All Featured Insights

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

Trump picks his healthcare cabinet nominees, PBMs sue the FTC over its insulin case, and controlled substance telehealth flexibilities are extended yet again.

After hearing reports from health systems about decreasing revenue capture from Medicare Advantage (MA) plans, this graphic dives into some of the trends driving this costly challenge providers are facing.

CMS finalizes the 2025 OPPS rule, an appeals court rules reverses a No Surprises Act decision, and MACPAC calls for more Medicaid payment oversight.

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.

CMS raises the bar for MA plan quality ratings, CVS announces corporate layoffs, and California passes healthcare AI legislation.

As the Medicare Advantage (MA) Annual Enrollment Period (AEP) is fast approaching, let us imagine a future where Artificial Intelligence (AI) plays a much bigger role in the health plan sales process.

The House Oversight Committee criticizes PBM pricing tactics, Humana’s CenterWell plans to open primary care centers at Walmarts, and a federal judge upholds the FTC’s noncompete rule, diverging from a previous district court ruling.

In honor of Pride Month, the graphic highlights the inequities many members of the LGBTQ+ community report facing when accessing healthcare services.

Novant cancels its plan to acquire two North Carolina hospitals from CHS amid an FTC challenge, Amazon expands its RxPass generic drug subscription service to Medicare, and the DOJ accuses two executives at telehealth startup Done of an Adderall distribution scheme.

For Medicaid plans that enjoyed a surge in business during the pandemic, this rapid decline in the market may be disheartening, and the large rapid shifts in the Medicaid risk pools will be challenging to manage to target profit margins in the near-term.