President-elect Trump taps former-TV personality Dr. Oz to lead the Centers for Medicare and Medicaid Services. The parent companies of major U.S. pharmacy benefit managers sue the Biden Administration over a recent suit brought by the FTC alleging that PBMS engage in anticompetitive rebate practices for insulin. And, CMS will lower importance of the call center metric in Medicare Advantage star ratings. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare...

Incoming President Donald Trump is reportedly weighing significant changes to Medicaid, and some states are rushing to get their waiver requests in before President Biden leaves office. UnitedHealth Group announces Change Healthcare’s clearinghouse services are fully operational following a massive cyberattack on the company earlier this year. And, nearly 10,000 Corewell nurses in southeast Michigan will unionize. We’ll get that story—and more—coming up on today’s episode of the Gist...

Retailers have made a big splash in the healthcare delivery space over the last decade, but many have seen mixed success with their healthcare business. Some companies, including CVS and Amazon, are still making progress. While others, like Walmart and Walgreens, have taken a tumble. On today’s episode of the Gist Healthcare podcast, host J. Carlisle Larsen discusses what we’ve seen in the retail space with Scott Christensen, Senior Vice President for Kaufman Hall’s Strategy and Business...

President-elect Donald Trump nominates Robert F. Kennedy Jr. as the next Secretary of the Department of Health and Human Services. And the Biden Administration sues to halt Optum’s multibillion dollar acquisition of home health provider Amedisys on antitrust grounds. We get 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.

Cigna confirms it is not pursuing an acquisition of rival health insurer Humana. OptumHealth and Aetna agree to settle a class action lawsuit alleging that they billed health plan members for administrative fees coded as medical expenses.  And, hospital-associated infection rates are down, according to recent data from the CDC. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare Hosted on Acast. See acast.com/privacy for more information.

General Catalyst’s HATco signs a definitive agreement to purchase Akron, OH-based Summa Health. The Food and Drug Administration plans to remove a common—but ineffective—decongestant ingredient from the market. And, more young people are landing in the emergency department for consuming too much caffeine. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare Hosted on Acast. See acast.com/privacy for more information.

Share prices of Medicare Advantage health insurers jump following former-President Trump’s victory in the 2024 presidential race. Novant Health completes its acquisition of 200-provider group from a South Carolina health insurer. And, Medicaid’s gross spending on GLP-1 drugs grew by 500% over a four-year period. We’ll get that story—and more—coming up on today's episode of the Gist Healthcare podcast. Hosted on Acast. See acast.com/privacy for more information.

Physicians are facing a Medicare pay cut again in 2025 and are calling on Congress to fix the issue. Virtual mental health provider company Cerebral has reached an agreement with the federal government to pay fines tied to allegations that it overprescribed controlled substances, like Adderall. And, a smaller proportion of healthcare workers have received the latest COVID shot. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See...

Following the COVID-19 pandemic, UMass Memorial Health in Worcester, Massachusetts began to pilot a new hospital-at-home program: one for postpartum patients. Benjamin Hamar, MD, Director of the Maternity Center at UMass Memorial and a member of the Maternal-Fetal Medicine Division, joins the podcast to tell host J. Carlisle Larsen more about the first-in-the-nation model. Hosted on Acast. See acast.com/privacy for more information.

Medicare’s largest accountable care program saved the federal government more than $2 billion dollars last year. CVS bucks the retail-healthcare contraction trend and announces expanded primary care services for its Aetna members at its MinuteClinic locations in certain markets. And, Cigna’s CEO brushes off Humana purchase rumors in a call to investors. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See acast.com/privacy for...

A government watchdog finds that Medicare paid health insurers billions for what it says were questionable home diagnoses. UnitedHealth and home healthcare company Amedisys are reportedly appealing to regulators in an effort to finalize their proposed multi-billion-dollar merger. And, Novo Nordisk wants to block compounding pharmacies from creating Ozempic knockoffs. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See...

The Medicare Advantage market has seen unprecedented growth in recent years, with a majority of Medicare eligible beneficiaries enrolling in one of these privately administered plans in 2024. But over the past couple of years, the industry has experienced some growing pains—ranging from more regulatory scrutiny to higher costs associated with members utilizing more healthcare services.     In the second half of their conversation, Joyjit Saha Choudhury, Managing Director of the Kaufman Hall’s...

The February cyberattack on Change Healthcare could have compromised the data of 100 million people, making it the largest healthcare data breach reported to the federal government. The Cleveland Clinic and Amazon to partner on primary care clinics in Ohio.  And, Senators want more information from Eli Lilly and Pfizer about their direct-to-consumer platforms. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See acast.com/privacy...

Cigna and Humana have reportedly resumed merger talks after abandoning plans late last year. Walgreens is looking at a healthcare future without VillageMD as a key component. And, Blue Cross Blue Shield will pay roughly $2.8 billion to settle a class action antitrust case brought by providers. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See acast.com/privacy for more information.

Enrollment in Medicare Advantage plans surpassed 54 percent for the 2024 plan year, as more eligible seniors seek to take advantage of the privately administered health plans. Though MA plans have become increasingly popular, the industry has had some growing pains, ranging from increased regulatory pressures and higher consumer medical utilization.    On today’s episode of the Gist Healthcare podcast, Joyjit Saha Choudhury joins host J. Carlisle Larsen to talk about his recent piece,...

UnitedHealth Group’s stock tumbles as it reveals a jump in medical costs hurt its 2025 profit outlook. More than 1,500 physicians call on the Trump campaign to release an outline of healthcare plans after the former-president said he wants to replace the Affordable Care Act. And, the Food and Drug Administration halts the clinical application of Novavax’s combination COVID-influenza shot, following a report of a significant reaction from a trial participant. We’ll get that story—and...

Medicare Advantage star ratings drop for the 2025 plan year, as expected. Walgreens plans to close more stores as the company continues to right its finances. And, the largest maker of IV fluid in the United States looks to import fluid from abroad to mitigate a hurricane-related shortage. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See acast.com/privacy for more information.

Nearly 80 percent of registered voters in the United States say that healthcare is either an extremely or very important issue, according to a recent Gallop poll. On today’s episode of the Gist Healthcare podcast, we take a look at some of the healthcare issues that have become platforms for the presidential tickets, as well as how some down ballot races are approaching healthcare policy. Dan Diamond, national healthcare reporter for the Washington Post, joins us to talk healthcare policy and...

The nation’s largest producer of I-V fluids is expanding allocations of its products to meet demand from hospitals in the aftermath of Hurricane Helene. UnitedHealth Group, Cigna, and CVS have asked a judge to remove FTC Chair Lina Khan and two other commissioners from the agency’s insulin price antitrust suit. And, interviews are making their return to the podcast. Stay tuned to learn about what’s on the docket. These stories—and more—coming upon today’s episode of the Gist Healthcare...

Democratic presidential candidate Kamala Harris proposes an expansion of Medicare’s home healthcare policy. The Government Accountability Office says the Centers for Medicare and Medicaid Services should be more diligent in ensuring hospitals are compliant with price transparency rules. And, some hospitals in Florida prepare to close facilities and evacuate patients as Hurricane Milton barrels through the Gulf. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare...

Hospitals around the country are reporting shortages of crucial IV fluid in the aftermath of Hurricane Helene.  Not-for-profit hospitals add ten times their value to communities relative to their tax breaks, according to a new report. And, the Federal Trade Commission could wade into the legal fight between startup Particle Health and the nation’s largest EHR vendor Epic. That story—and more—coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See...

The Vice Presidential candidates squared off this week and healthcare policy took center stage. Humana’s stock drops following news that federal regulators slashed the number of the company’s enrollees in high-star Medicare Advantage plans. And, the number of reported whooping cough cases has spiked this year. We’ll get that story--and more--coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See acast.com/privacy for more information.

CVS is rumored to be weighing breaking up its retail and insurance businesses amid investor pressure. Johnson & Johnson is abandoning its controversial 340B drug discount rebate plan.  And, The Biden Administration is no longer pursuing its push for greater Medicaid drug price transparency, according to a report.  We’ll get that story--and more--coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See acast.com/privacy for more information.

New legislation is introduced in the United States Senate that sets standards for healthcare cybersecurity. The Centers for Medicare and Medicaid Services finalizes national Medicaid renewal compliance deadlines. And, Novo Nordisk’s CEO blames health insurers and PBMs for the high cost of its blockbuster weight loss drug Ozempic. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See acast.com/privacy for more information.