Multi-agent LLM systems routinely generate multiple candidate responses that are aggregated by an LLM judge. To reduce the dominant prefill cost in such pipelines, recent work advocates KV cache reuse across partially shared contexts and reports substantial speedups for generation agents. In this work, we show that these efficiency gains do not transfer uniformly to judge-centric inference. Across GSM8K, MMLU, and HumanEval, we find that reuse strategies that are effective for execution agents can severely perturb judge behavior: end-task accuracy may appear stable, yet the judge’s selection becomes highly inconsistent with dense prefill. We quantify this risk using Judge Consistency Rate (JCR) and provide diagnostics showing that reuse systematically weakens cross-candidate attention, especially for later candidate blocks. Our ablation further demonstrates that explicit cross-candidate interaction is crucial for preserving dense-prefill decisions. Overall, our results identify a previously overlooked failure mode of KV cache reuse and highlight judge-centric inference as a distinct regime that demands dedicated, risk-aware system design.

Medical question answering fundamentally relies on accurate clinical knowledge. The dominant paradigm, Retrieval-Augmented Generation (RAG), acquires expertise conceptual knowledge from large-scale medical corpus to guide general-purpose large language models (LLMs) in generating trustworthy answers. However, existing retrieval approaches often overlook the patient-specific factual knowledge embedded in Electronic Health Records (EHRs), which limits the contextual relevance of retrieved conceptual knowledge and hinders its effectiveness in vital clinical decision-making. This paper introduces RGAR, a recurrence generation-augmented retrieval framework that synergistically retrieves both factual and conceptual knowledge from dual sources (i.e., EHRs and the corpus), allowing mutual refinement through iterative interaction. Across three factual-aware medical QA benchmarks, RGAR establishes new state-of-the-art performance among medical RAG systems. Notably, RGAR enables the Llama-3.1-8B-Instruct model to surpass the considerably larger GPT-3.5 augmented with traditional RAG. Our findings demonstrate the benefit of explicitly mining patient-specific factual knowledge during retrieval, consistently improving generation quality and clinical relevance.