Martin Cech

Research Notes: CVS Health Investor Day 2025

Dec 12, 2025

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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

•

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.

Nov 6, 2025

•

2 min read

A discussion with Stacy Edgar, CEO of Venteur

Turmoil in the marketplaces, silver loading, and how insurance companies stack the shelves around open enrollment

Weekly Health Policy Briefing 11/06/2025

Nov 6, 2025

•

14 min read

Weekly Health Policy Briefing 11/06/2025

tough choices for fragile state budgets, squeezing the Medicare balloon, and MA plans report earnings during a tricky year

Nov 5, 2025

•

7 min read

Earnings Notes: Clover Health Q3 2025

Clover Health beats expectations on revenue but missed on adjusted EBITDA for the quarter. 2025 guidance was revised, lowering adjusted EBITDA and raising expected Benefit Expense Ratio.

A discussion with Joe and Wesley from Evensun Health

Nov 3, 2025

•

2 min read

A discussion with Joe and Wesley from Evensun Health

What went wrong and what 2026 is looking like for the ACA individual market.

Positive Development: Initiation of Coverage Report

Nov 3, 2025

•

11 min read

Positive Development: Initiation of Coverage Report

The company is offering an attractive pitch to state Medicaid agencies and Medicaid Managed Care Organizations: comparable clinical outcomes at half the cost of ABA. Their key challenge is overcoming the inertia of the status quo.

Earnings Notes: Alignment Health Q3 2025

Oct 31, 2025

•

7 min read

Earnings Notes: Alignment Health Q3 2025

Alignment Health has raised EBITDA guidance 4x over the last year. How quickly can they grow, and can they sustain their performance as they do?