes of the streaming wars and the disruption therein. I’ll cover that, plus why more consolidation in Hollywood media looks likely, more good news on the Hollywood labor front, whether we’ll see an uptick in production in Los Angeles, some Broadway and theme park news, cellphone prices going up in the third world (and possibly everywhere), and more. Subscribe Most Important Story of the Week - Another Big Media & Entertainment Merger The story of the week is clearly Fox is buying Roku for $22 billion. I read a lot of good strategy takes on why Fox bought this streaming TV device maker—and I’ll have mine below—but what fascinates me more is how this deal connects to quite a few themes of the streaming wars, linking to everything from the pace of M&A to “aggregeddon” to Netflix’s recent M&A actions/inactions to the shift to advertising from pure play streaming and more. The only topic I can’t really connect it to is my old theory, “never bet against Rupert Murdoch” because he isn’t the one who did this deal; his son Lachlan inked it. (Do I think he provided advice, even at his 95 years of age? Sure.) That plus I have one additional piece of strategy for all entertainment players, inspired by this deal. So let’s dive into all those topics, starting with why I like this deal. Roku is a Great M&A Buy
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