The Gist Healthcare Podcast

United States Senators introduce legislation that would break up healthcare giants’ pharmacy benefit managers. Walgreens is reportedly looking into a sale to a private equity firm and going private. And, a new poll finds fewer than one in five Americans are satisfied with the cost of healthcare. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast. 

Police arrest suspect in the murder of UnitedHealthcare CEO Brian Thompson. Anthem Blue Cross Blue Shield backtracks on a controversial planned cap on anesthesia payments. And, dozens of Nobel laureates write to the US Senate urging lawmakers to oppose Robert F. Kennedy Jr.’s nomination to lead the Department of Health and Human Services. We’ll get those stories coming up on today’s episode of the Gist Healthcare podcast. 

Since January 2021, hospitals and health systems have been required to post the prices of standard charges publicly. The goal of the Hospital Price Transparency Rule has been to increase competition and bring down the cost of healthcare for consumers. Since the regulation went into effect three years ago, researchers at Turquoise Health wanted to see if the market had responded.   Carol Skenes, Interim Vice President of Product at Turquoise, joins host J. Carlisle Larsen to talk about what their researchers found after reviewing industry-wide data.   You can find the white paper discussed on today’s episode here.  

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.