HTN Discussions

Discussions with industry experts across the ecosystem.

Apr 7, 2026

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21 min read

Chris Klomp joins HTN to discuss the 2027 MA Final Notice

We discuss the implications of CMS finalizing an expected average change of 2.48%, a larger-than-expected jump from the previously proposed 0.09% rate increase

Kevin O'Leary

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.

Martin Cech

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?

Martin Cech

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.

Martin Cech

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.

Martin Cech

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

Martin Cech, Kevin O'Leary

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.

Martin Cech

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.

Martin Cech

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.

Martin Cech, Kevin O'Leary

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.

Martin Cech, Kevin O'Leary

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?

Martin Cech

Nov 14, 2025

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3 min read

Discussing Privia Health's Q3 earnings with Privia's Jason Ross, EVP of Medical Groups

Discussing Priva's Q3 earnings, the Evolent ACO acquisition, and Privia's solid VBC performance

Kevin O'Leary

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.

Martin Cech

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.

Martin Cech

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.

Martin Cech

Nov 6, 2025

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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

Kevin O'Leary, Martin Cech

A discussion with Joe and Wesley from Evensun Health

Nov 3, 2025

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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.

Kevin O'Leary, Martin Cech

Physician shortages and nurse practitioner enablement with Meghan Jewitt of Prax Health

Oct 28, 2025

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10 min read

Physician shortages and nurse practitioner enablement with Meghan Jewitt of Prax Health

Untapped supply from NPs and ideas on how to unlock it

Martin Cech

Prior authorizations, past and present with Archelle Georgiou, MD

Oct 23, 2025

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7 min read

Prior authorizations, past and present with Archelle Georgiou, MD

History doesn't always repeat, but it rhymes.

Kevin O'Leary

Provider consolidation and its malcontents: an interview Olivia Kosloff

Oct 21, 2025

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17 min read

Provider consolidation and its malcontents: an interview Olivia Kosloff

A discussion with the Acute Condition author and American Economic Liberties Project Senior Fellow on the alternatives to the increasingly corporate practice of medicine

Martin Cech, Olivia Kosloff

Rachel Wilson, Co-founder and COO of Bluebird Kids Health on pediatric value-based care

Oct 20, 2025

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33 min read

Rachel Wilson, Co-founder and COO of Bluebird Kids Health on pediatric value-based care

The challenges and opportunities of Medicaid Managed Care for children, build versus buy decisions, and the opportunity for generational returns by investing in children’s health.

Martin Cech

Russell Pekala, co-founder of Yuzu Health, on the merits of employer-sponsored health insurance and the role of Yuzu in managing plan operations.

Sep 30, 2025

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39 min read

Russell Pekala, co-founder of Yuzu Health, on the merits of employer-sponsored health insurance and the role of Yuzu in managing plan operations.

A discussion on the economics of third-party administration, opportunities to actually control costs in health care, and how simplicity can be a plan's saving grace.

Martin Cech, Kevin O'Leary, Claire Trautz

Mike Suiters, CEO of Positive Development, on choices for Autism Spectrum Disorder therapy

Sep 23, 2025

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26 min read

Mike Suiters, CEO of Positive Development, on choices for Autism Spectrum Disorder therapy

A discussion with Mike Suiters on Positive Development's pioneering of developmental therapy and why Autism Spectrum Disorder therapy has gotten so expensive

Martin Cech, Kevin O'Leary

HTN Discussions

Chris Klomp joins HTN to discuss the 2027 MA Final Notice

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

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

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

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

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

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

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

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

Discussing WISeR and the Merits of Prior Auths with Jeremy Friese

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

Discussing Privia Health's Q3 earnings with Privia's Jason Ross, EVP of Medical Groups

A discussion with Jeff Davis, Director at McDermott+

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

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

A discussion with Stacy Edgar, CEO of Venteur

A discussion with Joe and Wesley from Evensun Health

Physician shortages and nurse practitioner enablement with Meghan Jewitt of Prax Health

Prior authorizations, past and present with Archelle Georgiou, MD

Provider consolidation and its malcontents: an interview Olivia Kosloff

Rachel Wilson, Co-founder and COO of Bluebird Kids Health on pediatric value-based care

Russell Pekala, co-founder of Yuzu Health, on the merits of employer-sponsored health insurance and the role of Yuzu in managing plan operations.

Mike Suiters, CEO of Positive Development, on choices for Autism Spectrum Disorder therapy

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