The Gist Healthcare Podcast

Robert F. Kennedy Jr. Is confirmed as the next Secretary of the Department of Health and Human Services.  House Republicans outline $880 billion in healthcare cuts. And, the American Hospital Association calls on the Trump Administration to exempt medical devices from tariffs. That's coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See acast.com/privacy for more information.

A federal judge has issued a temporary stay on funding cuts to research institutions from the National Institutes of Health. The Department of Health and Human Services has been ordered to restore health information webpages following a lawsuit. And, a new study finds that using a popular weight loss drug can help patients lower their need for blood pressure medications. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See acast.com/privacy for more information.

A recent $10 million endowment to Northwestern’s Kellogg School of Management will establish a new Healthcare Leadership Center in partnership with Northwestern Medicine. The goal of the center is to train the next generation of healthcare leaders in an ever-evolving healthcare landscape. Craig Garthwaite, Professor of Strategy and the Director of Healthcare at Kellogg, joins host J. Carlisle Larsen to talk more about the goals of the center. He also shares his thoughts on the challenges facing the industry. Hosted on Acast. See acast.com/privacy for more information.

Elon Musk’s aides at the Department of Government Efficiency are reportedly probing Medicare payment systems for fraud. Physicians sue the Trump Administration over the scrubbing of health information from federal websites. And, maternal mortality is declining except among Black women. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See acast.com/privacy for more information.

Members of the Senate Finance Committee have advanced Robert F. Kennedy Jr.’s nomination to lead the Department of Health and Human Services to the full Senate. New legislation introduced in Congress would raise Medicare physician pay if it’s passed.  And, the Food and Drug Administration has approved the first non-opioid prescription painkiller in more than 20 years. We'll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See acast.com/privacy for more information.

On today’s episode of the Gist Healthcare podcast, we hear the second half of host J. Carlisle Larsen’s conversation with Modern Healthcare’s Michael McAuliff about a document making the rounds on Capitol hill that outlines potential federal healthcare spending cuts.   You can find the first part of their conversation here.  And, you can read Michael’s recent article about the proposed federal healthcare cuts here.   Hosted on Acast. See acast.com/privacy for more information.

The Trump Administration reverses course on a federal funding freeze memo that threw healthcare programs into chaos nationwide. Cigna announces plan to lower out-of-pocket prescription costs for members. And, the FDA approves Ozempic to treat diabetic kidney disease. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See acast.com/privacy for more information.

UnitedHealth Group reveals that the number of Americans impacted by last year’s Change Healthcare breach has nearly doubled. The University of Minnesota and Essentia Health announce a plan to form a new nonprofit healthcare entity.  And, Walgreens rumored sale of itself to a private equity firm is reportedly called off. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See acast.com/privacy for more information.

A document making the rounds in Congress outlines trillions of dollars in potential federal spending cuts to pay for an extension of tax cuts put into place during President Trump’s first term. And Healthcare makes up a sizable part of the proposed cuts. Michael McAuliff, politics and policy reporter for Modern Healthcare, joins host J. Carlisle Larsen to talk more about what healthcare programs could face spending cuts and reactions from lawmakers on Capitol Hill.  You can find Michael’s recent article about the proposed healthcare cuts here.   Hosted on Acast. See acast.com/privacy for more information.

The Trump Administration has paused federal health agencies’ external communications, pending a review.  The Affordable Care Act saw record enrollment for the 2025 plan year on the exchanges, but that growth could be stymied if enhanced tax subsidies expire at the end of the year.  And, RSV antibody shots given to mothers during pregnancy have been found to significant cut infection risk in infants. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See acast.com/privacy for more information.

Newly inaugurated President Trump has issued sweeping initial healthcare orders for his second term. The Department of Health and Human Services releases the next 15 Medicare Part D drugs chosen for negotiations with a blockbuster GLP-1 weight loss drug at the top of the list.  And, a new report from a federal watchdog raises red flags over the Food and Drug Administration’s accelerated approval process for experimental drugs.  We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See acast.com/privacy for more information.

The Biden Administration finalizes rule allowing practitioners to prescribe certain drugs for opioid use disorder via telehealth appointments. Fewer new Black and Hispanic students are enrolling in medical school following Supreme Court ruling that effectively stuck down Affirmative Action. And, the Centers for Medicare and Medicaid Services retracts recently released Medicare Advantage enrollment data. That's coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See acast.com/privacy for more information.

The Supreme Court says it will consider a broad lawsuit challenging the Affordable Care Act’s preventive care mandate. The Biden Administration will crack down on health insurance exchange brokers in a final rule issued this week.  And, Walgreens’ CEO confirms plans to sell VillageMD. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See acast.com/privacy for more information.

The man accused of killing UnitedHealthcare’s CEO has been extradited to New York on murder charges. National healthcare spending hit $4.9 trillion in 2023, likely due to increased utilization and intensity. And, the Centers for Disease Control and Prevention reports first severe human case of bird flu in the United States tied to a backyard flock. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare Hosted on Acast. See acast.com/privacy for more information.

Congress is another step closer to finalizing a year-end spending package to keep the government operating, and the plan includes some significant healthcare related spending. The Health Resources and Services Administration demands the French drugmaker Sanofi abandon its controversial 340B credit model.  And, fewer children are being vaccinated against the flu. We’ll get those stories—and more—coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See acast.com/privacy for more information.

President-elect Donald Trump has named a number of high-profile individuals to lead federal healthcare agencies. These include Robert F. Kennedy Jr. To lead the Department of Health and Human Services, and Dr. Mehmet Oz to lead the Centers for Medicare and Medicaid Services. On today’s episode, host J. Carlisle Larsen speaks with POLITICO’s Ben Leonard to talk more about his healthcare choices, their chances of getting confirmed by the Senate, and what his picks could signal about his second administration’s priorities.  Hosted on Acast. See acast.com/privacy for more information.

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.  Hosted on Acast. See acast.com/privacy for more information.

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.  Hosted on Acast. See acast.com/privacy for more information.

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.   Hosted on Acast. See acast.com/privacy for more information.

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. Hosted on Acast. See acast.com/privacy for more information.

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 Hosted on Acast. See acast.com/privacy for more information.

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.    Hosted on Acast. See acast.com/privacy for more information.

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.  Hosted on Acast. See acast.com/privacy for more information.

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 Hosted on Acast. See acast.com/privacy for more information.

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.   Hosted on Acast. See acast.com/privacy for more information.

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.  Hosted on Acast. See acast.com/privacy for more information.

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 Hosted on Acast. See acast.com/privacy for more information.

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 Hosted on Acast. See acast.com/privacy for more information.

Share prices of Medicare Advantage health insurers jump following former-President Trump’s victory in the 2024 presidential race. Novant Health completes its acquisition of 200-provider group from a South Carolina health insurer. And, Medicaid’s gross spending on GLP-1 drugs grew by 500% over a four-year period. We’ll get that story—and more—coming up on today's episode of the Gist Healthcare podcast. Hosted on Acast. See acast.com/privacy for more information.

Physicians are facing a Medicare pay cut again in 2025 and are calling on Congress to fix the issue. Virtual mental health provider company Cerebral has reached an agreement with the federal government to pay fines tied to allegations that it overprescribed controlled substances, like Adderall. And, a smaller proportion of healthcare workers have received the latest COVID shot. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See acast.com/privacy for more information.

Following the COVID-19 pandemic, UMass Memorial Health in Worcester, Massachusetts began to pilot a new hospital-at-home program: one for postpartum patients. Benjamin Hamar, MD, Director of the Maternity Center at UMass Memorial and a member of the Maternal-Fetal Medicine Division, joins the podcast to tell host J. Carlisle Larsen more about the first-in-the-nation model. Hosted on Acast. See acast.com/privacy for more information.

Medicare’s largest accountable care program saved the federal government more than $2 billion dollars last year. CVS bucks the retail-healthcare contraction trend and announces expanded primary care services for its Aetna members at its MinuteClinic locations in certain markets. And, Cigna’s CEO brushes off Humana purchase rumors in a call to investors. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See acast.com/privacy for more information.

A government watchdog finds that Medicare paid health insurers billions for what it says were questionable home diagnoses. UnitedHealth and home healthcare company Amedisys are reportedly appealing to regulators in an effort to finalize their proposed multi-billion-dollar merger. And, Novo Nordisk wants to block compounding pharmacies from creating Ozempic knockoffs. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See acast.com/privacy for more information.

The Medicare Advantage market has seen unprecedented growth in recent years, with a majority of Medicare eligible beneficiaries enrolling in one of these privately administered plans in 2024. But over the past couple of years, the industry has experienced some growing pains—ranging from more regulatory scrutiny to higher costs associated with members utilizing more healthcare services.   In the second half of their conversation, Joyjit Saha Choudhury, Managing Director of the Kaufman Hall’s Strategy and Business Transformation practice, joins host J. Carlisle Larsen to talk about the potential worst-case scenario for the market.   You can find the first part of their conversation here.  Hosted on Acast. See acast.com/privacy for more information.

The February cyberattack on Change Healthcare could have compromised the data of 100 million people, making it the largest healthcare data breach reported to the federal government. The Cleveland Clinic and Amazon to partner on primary care clinics in Ohio.  And, Senators want more information from Eli Lilly and Pfizer about their direct-to-consumer platforms. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See acast.com/privacy for more information.

Cigna and Humana have reportedly resumed merger talks after abandoning plans late last year. Walgreens is looking at a healthcare future without VillageMD as a key component. And, Blue Cross Blue Shield will pay roughly $2.8 billion to settle a class action antitrust case brought by providers. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See acast.com/privacy for more information.

Enrollment in Medicare Advantage plans surpassed 54 percent for the 2024 plan year, as more eligible seniors seek to take advantage of the privately administered health plans. Though MA plans have become increasingly popular, the industry has had some growing pains, ranging from increased regulatory pressures and higher consumer medical utilization.  On today’s episode of the Gist Healthcare podcast, Joyjit Saha Choudhury joins host J. Carlisle Larsen to talk about his recent piece, Preparing for Medicare Advantage’s Make-or-Break Moment.   The second part of their conversation will be available on Monday, October 28. Hosted on Acast. See acast.com/privacy for more information.

UnitedHealth Group’s stock tumbles as it reveals a jump in medical costs hurt its 2025 profit outlook. More than 1,500 physicians call on the Trump campaign to release an outline of healthcare plans after the former-president said he wants to replace the Affordable Care Act. And, the Food and Drug Administration halts the clinical application of Novavax’s combination COVID-influenza shot, following a report of a significant reaction from a trial participant. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See acast.com/privacy for more information.

Medicare Advantage star ratings drop for the 2025 plan year, as expected. Walgreens plans to close more stores as the company continues to right its finances. And, the largest maker of IV fluid in the United States looks to import fluid from abroad to mitigate a hurricane-related shortage. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See acast.com/privacy for more information.

Nearly 80 percent of registered voters in the United States say that healthcare is either an extremely or very important issue, according to a recent Gallop poll. On today’s episode of the Gist Healthcare podcast, we take a look at some of the healthcare issues that have become platforms for the presidential tickets, as well as how some down ballot races are approaching healthcare policy. Dan Diamond, national healthcare reporter for the Washington Post, joins us to talk healthcare policy and politics.   Hosted on Acast. See acast.com/privacy for more information.

The nation’s largest producer of I-V fluids is expanding allocations of its products to meet demand from hospitals in the aftermath of Hurricane Helene. UnitedHealth Group, Cigna, and CVS have asked a judge to remove FTC Chair Lina Khan and two other commissioners from the agency’s insulin price antitrust suit. And, interviews are making their return to the podcast. Stay tuned to learn about what’s on the docket. These stories—and more—coming upon today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See acast.com/privacy for more information.

Democratic presidential candidate Kamala Harris proposes an expansion of Medicare’s home healthcare policy. The Government Accountability Office says the Centers for Medicare and Medicaid Services should be more diligent in ensuring hospitals are compliant with price transparency rules. And, some hospitals in Florida prepare to close facilities and evacuate patients as Hurricane Milton barrels through the Gulf. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See acast.com/privacy for more information.

Hospitals around the country are reporting shortages of crucial IV fluid in the aftermath of Hurricane Helene.  Not-for-profit hospitals add ten times their value to communities relative to their tax breaks, according to a new report. And, the Federal Trade Commission could wade into the legal fight between startup Particle Health and the nation’s largest EHR vendor Epic. That story—and more—coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See acast.com/privacy for more information.

The Vice Presidential candidates squared off this week and healthcare policy took center stage. Humana’s stock drops following news that federal regulators slashed the number of the company’s enrollees in high-star Medicare Advantage plans. And, the number of reported whooping cough cases has spiked this year. We’ll get that story--and more--coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See acast.com/privacy for more information.

CVS is rumored to be weighing breaking up its retail and insurance businesses amid investor pressure. Johnson & Johnson is abandoning its controversial 340B drug discount rebate plan.  And, The Biden Administration is no longer pursuing its push for greater Medicaid drug price transparency, according to a report.  We’ll get that story--and more--coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See acast.com/privacy for more information.

New legislation is introduced in the United States Senate that sets standards for healthcare cybersecurity. The Centers for Medicare and Medicaid Services finalizes national Medicaid renewal compliance deadlines. And, Novo Nordisk’s CEO blames health insurers and PBMs for the high cost of its blockbuster weight loss drug Ozempic. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See acast.com/privacy for more information.

New legislation introduced this week in the US Senate would make ACA expanded subsidies permanent. Employers expect an increase in per employee healthcare benefit spend in 2025, according to a new survey. And, EHR giant Epic sued over allegations of anticompetitive business practices. We’ll get that story and more coming up on today’s episode of the Gist Healthcare podcast. Hosted on Acast. See acast.com/privacy for more information.

A bill introduced in Congress would exempt some smaller drugmakers from the Medicare drug price negotiation process. The Federal Trade Commission sues the nation’s largest pharmacy benefit managers over the cost of insulin.  And, consumers will be able to self-administer a nasal flu vaccine next year. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See acast.com/privacy for more information.

A move to extend pandemic-era telehealth and hospital-at-home flexibilities passes out of a key Congressional committee.  Another major health insurer plans to scale back their Medicare Advantage offerings for the upcoming plan year.  And, drug overdose deaths in the US are declining rapidly, according to data from the CDC. We’ll get that story--and more--coming up on today’s episode of the Gist Healthcare podcast. Hosted on Acast. See acast.com/privacy for more information.

The Health Resources and Services Administration threatens sanctions against Johnson & Johnson over the company’s decision to change how hospitals are provided 340B discounts on some prescription drugs.  And, a summer surge of COVID infections could be abating...We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast.  Hosted on Acast. See acast.com/privacy for more information.