The Gist Healthcare Podcast

UnitedHealthcare CEO Brian Thompson's killing in Manhattan this week sends shockwaves through the industry. Cone becomes the latest health system to join Kaiser Permanente’s Risant Health system. And, CMS proposes new guidelines regulating Medicare Advantage prior authorizations and advertisements. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.

Sanofi becomes the latest pharmaceutical company to introduce a rebate model for 340B-eligible healthcare organizations. A new rule proposed by the Biden Administration would allow Medicare and Medicaid to cover drugs like Ozempic for weight loss. And, patients with HIV can now donate and receive organ transplants from other individuals with the disease. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare

On this week’s Monday interview, host J. Carlisle Larsen speaks with Kaufman Hall’s Scott Christensen about trends within the retail healthcare delivery space and what hospitals can learn from these organizations’ stumbles and successes.  You can find the first part of our conversation here. And you can read Scott’s recent blog post about the topic here.   

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 podcast. 

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 Healthcare

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 Transformation team.   Scott recently wrote a blog post analyzing the retail healthcare business, read it here.  

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. 

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

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