All Featured Insights

The healthcare payment landscape continues to face uncertainty as support grows for additional “site neutrality” in reimbursement, with the policy goal of reducing or eliminating payment differentials between hospital-based outpatient departments (HOPDs) and freestanding physician offices or ambulatory care sites for the same services.

The financial challenges facing hospitals and health systems—from the One Big Beautiful Bill’s looming impacts to difficult operating conditions—are also keeping insurers up at night.

Key Takeaways The rapid adoption of value-based care (VBC) is accelerating the pressure on provider groups to take on downside risk—yet the right path forward is far from one-size-fits...

Multi-year health plan products have the potential to change a lot about how healthcare business models work today.

Assessing the future of healthcare price transparency requires taking a couple of steps back to review its recent history.

The hospital and health system leaders we work with are extremely concerned about the financial impact their organizations may experience from potentially significant Medicaid policy changes, following the recent passage of a budget resolution by the U.S. House of Representatives.

Health plans interested in inorganic growth should reflect deeply to better understand their motivations as it relates to their strategic goals.

The future will favor payers that adapt to changing market circumstances with agency and velocity. Payers will need to make tough choices.

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...

On a new 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.

FTC sues PBMs over insulin pricing, a House bill would extend telehealth flexibilities, and HRSA awards contracts for the new organ transplant system.

Following the US Senate Finance Committee’s recent white paper on Medicare physician payment reform, the graphic shows how Medicare payments to physicians have not kept pace with inflation.