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As Wearables Improve, They Can Boost Patient Engagement and Lower Risks

By Daniel Kent Cassavar, MD, MBA, FACC, Medical Director, The Doctors Company and TDC Group

Roughly one-third of Americans own a smartwatch, and the market for smart rings and other biometric-tracking gadgets is growing, though some metrics are more reliable than others. It’s not surprising that many of our patients seek to improve their health by sharing data from their devices with their practitioners.

Technology skeptics are asking: Remember when EHRs were going to lighten our burdens, not add to them? Remember when patients first got smartwatches, and our inboxes flooded with unusable, clinically irrelevant, low-quality data? Some got fed up and swore off looking at patients’ wearables, but it’s time to take a breath and try again.

As the data quality of consumer wearables improves, we can combine new capabilities with patient education to boost engagement and lower risks for patients and practitioners.

It’s Not About Tech Perfection—It’s About Patient Engagement

Often, data from wearables is less than optimal: A smartwatch can easily mistake a downhill run for tachycardia or commit other errors, because optical sensors worn at the wrist can be tricked by motion. Moreover, optical sensors’ accuracy degrades for patients with darker skin tones—obviously, that’s a problem we must pressure developers to fix.

Still, wearables present us with opportunities. If we educate our patients

about which metrics are relevant to their health concerns, and if we give instructions for how to tell us about those metrics, then we can reap immediate rewards in patient safety while kicking off longer-term positive feedback loops through patient engagement.

Here are some considerations when incorporating wearables into clinical practice:

It’s not an EKG—but it is a rhythm strip. As a cardiologist, it’s not ideal for me if a patient comes in and says, “My watch told me I had AFib last week,” and I say, “Well, let me see the strips,” and they don’t have them. Fortunately, I can teach the patient how to store this data on their iPhone, and then I can actually look at the tracings, which can be very high quality.

A wearable, even one with imperfect data, still gives me a general sense of a patient’s heart rate variability, which is a measure of how well they adapt to scenarios such as workout, stress, activity, or sleep. People with poorer prognoses don’t move much off of their baselines. Someone with significant heart rate variability is healthier. And rhythm strips can let us know if the patient’s heart rate is fast or slow and regular or irregular, which moves us

toward diagnosing life-threatening conditions like atrial fibrillation (AFib) or making recommendations for improving overall health. A wearable doesn’t have to provide a full-on EKG for me to start getting a sense of a patient’s baseline, or for me to start using their wearable’s data to explain some of these concepts to them.

It’s not a sleep study—but it’s a start. Smart rings help evaluate sleep patterns, though they vary in their degree of accuracy. For instance, some commercially available rings have trouble distinguishing waking up from being an active sleeper. That said, they’re still a place to start when we suspect a patient has sleep apnea. One reason we don’t test enough for sleep apnea in this country—although we know that sleep apnea raises patients’ risks for high blood pressure, AFib, and all sorts of other medical issues—is that it’s difficult to get approval from insurance companies. Depending on the details of your patient and your institution, a smartwatch or smart ring reporting hypoxia or bradycardia can be a place to start.

Speaking of wearables and testing,

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Legal Matters

Top 5 Reimbursement Highlights For Behavioral Health Care Providers In 2026

By Bragg E. Hemme, J.D.

Cody Pike, M.D., J.D. Polsinelli, PC

Behavioral-health reimbursement continues to evolve rapidly as the federal and state governments prioritize mental-health access, parity and integration across care settings, while balancing the increasing costs and tightening budgets for behavioral health care. The 2026 Medicare regulatory cycle, including the 2026 Medicare Physician Fee Schedule (PFS) and Outpatient Prospective Payment System (OPPS) rules, reflects continued expansion of behavioral-health coverage,

refined payment methodologies and heightened operational and compliance expectations for providers beginning Jan. 1, 2026. Unfortunately, however, the outlook for Medicaid payments of behavioral health care is not so good.

Five Updates Providers Should Know

1. Continued Movement Toward Integrated Care

CMS finalized new add-on codes for Advanced Primary Care Management (APCM) services for providers furnishing Behavioral Health Integration (BHI) or psychiatric Collaborative Care Model (CoCM) services. The codes are meant to pay rates directly comparable to existing CoCM and BHI codes, but unlike the existing codes, the new APCM add-on codes do not require time capture. CMS hopes the ability to be reimbursed for these additional services will increase adoption of CoCM as part of APCM services.

2. Updates to IOP and PHP Payment

Medicare will continue to cover Intensive Outpatient (IOP) services furnished for at least nine hours per week, and Partial Hospitalization Program (PHP) services furnished for at least 20 hours per week, when furnished by a hospital outpatient department, Community Mental Health Center (CMHC), Rural Health Clinic (RHC), Federally Qualified Health Center (FQHC) or Opioid Treatment Program (OTP). As before, Medicare payment will depend on whether the IOP/PHP services are based on three service days or four-plus service days.

The most significant update related to the calculation of the CMHC IOP and PHP rates. For 2026, CMS will not use CMHC costs data to set pricing but rather will apply a 40% relativity

adjustment to the hospital PHP/IOP geometric mean cost. This change will resolve a cost inversion in CMHC cost data that resulted in higher geometric mean costs for three service days than for four service days. CMS intends these revisions to provide more predictable rates while maintaining a methodology that reflects a broader set of cost data.

3. Short-Term Updates to Telehealth Services for Behavioral Health

Behavioral health providers received welcome, albeit short-term, relief from the expiration of several telehealth flexibilities that have been in place since the COVID-19 pandemic. As part of the legislation reopening see Legal Matters...page 14

Neuroscientists Develop Human Brain-Like Technology That Can Accelerate Understanding of Alzheimer’s, Other Neurodegenerative Diseases

Biological ‘Asteroids Belts’ Enable Researchers to Efficiently Replicate Long-Distance Human Brain Communication in the Lab

By Nathaniel Godwin

Houston Methodist neuroscientists have developed a first-of-its-kind method to rapidly produce synchronized, human brain wave-like activity in lab-grown neural networks that can communicate over long distances. This innovation offers researchers a powerful tool to study how brain connectivity is affected in neurodegenerative diseases such as Alzheimer’s and Parkinson’s and to explore potential treatments.

The study was led by Dr.

Robert Krencik, associate professor in the Center for Neuroregeneration and Department of Neurosurgery at the Houston Methodist Research Institute, and was recently published in Advanced Healthcare Materials.

“A major advantage of our approach is that we can mix and match these biological neural networks into more complex structures, similar to using Lego building blocks, enabling us to study interactions between healthy and diseased tissue.” Krencik said. “To test the new tool’s potential, we treated

Advancing the practice of good medicine.

the biological ‘Asteroid Belts’ with toxic molecules like oxidative stressors and amyloid beta protein, which are linked to Parkinson’s and Alzheimer’s, respectively.”

When Krencik’s team did this, the damaged networks stopped functioning properly and blocked signals from spreading between healthy networks. However, if one Asteroid within the Asteroid Belt was treated with mild amounts of toxin, the healthy networks were able to

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propagate through the mildly diseased network.

The team combined neural cells in an organ-like cluster, known as organoids, together with star-shaped cells called astrocytes, in a final product named Asteroids. These optimized Asteroids rapidly produced synchronized neural networks in only a few weeks—far faster than previous

see Alzheimer’s . ...page 13

Oncology Research After You Receive a Cancer Diagnosis

By Emily Pearcy, LCSW-S, OSW-C®| Director, Social Work, Texas Oncology

recommendation or refer you to a specific oncologist, and it’s important to find the right fit for you. Review physician information online before you schedule, and consider:

• How experienced is this doctor in treating your specific cancer type?

provided with important patient paperwork to be completed online. Your first appointment will include questions about your medical history, family history, and current health conditions. We suggest you bring a list of all your medications, including how often you take them and the dosage.

Receiving a cancer diagnosis — or learning that a loved one has cancer — often feels overwhelming. Countless decisions about treatment options, financial planning, and lifestyle changes may arise, sometimes for the first time in your life. Your care team is here to help and connect you with resources for cancer care and the challenges that come with navigating your condition.

First Step: Finding a Doctor

If your cancer was diagnosed by a doctor who is not a cancer specialist, your first step is to schedule an appointment with an oncologist. Your current provider may have a

• Is this doctor accepting new patients? How quickly can you get an appointment?

• How far is the office from where you live? Certain treatments like radiation and chemotherapy require frequent office visits.

When you call to schedule your first visit, you will want to ensure your insurance is accepted. Because cancer care is complex, you will be working closely with your oncologist and their team to make decisions about your care plan. Feeling comfortable with your oncologist is key to creating a treatment plan that reflects your needs, values, and goals.

First Visit: How to Prepare Before your visit, you will be

The first visit may include an explanation about your test results and diagnosis, as well as details about the type of cancer you have. Your oncologist may recommend that will guide treatment plan options.

During this discussion, you will receive a lot of information in a short amount of time. It’s good to write questions down ahead of time and bring a loved one or friend to be a second set of ears. As cancer care providers, we want all patients to make informed decisions and be active participants in choosing the treatment that is right for you and your family. Take time to consider your options and ask your care team to clarify anything you don’t understand.

Possible questions may include:

• Is the goal of treatment to cure the cancer or to control the cancer and prolong life?

• What are the treatment options? How effective are they?

• Am I eligible for a clinical trial?

• What are possible side effects and risks of treatment? How are these managed?

• How do I get in touch with my care team in case of concerns?

• How long will treatment last?

• How will this affect my day-to-day life and my ability to do what is important to me?

• Are there other specialists I will

• Should I do genetic testing to help inform my family if they are at increased risk?

Mental Health Avoiding Caregiver Burnout

By American Geriatrics Society

Asmany as 43.5 million Americans care for older parents, grandparents, spouses and other older adults.

Some older adults need only a little assistance, such as help with shoveling snow or rides to and from the grocery store. Others need a lot of help with daily activities like eating, bathing, dressing, taking medications, and managing money. Over time, some older adults with increasing medical problems often need significant help from caregivers in performing activities of basic living.

While caring for an older family member can be one of the most rewarding experiences of a lifetime, it can also become stressful at times. This is especially true if the older adult has dementia or needs around-the-clock care. Most caregivers are spouses/ partners or adult children. They may have health problems of their own, have children to care for, work outside the

home, or all of these. The additional duties of providing care for an older person can lead to excessive physical or emotional fatigue, called “caregiver burnout.”

It is important to get help before caregiving becomes overwhelming

If you’re caring for an older adult, the American Geriatrics Society’s Health in Aging Foundation suggests the following: Get information

It’s likely that an older person you care for has multiple health problems. They may take quite a few medications and see several different healthcare providers to manage these conditions. This can make managing their care more complicated for you as a caregiver.

It’s helpful to accompany the older adult to their medical appointments to learn about their health problems and how these are likely to change over time. As a first step in learning more, HealthinAging.org has a wealth of information on health conditions

and needs unique to older adults that can help you be a better informed and prepared caregiver.

Help the older adult help themselves

You can make it possible for an older person to keep doing certain things independently by doing things as simple as putting a no-slip seat in the shower or bathtub; installing “grab bars” in the bathroom and near the bed; moving frequently used items to lower shelves; or getting easy-grip can openers and other utensils.

Ask trustworthy family, friends, and neighbors for assistance

Ask family and friends for help, and accept help if it is offered. Explain what needs to be done, but try not to criticize if others don’t care for the older person in exactly the same way you would. The important thing is that their needs are getting met.

Take care of yourself, too

Take time to eat well, exercise, and relax and enjoy yourself - these are key to avoiding burnout. Look into “respite” programs to allow yourself a short break. Also know the warning signs of depression and get help if needed.

Don’t take it personally

If an older person has dementia or other mental or emotional problems, they may get angry or say hurtful things. Remind yourself that this is because of the illness. Try not to take it to heart.

Talk about it

Talking about your experiences and feelings can make caregiving less stressful. Consider joining a caregiver support group in your area.

Contact professionals & organizations that assist caregivers

A wide range of programs, agencies, organizations, and individuals in your community can help you manage the challenges of caring for an older person. This assistance may be see Mental Health . ...page 13

Healthy Heart Wear Red for Women’s Health

This National Wear Red Day

By Dion Bart, American Heart Association

The American Heart Association’s Go Red for Women Movement Urges Houston to Join The Fight Against the No. 1 Killer of Women

Cardiovascular disease (CVD) is the leading cause of death for women in the United States. On Friday, February 6, National Wear Red Day®, the community and landmarks across the nation will “go red” to raise awareness of women’s No. 1 killer.

The American Heart Association, dedicated to building longer, healthier lives for all, is amplifying awareness that heart disease and stroke can affect women at any

monitor, educational materials to help women understand their readings, and supportive tools such as a water bottle and pedometer. Participants also receive Infant CPR kits and nutrition education, along with produce boxes to help families practice heart healthy recipes. In its first year, more than 200 MomRX kits have been distributed, with participating sites reporting strong positive outcomes.

The American Heart Association’s Go Red for Women movement, nationally sponsored by CVS Health, is asking women to make bold moves today for a healthier tomorrow:

• Know your numbers: Maintaining good blood pressure, blood glucose, total cholesterol and body mass

age. Nearly 45% of women over the age of 20 are living with some form of CVD. , underscoring the urgent need for education, prevention, and action.

CVS Health is committed to ensuring that clinics and community collaborators work together to meet local health needs. As part of these efforts in Houston, the American Heart Association launched the MomRX program to help support pregnant and postpartum women. The initiative educates women about the dangers of high blood pressure during, after, and between pregnancies.

Participating Women are identified by partnering organizations—including Spring Branch Community Health Center, El Centro de Corazón, the UH Family Care Center, and Harris County Public Health—to receive a MomRX kit. Each kit contains a blood pressure

index can lower your risk for heart disease and stroke.

• Join Research Goes Red to help ensure more women are represented and counted when it comes to scientific discovery: Women continue to be underrepresented in cardiovascular research

• Learn Hands-Only CPR and be equipped with the knowledge to save a life: women are less likely to receive bystander CPR

On National Wear Red Day, the Heart Association encourages everyone to join the Go Red for Women® movement by wearing red, starting conversations about heart health, and sharing lifesaving information online using #WearRedDay, and

and

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Join a growing medical school where your work helps train future doctors and strengthen healthcare delivery across Texas.

SELECT OPPORTUNITIES INCLUDE:

• Residency Program Director roles across multiple specialties

• Faculty appointments in clinical medicine and emerging areas such as medical AI

• Additional academic, research, and administrative positions

Mcgovern Medical School Featured As Standout Lifestyle Medicine Institution

By Roman Petrowski

McGovern Medical School was featured by the Association of American Medical Colleges as a standout lifestyle medicine institution in its Elevating Nutrition in Medical Education series, highlighting efforts to equip medical trainees with tools to prevent disease through healthful behaviors.

The Elevating Nutrition in Medical Education initiative aims to partner with nutrition and

By AAMC

College of Lifestyle Medicine’s six pillars: a whole-food, plant-based eating pattern; physical activity; restorative sleep; stress management; avoidance of risky substances; and positive social connections.

Through the ICARE program, McGovern students collaborate with dietetic interns and nursing students to work with clients from the Houston area and the Texas border region, including participation in a culinary medicine week. Held at the Nourish Research and

dietetic practitioners, public health professionals, and lifestyle medicine experts to co-develop and deliver interprofessional education. Rather than creating standalone modules, the project focuses on integrating and strengthening nutrition content within existing, high-impact curricula.

One leader in lifestyle medicine education at McGovern Medical School is Puja Gandhi, MD, MPH, assistant professor in the Department of Internal Medicine and director of the Improving Care Access and Realizing Empowerment (ICARE) program. After graduating from McGovern Medical School in 2018 and working in private practice, Gandhi recognized a gap in her training related to counseling patients on lifestyle medicine.

Upon returning to McGovern Medical School as a faculty member, Gandhi drew on her clinical experience to help lead the school’s lifestyle medicine concentration, which is grounded in the American

Demonstration Kitchen at UTHealth Houston School of Public Health, the experience emphasizes culturally responsive discussions about lifestyle habits and includes hands-on cooking demonstrations focused on basic knife and cooking skills. Students also have opportunities to shadow lifestyle-related professionals and participate in journal clubs and wellness sessions such as meditation, yoga, and culinary medicine classes.

The Nourish Research and Demonstration Kitchen serves as the home for UTHealth Houston’s culinary medicine curriculum across medicine, dentistry, nursing, and public health and supports partnerships and training with Texas Medical Center institutions and community organizations. It is also used for education and research, allowing faculty to teach medical nutrition therapy, disease-specific diets, and healthy cooking techniques.

The Keys To Healthy Aging Start At Any Age

By Emma Lawson

America is rapidly aging as the second largest generation, Baby Boomers, will be at least 65 by 2029. Texas A&M University researchers are developing new ways to help older people tackle challenges that come with aging.

More than 10,000 Americans each day are celebrating their birthdays with 65 candles on the cake. Although that may be a cause for alarm for some, it’s never too late to develop healthy aging habits and change mindsets on aging, a Texas A&M University expert says.

Baby Boomers, the second largest generation, are creating a shift in the age composition of the U.S. population. According to the Population Reference Bureau, people ages 65 and older will make up nearly 20% of the U.S. population by 2029. This is a striking difference from the 1900s when the average life

expectancy at birth was less than 50 years old.

Growing older is a universal factor that everyone navigates, although many older people battle with ageism, or discrimination against older people due to inaccurate stereotypes. Dr. Marcia Ory, Regents and Distinguished professor in the Center for Community Health and Aging at the Texas A&M School of Public Health, said these negative stereotypes can impact their health and quality of care.

“The worst part is when older people themselves internalize that stigma and believe aging means being sick and frail. When you internalize those stereotypes, research has shown it can become a health hazard,” she said. “We need to stop thinking of aging as a problem, but as a challenge to be solved, and that’s what public health research can do.”

As demographics change in the U.S. and the older population

grows, Ory said research is critical to understanding risk factors for healthy longevity and developing strategies that can promote healthy aging across the life-course.

“ We need integrated health care that brings the social, mental and physical health care together,” she said. “For example, it’s important for older people to be treated as a whole and not for each body part. We need to treat people instead of organs.”

There are many factors that impact healthy aging, such as staying physically active, eating well and staying socially engaged. Ory said her research can pinpoint what determines healthy aging, but there are often challenges in implementing best practices.

“The most difficult thing is to get communities to do what we know will lead to more healthy aging,” she said. “We know being physically active is one of the best things you can do, but it’s not as easy as just telling people to be more physically active. Older people may need some motivation, like a friend or family member to walk with them to be active. They need to have a place where they can walk safely.”

A key part of creating an aging-friendly community is to help individuals “age-in-place.” This involves creating an environment that can accommodate the new challenges that come with aging, Ory said.

“Most people want to stay in their homes. They don’t want to go to nursing homes or assisted living,” she said. “If you’re not as steady on your feet when you get older, you can have grab bars in the bathroom or have ramps or rails going up and down stairs. For every problem, there is a solution.”

Alongside pre-existing technology, Ory and colleagues are identifying and testing new technologies to assist people to prevent or control age-related conditions such

Just 20 Minutes of Activity Twice Weekly May Help Halt Dementia

Researchers Uncover How Much Exercise Helps Keep Mild Mental Decline from Becoming Dementia

By Ann Kellett, PhD

Howmuch physical activity—and how often—is needed to help stall dementia? For older adults with mild cognitive decline, there is now an answer: at least 20 minutes, at least twice weekly.

That’s according to a new study led by researchers with the Center for Community Health and Aging in the Texas A&M University School of Public Health.

“The benefits of exercise for this group have long been known, but by using a longitudinal study design and analyzing various levels of activity, we could determine the amount and duration needed to help prevent further decline,” said Jungjoo “Jay” Lee, PhD, who led the study, which was published in the Journal of Physical Activity and Health.

Oncology

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He added that mild cognitive impairment—a loss of memory or other need to see?

• Are there changes to exercise and nutrition that can support my treatment and recovery?

• Can your team help me navigate my insurance?

• What supportive services do you offer for comprehensive care?

• What is the role of advance care planning?

Cancer care is provided by a diverse team that may include medical assistants, nurses, advanced practice providers, medical oncologists, surgeons, radiation oncologists, pharmacists, social workers, dieticians, physical therapists, genetic counselors,

Keys to Age

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as dementia or diabetes. One new topic of research being looked into is sensors around a home that can detect when someone has fallen and provide emergency response.

thinking processes that is noticeable but does not affect everyday life—is thought to be one step on the path to Alzheimer’s disease and related dementias, but the relationship is not always straightforward.

While those with mild cognitive impairment are at greater risk of developing dementia compared to others, some with the condition stay stable or even improve over time, while others progress to dementia, he said.

“Our age and how well our brain was working to begin with are factors,” he said. “In addition, solving puzzles, spending time with others and staying physically active may help slow down or even stop the slide.”

For their study, the team analyzed longitudinal data about the relationship between physical activities and dementia for participants in the 2012 to 2020 Health and Retirement Study Core data, a national study of adults age 50 and older

and other specialists. Your oncologist will connect you with the right providers for your needs and can explain their roles in your care. You can also reach out to your nursing team with questions by phone or through the patient portal.

First Day: The Rest of Your Life

No matter what type of cancer you have, the day you receive your diagnosis is the day survivorship begins. Though the road ahead may be hard, you do not have to face uncertainties alone.

In recent decades, cancer treatment has advanced tremendously, making side effects such as nausea and pain more manageable. Today, treatments are often less invasive, with

in the United States that is produced every other year.

The researchers assessed mild cognitive impairment through three types of cognition: memory (participants’ recall of 10 words immediately after hearing them and again after five minutes), working memory (subtracting seven from 100 over five trials) and attention and processing speed (counting backward from 20 to 10 over two trials).

This resulted in 9,714 participants, of which 68.6% were male and 31.4% female. Their median age was 78, just over half were married and 42% were widowed or divorced. Eight percent had been diagnosed with Alzheimer’s disease or dementia during the study period.

To measure cognitive decline, they used participants’ medical diagnosis of either Alzheimer’s disease or dementia and any changes since 2012.

The team then analyzed how often participants engaged in 21 types of activities, such as playing sports or walking, and for how long.

“Older adults who maintained moderate levels of physical activity showed a significantly lower chance of developing dementia over time, while those who were less active saw little to no benefit,” said co-author and center colleague Junhyoung “Paul” Kim, PhD. “This highlights the

faster recovery times and improved quality of life. Emotional and social support is widely accessible, with support groups available for patients and caregivers.

Regardless of the path ahead, you will have a team behind you every step, providing answers, guidance, and the resources you need.

Alternate ending recommendation:

Regardless of the type of cancer you have, the day you receive your diagnosis is the day survivorship begins. While the road ahead may feel uncertain or challenging, you do not have to face it alone.

Cancer treatments have advanced tremendously in recent years, and are often less invasive, with

importance of regular movement—such as walking—as a simple and effective strategy to support brain health.”

In addition, the study found that the risk of developing dementia increased with age, while higher levels of education and cognitive function lowered the risk, and sex had no effect.

Despite the study’s limitations, Lee is optimistic that this new knowledge could help in the development of new therapies for this group.

“One out of every nine adults 45 and older in the United States say they experience confusion or memory loss that is getting worse, and that shows no signs of improving,” Lee said. “This study and future studies could help in the development of community-based, comprehensive activities for this growing population.”

faster recovery times, and support an improved quality of life. Many side effects—such as nausea and pain—are now better managed.

Emotional support is widely accessible. In addition to support groups for patients and caregivers, individualized mental health support may be available to help patients build resilience, strengthen coping strategies, and receive care tailored to your personal needs and goals.

No matter what lies ahead, you will be supported by a care team committed to guiding you every step of the way, with access to resources that support both your health and well being.

Healthy aging habits can be adopted at any age, but it’s largely up to the individual to make lifestyle changes, families to be supportive, and the community to remove barriers, Ory said.

“The public health mantra is, ‘let’s make the right thing the easy thing to do and let’s not throw up barriers,’” she said. “In my research, I’ve seen how behavioral programs, social engagement programs, and improving environments and technology can provide the support needed, particularly when there’s not enough healthcare professionals.”

“Aging doesn’t start when you hit 65, 85 or 100. It starts from the moment you’re born to the moment you die,” she said. “Let’s think about the risk factors and what we can do across one’s whole life to mitigate these factors, not just what we can do when we turn 80 or 100.”

Financial Forecast

Tax Planning Strategies for High-Income Earners in 2026 With Remaining 2025 Prior-Year Contribution

FBy Grace S. Yung, CFP Midtown Financial Group, LLC

or high-income earners, taxes are often one of the largest annual expenses - and one of the most important areas for proactive planning. As income rises, marginal tax rates increase, deductions phase out, and additional surtaxes may apply. While taxes cannot be eliminated, thoughtful planning can help reduce taxable income and improve overall tax efficiency.

As we look ahead to 2026, it’s important to understand the most up-to-date IRS rules and

Opportunities

allow the higher “super” catch-up.

• Important change for high earners (SECURE 2.0): Beginning in 2026, certain high-income employees (e.g., those earning more than approximately $150,000 in FICA wages in the prior year) must make catch-up contributions on a Roth (after-tax) basis, rather than pre-tax.

These increases mean a high-income saver can put more away in tax-advantaged accounts in 2026, helping reduce taxable income and grow retirement savings.

IRA Planning and Prior-Year Contributions

2026 IRA Contribution Limits:

• Traditional and Roth IRAs: Up to $7,500 for 2026.

• Catch-up contribution (age 50+): Additional $1,100.

opportunities. Certain prior-year contribution windows for 2025 remain open (e.g., IRAs and Health Savings Accounts), but many employer-plan deferral opportunities are now locked to 2026 limits only.

Below are key strategies high-income earners often consider when planning for 2026 while still taking advantage of 2025 deadlines where applicable.

Maximize 2026 Retirement Plan Contribution Limits (Employer Plans)

For 2026, the IRS has increased key retirement plan limits to help savers keep pace with inflation:

• 401(k), 403(b), and most 457(b) plans: base elective deferral limit of $24,500. Catch-up contribution limits for participants age 50 and over rise to $8,000, or up to $11,250 for those ages 60 - 63 in plans that

These IRA contributions generally must be made by the tax-filing deadline in 2027 to count for tax year 2026. However, 2025 IRA contributions can still be made until the tax-filing deadline in 2026, offering an opportunity to reduce your 2025 taxable income if you have not yet maxed out those limits.

Keep in mind that income limits affect the deductibility of traditional IRA contributions and eligibility for Roth IRA contributions; higher earners often use strategies such as a backdoor Roth IRA when direct contributions are phased out.

Use Health Savings Accounts (HSAs) Strategically

For those enrolled in a qualifying high-deductible health

Alzheimer’s

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methods. Additionally, by merging several of these networks together in a structure named Asteroid Belts, the researchers observed long-distance propagation of this activity within 24 hours, mimicking how signals travel long distances in the human brain.

Mental Health

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free, or available at low cost. The following agencies and people can help you find the help you need Eldercare Locator

Visit www.eldercare.gov to search for community services by zip code, city or topic. Or call 800-677-1116 to speak with an Information Specialist.

You can find your local Area Agency on Aging through the Eldercare Locator. Among other things, an Area Agency on Aging caseworker can visit you and the older person and give you information about different sources for the help you need, how much this

Healthy Heart

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#GoRedforWomen.

“National Wear Red Day is about more than the start of American Heart Month – it’s a national call to protect the health of women we love,”

Financial

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plan (HDHP), HSAs offer a powerful triple tax advantage: tax-deductible contributions, tax-deferred growth, and tax-free withdrawals for qualified medical expenses.

2026 HSA Limits:

• Self-only coverage: $4,400

• Family coverage: $8,750

• Catch-up (age 55+): $1,000 (unchanged)

Like IRA contributions, HSA contributions for 2025 can still be made through the 2026 tax-filing deadline, provided all eligibility requirements were met in 2025. This allows taxpayers to reduce their 2025 taxable income

Krencik said this offers a new way to study factors that influence brain wave-like activity and could guide strategies for integrating healthy cells into diseased networks for therapy.

“The single most surprising finding in the study was the restoration of synchronous network activity through an otherwise dysregulated diseased network. This gave us hope regarding the use of healthy networks

to repair function through neighboring unhealthy tissue,” Krencik said. “This is a next-generation tool for neuroscientists to test how disease and potential therapeutics can affect brain network activity at the functional level.”

According to the Alzheimer’s Association, Texas had nearly 460,000 adults over 65 living with Alzheimer’s disease in 2024.Neurodegenerative

disorders, such as Alzheimer’s disease and Parkinson’s disease, involve miscommunication between distant brain regions, leading to cognitive decline and motor impairment. The tools developed by Krencik and his team now allow scientists to study how this breakdown occurs and to test strategies that protect or restore connectivity.

help might cost, and how you can get financial help.

Other Community Resources

Your local United Way and faith-based organizations can also help you find assistance.

Look into a Program of All Inclusive Care for the Elderly (PACE) program in your area, which can provide adult day care and medical care all under one roof.

Social workers

Social workers at hospitals, clinics, and home health agencies, as well as specially trained geriatric care managers, can help, too. The Aging Life Care Association can provide more information on geriatrics care managers. (Note: Insurance usually doesn’t cover

said Jeanna Bamburg, Houston Go Red for Women volunteer chair and chief executive officer, The Woman’s Hospital of Texas. “Across Houston and the country, individuals are coming together to take action, raise awareness, and build healthier communities for women and their families. Find resources to support

while planning for 2026 contributions separately.

Equity Compensation Planning

Equity compensation - such as restricted stock units (RSUs), incentive stock options (ISOs), non-qualifying stock options (NSOs), and employee stock purchase plans (ESPPs) - can significantly increase taxable income if not managed carefully.

For high earners, coordinating the timing of vesting, exercising, and sales with retirement plan contributions, charitable giving, and estimated tax payments can help smooth taxable income and mitigate bracket creep.

Though the contribution rules themselves change annually, the discipline of timing and coordination

the cost of geriatric care manager assistance.)

Among other things, these groups and individuals can help you find the following kinds of help:

• Financial: Assistance and advice on paying for the services the older adult needs, including assistance completing paperwork.

• Transportation: To take the older adult shopping or to and from medical appointments.

• Meals: Including help preparing meals or having meals delivered.

• Home medical services: Including visits from house call physicians, registered nurses, private duty nurses, nurses aides, and/or a hospice team, to manage medical

women’s heart health at every age and stage of life at GoRedforWomen.org and learn more about National Wear Red Day at WearRedDay.org. Go Red for Women is locally sponsored by The Woman’s Hospital of Texas. For more information about the Houston Go Red for Women movement, contact Go Red for Women associate vice president,

across income sources remains critical regardless of which tax year you are planning. (No specific IRS 2026 equity tax rules were found beyond general contribution guidance.)

Charitable Giving and Investment

Tax Efficiency

Charitable contributions to qualified public charities can offer valuable deductions, particularly when using techniques like donor-advised funds or gifting appreciated securities. These strategies may allow you to maximize the value of your giving while reducing taxable income.

Tax-aware investment strategies - such as proper asset location and tax-loss harvesting when appropriatecan help improve after-tax returns over time. These strategies are especially

problems in the comfort of home.

• Respite care services: Which send trained helpers to the older adult’s home so you can take a break.

• Reliable “home helpers”: Who can visit the older person for an hour or two at a time to help with bathing, light housekeeping, cooking, and errands.

• Adult day care: Centers where older adults can go for several hours during the day for care supervised by healthcare staff. This care usually includes social programs, recreation, and meals. Special adult day care programs are available for people with dementia, depression, and social problems.

Sara Ritenour, Sara.Ritneour@heart. org or visit 2025-2026 Houston Go Red Luncheon.

beneficial when annual contribution limits and income phase-out thresholds tighten for high-income taxpayers.

Work With a Certified Financial Planner Professional

For high-income earners, effective tax planning requires a coordinated, multi-year approach that aligns contributions, timing, cash flow, and long-term goals under current IRS rules. A Certified Financial Planner professional can help evaluate which strategies are appropriate for your situation, integrate 2025 carry-forward opportunities, and position you for a tax-efficient 2026 and beyond.

Wearables

Continued from page 1

for patients who require further sleep investigation, many sleep labs now get more accurate results by sending clinical-grade devices home with patients, rather than having patients come in for a sleep study.

But commercial wearables are helpful, even when dealing with patients who simply benefit from social accountability in maintaining healthy sleep habits.

Patient engagement doesn’t eliminate risks—but it reduces them. Engagement is tied to both patient adherence to care plans and to practitioners’ professional satisfaction. We can recruit patients’ involvement in their own care and take advantage of any actionable data.

Some physicians caution against leaning in to wearables, worried that patients may counterproductively fixate on one metric at the expense of their overall health. Others worry that patients will become low-grade hypochondriacs, driven to seek care over routine ebbs and flows in biorhythms. True, some patients do need a reminder to not obsess (and to not call my office every day). But for most patients, the more data they’re armed with that’s actionable, the better for both of us. Higher patient engagement contributes

Legal Matters

Continued from page 3

the government after the lengthy shut down, Congress extended the waiver of in-person visit requirements for mental health providers until Jan. 30, 2026. Without Congressional action, providers will need to ensure that they see telehealth patients in-person within six months of an initial telehealth visit and annually thereafter beginning Jan. 30, 2026. As with the prior temporary loss of the telehealth flexibilities, Medicare may choose to pend claims for a short time in hopes that Congress will make the flexibilities permanent.

4.Expanded Access to Digital Mental Health Treatment (DMHT)

In 2025, CMS adopted payment provisions for DMHT devices approved by the FDA under 21 C.F.R. § 882.5801

to higher patient adherence, which can mitigate patient risks. In a recent study of patients with type 2 diabetes, patients using wearable devices showed stronger adherence to the exercise plan.

It’s not the Olympics—we don’t need perfect data for some things. Patients mean different things when they say, “Yes, doctor, I’m exercising three times per week.” A smartwatch can help quantify things enough to get us on the same page for goal-setting purposes.

It’s not the data Wild West— patients can send data through your EHR portal. In the early days of wearables, clinicians worried about the deluge of patient data, about security, and about HIPAA compliance. These days, we can lean in to interoperability improvements—some wearables can transmit data directly into the EHR— or we can educate patients (or ask staff members to educate patients) regarding how to send data through our EHR’s patient portal.

It’s not a data firehose—it’s a drip system that you design with your patient. I don’t see data saturation as a problem anymore, provided that we have office processes in place to sift, sort, and prioritize messages, as well as the ability to discuss expectations with patients. When a patient sends me eight rhythm strips a day, it’s time for a conversation. Plus, members of my team

can manage these information flows so they don’t clutter my inbox.

It’s not solo practice—it’s top-of-license practice on a team. I’m not dealing personally with all my patients’ wearables data, and neither is my nurse, my nurse practitioner, or my physician assistant. Questions about how our practice should handle patients’ wearables data are answered in part through clear role definitions, a culture of safety, and a team-based model of care.

Wearables Aren’t Going Away, So Let’s Use Them Wisely

Researchers and developers are finding novel ways to apply metrics from commercial wearables, such as a recent study in the detection and prediction of inflammatory bowel disease flare-ups. In mental health, researchers are investigating how the motivational aspects of incorporating wearables into care could engage patients with depression.

Clinicians can capitalize on patients’ interest in wearables and biometrics to elevate patients’ engagement. Wearables can, at a minimum, remind patients of the conversations they’ve had with us: As one physician observed, “What wearables do is encourage good habits”— with a reminder of the good advice that we’ve been giving all along.

(Computerized behavioral therapy device for psychiatric disorders). To seek payment, the billing practitioner must diagnose the patient with a mental health condition, order the use of DMHT, incur the cost of the device and furnish it incident to ongoing behavioral health treatment. Further, the DMHT device must be used in accordance with the FDA-classified indications.

In 2026, CMS expanded coverage to devices approved by the FDA under 21 C.F.R. § 882.5803 (Digital therapy device for ADHD). All the previous guidance and the relevant codes remain the same. CMS declined to extend coverage to non-FDA approved digital tools.

Medicare will continue to pay for the initial supply of the device and patient education under HCPCS G0552. Although commenters raised concerns regarding inconsistent pricing across MAC jurisdictions,

CMS responded that national pricing was not yet feasible due to the limited claims data and the rapidly evolving technology. As such, devices will continue to be contractor priced in 2026.

5. Medicaid Budget Issue may Thwart Goals of Expanded Behavioral Health

We anticipate that 2026 will see state governments and Medicaid agencies grappling with their stated plans to expand access and reimbursement for behavioral health care and the budget realities prompted by the July 4, 2025 adoption of H.R. 1 (a/k/a the One Big Beautiful Bill Act). H.R. 1 is expected to significantly limit states’ options for financing Medicaid. We anticipate that states will continue to move toward broader adoption of integrated care and value-based care as they plan for the cuts. 

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