Martin Cech

Jan 15, 2026

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9 min read

Weekly Health Policy Briefing 01/15/26

Some JPM highlights, an ACA enrollment update, and pondering what the right % of household income is for healthcare spending

Jan 8, 2026

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14 min read

Weekly Health Policy Briefing 01/08/26

The rural transformation begins, an update on ACA subsidies and enrollment, and a big fundraising round for a business with Medicaid exposure.

Should Medicaid pay for Direct Primary Care memberships? A discussion with Lawson Mansell, Health Policy Analyst at the Niskanen Center

Dec 19, 2025

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3 min read

Should Medicaid pay for Direct Primary Care memberships? A discussion with Lawson Mansell, Health Policy Analyst at the Niskanen Center

There's an acute need for new approaches to primary care in Medicaid, and a bill before Congress would extend additional flexibilities to state Medicaid agencies interested in exploring DPC as a potential solution.

Alternative choices for Autism Spectrum Disorder therapy with Positive Development’s Mike Suiters and Dr. Josh Feder

Dec 19, 2025

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3 min read

Alternative choices for Autism Spectrum Disorder therapy with Positive Development’s Mike Suiters and Dr. Josh Feder

Every payer is trying to manage ABA spending with rate cuts and UM. But what if the answer is an entirely different clinical model?

Weekly Health Policy Briefing 12/18/2025

Dec 18, 2025

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11 min read

Weekly Health Policy Briefing 12/18/2025

Reading the ACA tea leaves, skin substitute determinations, and OIG audits.

The Regional Not-For-Profit Health Insurance Shakeout

Dec 18, 2025

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9 min read

The Regional Not-For-Profit Health Insurance Shakeout

Expect a lot of M&A and affiliations in the payer market, and eventually a market equilibrium with health systems.

Research Notes: CVS Health Investor Day 2025

Dec 12, 2025

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12 min read

Research Notes: CVS Health Investor Day 2025

CVS's Investor Day highlights confidence in core business execution and a refocusing around key pharma assets while the care delivery business is de-prioritized

Weekly Health Policy Briefing 12/11/2025

Dec 11, 2025

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13 min read

Weekly Health Policy Briefing 12/11/2025

ACA enrollment numbers come in hot, Medicaid infrastructure comes into focus, and the regulatory tailwind of the 21st Century Cures Act for ESRD

Mission and margin in rural healthcare with Hopscotch Primary Care leaders Tim Gronniger and Dr. Aditi Mallick

Dec 10, 2025

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20 min read

Mission and margin in rural healthcare with Hopscotch Primary Care leaders Tim Gronniger and Dr. Aditi Mallick

Hopscotch Primary Care makes for an interesting data point as the country embarks on the Rural Health Transformation Program.

How plans are thinking about MA supplemental benefits for 2026 with Rose Mollitor, Managing Director at ATI Advisory

Dec 10, 2025

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2 min read

How plans are thinking about MA supplemental benefits for 2026 with Rose Mollitor, Managing Director at ATI Advisory

Creative supplemental benefit design, regulations requiring plans to show their work, and major themes going into 2026 across MA and SNP plans.

House Rx CEO Ogi Kavazovic on medically integrated dispensing and bringing speciality pharmacy into provider practices

Dec 10, 2025

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2 min read

House Rx CEO Ogi Kavazovic on medically integrated dispensing and bringing speciality pharmacy into provider practices

Nothing in specialty pharmacy is ever simple, but House Rx sees an opportunity for independent doctors to operate speciality pharmacies in their clinics to make things easier on the patients and add a line of business that helps them stay independent.

How UnitedHealth Group is thinking about AI with Syed Mohiuddin, SVP and Chief AI Transformation & Strategy Officer

Dec 10, 2025

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3 min read

How UnitedHealth Group is thinking about AI with Syed Mohiuddin, SVP and Chief AI Transformation & Strategy Officer

AI optimism, navigating internal tensions between innovations in the payer and provider businesses, and a framework for deploying AI across large organizations

Weekly Health Policy Briefing 12/04/2025

Dec 4, 2025

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12 min read

Weekly Health Policy Briefing 12/04/2025

ACA open enrollment, final rules, and the sub-optimal policy trap

A look at the Non-Emergent Medical Transport (NEMT) business with Lyft's VP of Health, Buck Poropatich

Dec 2, 2025

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4 min read

A look at the Non-Emergent Medical Transport (NEMT) business with Lyft's VP of Health, Buck Poropatich

NEMT is an obvious solution to a real problem, but it's also suffered from outsized levels of Waste, Fraud, and Abuse. Buck talks us through the balancing program integrity and convenience while opening up a new market for the ride share platform.

ACA Marketplace Pricing Strategies for ’26 with Rebecca Stob, Evensun Health

Nov 25, 2025

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2 min read

ACA Marketplace Pricing Strategies for ’26 with Rebecca Stob, Evensun Health

How payers are navigating pricing, growth, profitability, risk adjustment, and geography in the ACA marketplaces.

Rural primary care and the RHTP with Hopscotch Primary Care's Tim Gronniger and Dr. Aditi Mallick

Nov 21, 2025

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3 min read

Rural primary care and the RHTP with Hopscotch Primary Care's Tim Gronniger and Dr. Aditi Mallick

Value-based care, tech-enabled clinics, and some thoughts for states on how to make the most of their Rural Health Transformation Program budgets.

Discussing WISeR and the Merits of Prior Auths with Jeremy Friese

Nov 20, 2025

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4 min read

Discussing WISeR and the Merits of Prior Auths with Jeremy Friese

Prioritizing high value care, getting to yes, and when gold carding makes sense.

On the new Ambulatory Specialty Model from CMMI with Luis Argueso, partner at InHealth Advisors

Nov 20, 2025

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3 min read

On the new Ambulatory Specialty Model from CMMI with Luis Argueso, partner at InHealth Advisors

The new model has everything: it's mandatory, has upside and downside risk, and is focused on heart failure and low back pain. But is the juice worth the squeeze?

Weekly Health Policy Briefing 11/20/2025

Nov 20, 2025

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15 min read

Weekly Health Policy Briefing 11/20/2025

the ACA extension party lines, what enacted and imposted means, and a new strategy for CMS' innovation center

Nov 17, 2025

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3 min read

Q3 2025 Earnings Wrap-Up

Payers think they're priced correctly for 2026 medical trend, most companies retrenching while Privia and Alignment Health get asked about growth, and personalization and AI are still the buzz words with interesting examples from Hims, Oscar, and UnitedHealth Group.

Nov 14, 2025

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10 min read

Earnings Notes: Ardent Health Q3 2025

Volume and revenue growth were as expected for the midsized urban market hospital operator, but cost pressures from professional fees and payer denials have caused them to revise their EBITDA guidance down for the year.

A discussion with Jeff Davis, Director at McDermott+

Nov 13, 2025

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3 min read

A discussion with Jeff Davis, Director at McDermott+

The complicated formula that CMS uses to compensate physicians got its annual update, including a raise for the first time in six years although not everyone is celebrating.

Weekly Health Policy Briefing 11/13/2025

Nov 13, 2025

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15 min read

Weekly Health Policy Briefing 11/13/2025

the HSA option, BearCare, and the trouble with policy making around the most or least sympathetic cases

A discussion with Lauren Makhoul, Sean Dillon, and Amy Hunsberger from Manatt Health

Nov 12, 2025

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3 min read

A discussion with Lauren Makhoul, Sean Dillon, and Amy Hunsberger from Manatt Health

Big changes in Medicare physician payment, drug and skin substitute pricing, and other insights from the 2,300-page Medicare Physician Fee Schedule, explained by regulatory experts from Manatt Health.

Jonathan Palisoc, health economist and Medicaid expert, on provider taxes and state directed payments

Nov 7, 2025

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3 min read

Jonathan Palisoc, health economist and Medicaid expert, on provider taxes and state directed payments

Provider taxes and state directed payments will pull over $40 billion a year out of Medicaid spending once they're fully implemented which will send ripples through the health care economy.