Gist Healthcare Daily

Site-neutral payment is shifting from policy debate to operational reality. With drug administration services now included in the Medicare 2026 final rule and additional changes potentially ahead, health systems face growing uncertainty around reimbursement, site-of-care strategy and margin impact. In this two-part conversation, Gist Healthcare Podcast host J. Carlisle Larsen speaks with Joyjit Choudhury, Managing Director with Kaufman Hall in the firm's Strategy and Business Transformation practice, about his recent blog piece examining site-neutral payments and how hospitals and health systems can build a plan amid uncertainty. Hosted on Acast. See acast.com/privacy for more information.

President Trump highlights healthcare reforms in this year's State of the Union. Fifteen states sue HHS over changes to the federal childhood vaccine schedule. And Medicare Advantage margins outperform other lines of business in 2024. Listen to the latest episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

On this episode of The Gist Healthcare Podcast, we cover the FDA's fast track for rare disease treatments, the end of two major healthcare labor strikes and a measles outbreak in South Carolina nearing 1,000 cases. Hosted on Acast. See acast.com/privacy for more information.

Rural communities across the United States are facing a sustained decline in access to primary care. Since 2017, the number of family physicians practicing in rural areas has dropped by more than 10%, according to a report published late last year. In many regions, that reduction has implications for care capacity, hospital stability and long-term workforce planning. In the second part of the conversations, host J. Carlisle Larsen speaks with Colleen Fogarty, M.D. of the University of Rochester about the structural factors shaping the rural physician workforce and what it will take to strengthen it, examining rural residency programs, medical training pipelines, immigration pathways and loan repayment incentives as policy levers aimed at stabilizing rural access to care. You can listen to the first half of the conversation here. Hosted on Acast. See acast.com/privacy for more information.

The Food and Drug Administration will review Moderna's new flu vaccine after reversing course. Medicare Advantage growth in 2026 is trailing prior years. And Amazon is expanding same-day prescription delivery to nearly 5,000 cities nationwide. Those stories and more on today's episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

A federal judge vacates the FTC's expanded premerger notification rules. Humana makes a significant primary care acquisition. And new data show primary care telehealth use has stabilized after its pandemic peak.These stories and more on today's episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

Rural America has lost more than 10% of its family physicians since 2017, according to a report published late last year. What does that mean for patients and communities? On today's episode, host J. Carlisle Larsen speaks with Colleen Fogarty, M.D., the William Rocktaschel Professor and Chair of the Department of Family Medicine at the University of Rochester School of Medicine and Dentistry and lead author of the national study, about what the data reveals — and what happens when even one doctor leaves town. Next week, we listen to the second part of their conversation where they look at the forces driving this decline. Hosted on Acast. See acast.com/privacy for more information.

Healthcare accounted for more than half of all new jobs added in January. Nurses at four New York City hospitals have ratified new contracts. A new report also finds that investing in Poison Control can reduce costs for health systems. Those stories and more, coming up on today's episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

Physicians face higher rates of depression, anxiety, and suicide risk than the general population — yet fewer than one in three with a mental health condition ever receives care. In this episode, Dr. Jesse Ehrenfeld, professor of anesthesiology at the Medical College of Wisconsin and Global Chief Medical Officer for AIDOC, discusses what happens when physicians consider getting help. The conversation looks at how concerns about licensing, confidentiality, and other structural barriers can make seeking care feel risky, and why progress has been uneven. You can listen to the first half of the conversation here. Hosted on Acast. See acast.com/privacy for more information.

Today on The Gist Healthcare Podcast, negotiations to reinstate the Affordable Care Act's enhanced premium tax credits stall in the Senate. Express Scripts reaches a landmark settlement with the FTC in the agency's lawsuit against PBMs. Plus, a new report shows healthcare bankruptcies declined last year, even as financial pressure across the industry remains high. These stories and more, coming up. Hosted on Acast. See acast.com/privacy for more information.

Nearly 53 million prior authorization requests were submitted to Medicare Advantage plans in 2024. Enrollment on the Affordable Care Act marketplace slipped this year. Two major hospital deals also closed this week. Those stories and more on today's episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

Physicians face higher rates of depression, anxiety, and suicide risk than the general population, yet most never seek mental health care. In this episode, Dr. Jesse Ehrenfeld, professor of anesthesiology at the Medical College of Wisconsin and Global Chief Medical Officer for AIDOC, discusses new JAMA research examining why. The conversation looks at how medical culture, stigma, time constraints and concerns about confidentiality or professional consequences can keep physicians from getting help, even when effective treatment exists. Hosted on Acast. See acast.com/privacy for more information.

Healthcare costs top Americans' financial worries, Medicare drug price negotiations expand, and a measles outbreak grows in South Carolina. Those stories and more on today's episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

The Trump administration proposes a modest pay increase for Medicare Advantage plans. The American Academy of Pediatrics releases its updated childhood vaccine schedule. And a platform billed as “ChatGPT for doctors” becomes the most valuable healthcare AI startup. Those stories and more, on today's episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

Advanced practice providers are a growing part of the healthcare workforce, but many organizations aren't necessarily seeing the productivity gains they expected. On today's episode, we examine new Kaufman Hall insights on why traditional physician-APP models often underperform, and how redesigning team roles, incentives, and compensation could yield better outcomes for clinicians and patients alike. Bonnie Proulx, DNP, APRN, PNP-BC, FAAN, Senior Vice President with Kaufman Hall and a member of the firm's Physician Enterprise practice, joins the podcast to explain more. You can read Bonnie's blog post here. Hosted on Acast. See acast.com/privacy for more information.

Some of the nation's largest health insurers testify on Capitol Hill over healthcare affordability. Missouri becomes the latest state to sue pharmacy benefit managers and drug manufacturers over insulin pricing. The American Red Cross declares a severe blood shortage nationwide. These stories and more on today's episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

Congressional leaders unveil a new bipartisan healthcare bill as part of a larger spending package. Measles cases double in South Carolina. And another large healthcare worker strike could be on the horizon. Those stories and more on today's episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

Health spending topped $5 trillion in 2024. Medicaid coverage for GLP-1 weight loss drugs is ending in several states. And a major retailer is reentering healthcare after stepping away from care delivery. Those stories on today's episode of the Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

Today on The Gist Healthcare Podcast, we cover falling ACA exchange enrollment, a major nursing strike in New York City, and two AI companies push into healthcare. Hosted on Acast. See acast.com/privacy for more information.

Congress moves to extend Affordable Care Act subsidies. Utah launches a first-in-the-nation AI-powered prescription renewal pilot. And a major New Jersey health system plans a new hospital acquisition. Those stories on today's episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

Today on The Gist Healthcare Podcast, the CDC scales back vaccine recommendations for children, the Trump Administration distributes new funding for rural healthcare, and a pill version of a leading GLP-1 drug enters the market. Those stories and more. Hosted on Acast. See acast.com/privacy for more information.

Today on The Gist Healthcare Podcast, Congress advances a healthcare bill without extending ACA enhanced tax credits, Texas files an antitrust lawsuit against Epic Systems, and new research reveals which U.S. cities face the highest healthcare costs. Hosted on Acast. See acast.com/privacy for more information.

Former senior CDC officials are set to lead a major public health effort in California. A bipartisan group of lawmakers is urging the Trump Administration to classify advanced nursing degrees as professional. New research also shows COVID-19 vaccines significantly reduced pediatric emergency department visits. These stories and more are coming up on today's episode of the Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

From rapidly expiring Affordable Care Act enhanced tax credits a fast-evolving federal public health agenda, today's episode of the Gist Healthcare Podcast delves into some of the biggest healthcare policy news of 2025. Michael McAuliff, Modern Healthcare's policy and politics reporter, joins host J. Carlisle Larsen to break down the news and provide a lookahead to 2026. Hosted on Acast. See acast.com/privacy for more information.

On today's Gist Healthcare Podcast, the Senate fails to pass legislation meant to address expiring enhanced ACA tax credits, a new study finds that federal relief after the Change Healthcare cyberattack was distributed unevenly, and a record number of medical students now entering the pipeline. Hosted on Acast. See acast.com/privacy for more information.

In this episode of The Gist Healthcare Podcast, we cover Senate Republican plans for the potential expiration of enhanced Affordable Care Act tax credits, a CDC advisory committee proposal that would shift vaccine recommendations for newborns, and new survey findings that connect clinician turnover to negative EHR experiences. Hosted on Acast. See acast.com/privacy for more information.

Burnout continues to challenge physicians, and new data from The Permanente Medical Group shows ambient AI scribes may help ease the burden. On today's episode, Kristine Lee, MD, Associate Executive Director of Virtual Medicine, Technology, and Innovation at The Permanente Medical Group, returns to share what TPMG learned from its year-long evaluation of the technology, including major time savings, improved workflows, and better patient interactions. Hosted on Acast. See acast.com/privacy for more information.

Senate Democrats introduced legislation that would extend Affordable Care Act tax credits, a proposal that could affect coverage affordability. The Trump Administration issued a revised definition of which professions qualify for higher cap federal student loans. New research also links early adolescent smartphone use to increased risks of depression, obesity, and poor sleep. Hear the full update on The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

The Centers for Medicare and Medicaid Services is considering updates to how it calculates Medicare Advantage star ratings. The United States and the United Kingdom have agreed to a zero percent pharmaceutical tariff. The House passes legislation to extend the hospital-at-home waiver. Hear more on today's episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

On today's Gist Healthcare Podcast: Medicare Part B premiums rise 10 percent next year, the White House is in talks about extending ACA enhanced tax credits, and a federal judge signs off on Purdue Pharma's bankruptcy plan tied to the opioid crisis. Hosted on Acast. See acast.com/privacy for more information.

Following recent improvements in surgical outcomes, hospitals are now confronting new challenges tied to patient complexity, post-acute care access, and workforce capacity. In this episode, Chris DeRienzo, MD, Senior Vice President and Chief Physician Executive for the American Hospital Association, discusses findings from the latest Vizient and AHA analysis, including how delayed discharges and administrative demands affect care delivery. The conversation also looks at what hospitals are doing to sustain safety gains amid increasing acuity and staffing pressures. You can listen to the first half of the conversation here. Hosted on Acast. See acast.com/privacy for more information.

On today's Gist Healthcare Podcast: The government shutdown ends without an agreement to extend Affordable Care Act tax credits. Canada loses its measles elimination status, signaling renewed public health risks. And the Trump Administration seems likely to extend telehealth flexibilities that allow clinicians to prescribe controlled substances without an in-person visit. Hosted on Acast. See acast.com/privacy for more information.

On today's Gist Healthcare Podcast: The Senate passes a spending bill to end the government shutdown without extending Affordable Care Act subsidies. The FDA plans to remove black box warnings from hormone replacement therapies for menopause. And UnitedHealthcare pulls back coverage for remote patient monitoring. Hosted on Acast. See acast.com/privacy for more information.

A new analysis from Vizient and the American Hospital Association shows that outcomes for hospitalized surgical patients have improved in recent years. In this episode, Chris DeRienzo, Senior Vice President and Chief Physician Executive for the AHA, discusses the data behind those findings and what may be contributing to the changes. The conversation looks at how hospitals are managing increasingly complex patients while maintaining gains in safety and quality. Hosted on Acast. See acast.com/privacy for more information.

The Trump Administration reaches a deal to lower prices on weight loss drugs, the FDA fast-tracks biosimilars, and a new report shows UnitedHealthcare pays its Optum physicians more than others. Hear the latest on The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

On today's episode of The Gist Healthcare Podcast, CMS finalizes a Medicare pay bump for physicians. Kimberly-Clark to purchase Tylenol maker Kenvue, and Pfizer sues to block Novo Nordisk's merger with an obesity startup. Hosted on Acast. See acast.com/privacy for more information.

Millions of Americans relying on food assistance could lose benefits as the government shutdown continues. A new study explores how proposed H-1B visa changes may affect staffing in rural hospitals. Plus, a court ruling dismisses a case from nurse practitioners challenging the definition of “doctor.” All that and more on today's episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

Texas files suit against the maker of Tylenol, alleging hidden autism risks. Furloughed CMS employees are called back to manage Medicare and ACA enrollment. And Cigna takes a new approach to drug pricing by moving away from rebates. Hear these stories and more on The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

In this episode of the Gist Healthcare Podcast, the nation's second-largest measles outbreak continues to expand along the Arizona–Utah border. Family job-based health insurance premiums hit an average of $27,000 in 2025, while UnitedHealth Group launches an AI tool designed to accelerate medical claims processing. Hosted on Acast. See acast.com/privacy for more information.

Moderate House Republicans are urging Speaker Mike Johnson to take up the issue of expiring Affordable Care Act tax credits once the shutdown ends. A new poll shows declining trust in President Trump and Health Secretary Robert F. Kennedy Jr., while DocGo moves to acquire SteadyMD. Those stories and more on The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

In today's episode of The Gist Healthcare Podcast, we look at three headlines shaping healthcare this week: rising 2026 ACA exchange prices, California's plan to sell its own insulin, and Prospect Medical Holdings' move to sell more hospitals. Hosted on Acast. See acast.com/privacy for more information.

For decades, pregnant women have been excluded from most clinical drug trials. The policy was meant to protect mothers and babies, but it has left major gaps in medical knowledge. Now, renewed debate over the safety of common medicines like Tylenol has brought those gaps into sharp focus. In this episode, STAT News reporter Lizzy Lawrence joins host J. Carlisle Larsen to discuss how history, politics, and caution shaped the science of pregnancy, and what it will take to ensure women are fully included in research that affects their health. You can read her piece here. Hosted on Acast. See acast.com/privacy for more information.

In today's episode of The Gist Healthcare Podcast, we look at headlines making waves in the industry: Qualtrics' plan to acquire Press Ganey Forsta in a multibillion-dollar deal, new polling that shows a decline in public trust in the CDC, and a report revealing that some potentially unnecessary back surgeries have cost Medicare nearly $2 billion over three years. Hosted on Acast. See acast.com/privacy for more information.

In this episode of The Gist Healthcare Podcast, President Trump signals that he's open to healthcare discussions with Democratic lawmakers as part of efforts to end the government shutdown. General Catalyst's HATCo has finalized its acquisition of Summa Health. And the CDC approves new vaccine recommendations. Hosted on Acast. See acast.com/privacy for more information.

In this episode of The Gist Healthcare Podcast, we cover the political fight over extending Affordable Care Act tax credits as lawmakers avert a shutdown. The Trump administration has reached a deal with Pfizer to lower drug costs in the United States. And dueling lawsuits reflect how competition is intensifying in the AI healthcare space. Hosted on Acast. See acast.com/privacy for more information.

President Trump is expected to propose changes to the nation's largest work visa program, with implications for healthcare staffing. A CMS pilot adding prior authorizations to traditional Medicare is facing pushback from Congressional leaders. A major medical supply manufacturer is reportedly planning a high-profile IPO next month. More on these stories in today's episode of the Gist Healthcare podcast. Hosted on Acast. See acast.com/privacy for more information.

On today's episode of the Gist Healthcare podcast, the CDC's top vaccine panel prepares to vote as questions grow around future access. Privia Health expands further into value-based care with a new deal to acquire Evolent's ACO business. And a new report explores why more hospitals are closing in urban areas. Hosted on Acast. See acast.com/privacy for more information.

In today's episode of the Gist Healthcare podcast, we look at three headlines making waves in the industry: the Trump administration's claim of a connection between Tylenol use during pregnancy and conditions such as autism and ADHD, CVS's Omnicare division filing for bankruptcy protection, and VillageMD will sell more than 30 of its Texas clinics. Hosted on Acast. See acast.com/privacy for more information.

One of this year's most talked-about shows is The Pitt, a critically acclaimed HBO Max medical drama starring Noah Wyle of ER fame. Touted as one of the most realistic portrayals of an emergency department, the series recently earned multiple Emmy Awards, including Outstanding Drama Series and Best Lead Actor.In this episode of the Gist Healthcare podcast, host J. Carlisle Larsen speaks with Sylvia Owusu-Ansah, MD, a medical consultant for the show who helped shape key storylines. Dr. Owusu-Ansah is an associate professor of pediatrics and emergency medicine at the University of Pittsburgh School of Medicine and serves as director of EMS at UPMC Children's Hospital of Pittsburgh. Hosted on Acast. See acast.com/privacy for more information.

House Republicans propose a stop-gap funding bill that includes continued telehealth flexibilities but avoids addressing Affordable Care Act subsidies. Health insurers say they'll continue to cover vaccines, even as questions remain around long-term access. And Kaiser Permanente expands into a new market through a joint venture. All that and more on today's episode of the Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

The Centers for Medicare & Medicaid Services has opened applications for the $50 billion Rural Health Transformation Program. Health Secretary Robert F. Kennedy Jr. has appointed new members to a key CDC vaccine advisory panel. Plus, a new report reveals just 5% of plastic medical waste is currently recycled. These stories and more coming up on today's episode of the Gist Healthcare podcast. Hosted on Acast. See acast.com/privacy for more information.