Gist Healthcare Daily

On today's episode of The Gist Healthcare Podcast: health systems join a new federal initiative aimed at streamlining prior authorizations, lawmakers revive legislation that would ban PBMs from owning retail pharmacies, and a judge clears the way for CVS Health to sell its long-term care pharmacy business. Hosted on Acast. See acast.com/privacy for more information.

Medicare pauses home health and hospice enrollment over fraud concerns, a congressional advisory committee calls for more oversight of AI prior authorization in Medicaid, and drug overdose deaths fell for the third year in a row. Coming up on today's episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

Dr. Marty Makary is out as FDA commissioner. Sanford Health plans to merge with Minnesota-based North Memorial Health. And healthcare added the most jobs in April. Coming up 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: California hospitals sue Anthem, Leapfrog reports patient safety gains, and a study links post-surgery walking to better outcomes. Hosted on Acast. See acast.com/privacy for more information.

Pennsylvania sues an AI company, alleging its chatbots posed as licensed medical providers. Two North Carolina nonprofit health systems plan to merge. And the American Hospital Association is partnering with West Health to expand hospital technology adoption. Those stories and more on today's episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

Coming up on The Gist Healthcare Podcast: UnitedHealthcare cuts prior authorizations by 30 percent. Healthcare bankruptcies rise in the first quarter. The Trump administration names a new Surgeon General. Hosted on Acast. See acast.com/privacy for more information.

Artificial intelligence in healthcare is already being used in practice—but those tools aren't perfect. In the final part of a three-part series, host J. Carlisle Larsen continues her conversation with Dr. Robert Wachter, Chair of the Department of Medicine at the University of California, San Francisco and author of A Giant Leap: How AI Is Transforming Healthcare and What That Means for Our Future. As these tools move into wider use, Wachter explains how their limitations show up in real-world settings—from questions about reliability to how they're used by clinicians and patients. The conversation examines what happens when imperfect systems are used in higher-stakes environments, and what that means for how AI is adopted going forward. You can listen to Part 1 here. And Part 2 here. Hosted on Acast. See acast.com/privacy for more information.

CMS to require state audits of Medicaid providers, the Trump administration plans faster Medicare coverage for breakthrough devices, and a new survey shows physician burnout declining, on today's episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

UnitedHealthcare eliminates a majority of prior authorizations for rural providers, the White House taps a new CDC director, and Michigan lowers the measles vaccine age in some counties, coming up on today's episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

Artificial intelligence in healthcare is often discussed in terms of what it might do. But, in some areas, it's already being put to use. In Part 2 of a three-part series, host J. Carlisle Larsen continues her conversation with Dr. Robert Wachter, Chair of the Department of Medicine at the University of California, San Francisco and author of A Giant Leap: How AI Is Transforming Healthcare and What That Means for Our Future. This episode focuses on AI scribes—one of the first use cases gaining traction across health systems—and what they reveal about how this technology is being adopted in practice. Wachter explains why scribes have emerged as an early success and what they signal about where AI may go next. You can listen to the first half of the conversation here. Hosted on Acast. See acast.com/privacy for more information.

New drug prior authorization rules are under consideration, physician pay rose slightly in 2025, and proposed legislation would count direct-to-consumer drug purchases toward deductibles. Those stories and more on today's episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

Medicare inpatient pay edges up, measles cases top 1,700, and vaccine confidence slips, on today's episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

Artificial intelligence is being positioned as the next major transformation in healthcare, but the industry has seen similar waves of technological change before. In Part 1 of a three-part series, host J. Carlisle Larsen speaks with Robert Wachter, M.D., Chair of the Department of Medicine at University of California-San Francisco and author of A Giant Leap: How AI Is Transforming Healthcare and What That Means for Our Future, about how to understand this moment in AI. Drawing on lessons from the rollout of electronic health records, Wachter explains why previous efforts to digitize healthcare often fell short of expectations and what may be different this time. Hosted on Acast. See acast.com/privacy for more information.

Jefferson Health sues Aetna over a so-called Medicare Advantage "down coding" policy, CMS raises MA rates next year, and healthcare affordability tops domestic concerns, on today's episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

The White House proposes a 12% cut to HHS, insurers report further reductions in prior authorization, and a new study links AI scribes to modest documentation time savings, 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. This interview first aired on Monday, January 26, 2026. Hosted on Acast. See acast.com/privacy for more information.

HHS forms a new healthcare advisory committee, the FDA approves Eli Lilly's oral weight loss pill, and a Senate bill targets insulin price caps in private plans, those stories and more coming up on The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

HHS tightens hospital nutrition standards, ACA marketplace enrollment dips 5 percent, and one in three people turn to AI chatbots for health questions, on today's episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

As healthcare organizations respond to the cyberattack on Stryker, the focus is shifting from what happened to how decisions are made in the moment. Gist Healthcare Podcast host J. Carlisle Larsen speaks with Phil Englert of Health-ISAC about navigating uncertainty during an incident, how these events shape perceptions of medical device risk, and what it takes for organizations to coordinate under pressure. You can listen to the first half of the conversation here. Hosted on Acast. See acast.com/privacy for more information.

CVS Health reaches a proposed insulin pricing settlement with the Federal Trade Commission. The Trump administration misses a deadline to name a new director of the Centers for Disease Control and Prevention. And a new study finds sepsis is linked to 18 percent of pediatric hospital deaths. Those stories coming up on today's episode of the Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

In this episode of The Gist Healthcare Podcast, the Federal Trade Commission launches a new healthcare taskforce, CMS advances efforts to move away from fax and mailed claims, and new data shows coverage gaps for some ACA marketplace enrollees. Hosted on Acast. See acast.com/privacy for more information.

A cyberattack on Stryker disrupted operations across one of the largest medical device companies in the world, affecting ordering, manufacturing, and shipping and prompting hospitals to assess potential impacts. Unlike most healthcare cyber incidents, this was not a typical ransomware attack. In this episode, Gist Healthcare Podcast host J. Carlisle Larsen speaks with Phil Englert of Health-ISAC about what made the incident unusual and what it reveals about how healthcare organizations may need to rethink their response when an attack is focused on disruption rather than payment. Hosted on Acast. See acast.com/privacy for more information.

Sutter Health and Allina Health announce plans to merge. The Leapfrog Group will remove hundreds of hospital safety grades following the Tenet Healthcare decision. And a new survey finds physicians are concerned about the accuracy of AI tools. 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.

A judge blocks recent changes to federal vaccine policy, a new report finds oversight could reduce Medicare Advantage overpayments, and a cyberattack disrupts Stryker's ordering system. These stories and more on today's episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

Healthcare policy has taken a back seat on Capitol Hill so far in 2026, as lawmakers focus on other matters. But several issues are still unfolding, including Medicaid work requirements, a potential Surgeon General confirmation battle, and policy proposals that could advance or stall as Congress heads toward the midterms. Michael McAuliff, who covers politics and policy in Washington, D.C. for Modern Healthcare, joins host J. Carlisle Larsen to break down what to watch. Hosted on Acast. See acast.com/privacy for more information.

A cyberattack tied to Iranian hackers hits a large medical device manufacturer. A new analysis links Medicare Advantage overpayments to higher premiums for seniors. And CVS Health partners with Google on a new consumer health engagement platform. That's coming up on today's episode of the Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

In this episode of The Gist Healthcare Podcast, we cover the FDA's top vaccine official stepping down, a federal ruling involving Leapfrog and Tenet hospitals, and a new agreement between Novo Nordisk and Hims and Hers. Hosted on Acast. See acast.com/privacy for more information.

As reimbursement levels shift under site-neutral payment, health systems must move from strategy to execution. On today's episode of the Gist Healthcare Podcast, we hear the second part of host J. Carlisle Larsen's conversation Kaufman Hall Managing Director Joyjit Choudhury about what cost restructuring looks like in practice. That includes rethinking business and operating models, integrating site-neutral planning into broader enterprise strategy and aligning finance, operations and clinical leadership around a sustainable path forward. Be sure to check out Joyjit's recent blog about this topic. You can find the first part of our conversation here. Hosted on Acast. See acast.com/privacy for more information.

Amazon introduces a new agentic AI tool designed for healthcare. States signal plans to invest Rural Health Transformation Fund grants in value-based care initiatives. And Eli Lilly launches a direct-to-employer platform for weight loss drugs. That's coming up on today's episode of the Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

Elevance Health's Medicare Advantage plans face federal sanctions. The University of Mississippi Medical Center clinics reopen after a ransomware attack. And the FDA warns telehealth companies about marketing compounded weight loss drugs. That's coming up on today's episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

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.