The Gist Healthcare Podcast

CVS unveils a new ‘cost plus’ drug pricing model meant to streamline the drug reimbursement process. States that don’t fix their Medicaid redeterminations issues could face a loss of federal funding and fines under an interim final rule. And, a cyberattack on a Corewell Health vendor exposes the personal data of one million of its patients. That’s coming up on today’s episode of Gis...

North Carolina’s Medicaid expansion goes into effect. Community Health Systems finalizes its sale of three of its Florida hospitals to Tampa General. And, a House panel will investigate the Food and Drug Administration over its decision to declare certain oral, over-the-counter decongestants as ineffective. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. Se...

In March, employee healthcare navigation company Transcarent announced it would acquire AI-powered primary care startup 98point6’s virtual care platform and care business. On today’s episode of Gist Healthcare Daily, we hear the second part of JC’s conversation with Transcarent CEO Glen Tullman about that acquisition and how it fits into his Transcarent’s long-term goals. They also discuss Tullman...

The Biden Administration will invoke the Defense Production Act to manufacture more drugs in the United States amid an ongoing shortage. The FTC announces it will investigate the safety of CAR-T therapies. And, Federal lawmakers introduce a bill that would ban fees for electronic healthcare payments. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast...

Major health insurers Cigna and Humana are reportedly in talks to merge. The number of US physicians either employed by or affiliated with Optum  swells to nearly 90,000. And, the merger between BJC HealthCare and St. Luke’s Health System is expected to close at the beginning of the year. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy...

A massive data breach last week disrupts operations at a large, multi-state health system. Optum faces a federal lawsuit from a California hospital alleging antitrust violations. And, Fairview Health plans to end its current partnership with the University of Minnesota. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

The Biden Administration proposes a rule that could make dental care covered under Affordable Care Act plans. Hospitals and health system executives say investing in cyber security is their top investment priority for their 2024 IT budgets. And, a new survey finds that nearly half of American adults faced healthcare billing issues within the last year. That’s coming up on today’s episode...

Employee healthcare navigation company Transcarent announced in September that it has partnered with an inaugural group of 10 large health systems to create what it calls a national, independent “provider ecosystem” in order to  provide higher-quality care to the covered beneficiaries of its more than 300 employer clients. On today’s episode of Gist Healthcare Daily, Transcarent CEO Glen Tull...

The American Medical Association releases its latest policy focuses…including pushing for diabetes drugs to be covered for weight loss. Medicare will cover navigation services for cancer patients under a new rule, And, around 36 million adults in the US have received the updated COVID shot. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy fo...

UnitedHealth faces a lawsuit over its use of an algorithm in its Medicare Advantage denials. State Medicaid administrators anticipate a steep drop in enrollment and more spending on the program from state governments in 2024.  And, the Biden Administration issues its final rule requiring nursing homes to be more transparent with their ownership information. That’s coming up on today...

Amazon’s One Medical inks more partnerships with health systems across the country. New York lawmakers propose tighter cybersecurity restrictions for hospitals. And, life expectancy for men in the US drops to 73 years--six years less than women--according to a new study. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Health systems sue the Health Resources and Services Administration over its recent reversal of its 340B off-site clinic registration policy. Pharmacy benefit managers would face tighter restrictions under a new Senate bill. And, private equity firm Thoma Bravo finalizes its acquisition of electronic health records vendor NextGen. That’s coming up on today’s episode of Gist Healthcare Da...

On today’s episode of Gist Healthcare Daily, Brad Kittredge , founder and CEO of digital mental healthcare provider platform Brightside Health , joins to talk more about the services Brightside provides. He also discusses the organization’s recent announcement that it will expand access to Medicaid and Medicare populations through its partnerships with health insurers. Hosted on Acast. See ac...

Kaiser Permanente healthcare workers approve a new four-year contract a month after their historic, large-scale strike. Amazon offers a reduced membership price to One Medical for its Prime subscribers. And, the Food and Drug Administration approves Eli Lilly’s GLP-1 drug–tirzapetide–for chronic weight management. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted...

Hospitals and health systems across the country have seen an alarming increase in both the frequency and severity of workplace violence incidents. Toni Ardabell, Chief of Clinical Enterprise Operations for Inova Health System in Falls Church, Virginia joins Gist Healthcare Daily to talk more about how Inova has created a  multidisciplinary team to better address the issue and create a safer e...

The Biden Administration proposes stricter marketing rules for Medicare Advantage plans. North Carolina’s Attorney General threatens to sue for-profit health system HCA for violating its Mission Health purchasing agreement. And, the rate of hospital-acquired infections has dropped after a surge during the pandemic. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on A...

CMS issues its final Medicare reimbursement rules for 2024, with outpatient facilities seeing a pay bump and physicians facing payment cuts. The American Hospital Association challenges the Department of Health and Human Services over its third-party web tracking rule in a new lawsuit. And, a new Minnesota law requires hospitals in the state to inform patients of financial assistance bef...

For months, federal lawmakers in Washington D.C. have been at odds over reauthorizing the United States President's Emergency Plan For AIDS Relief–better known as PEPFAR–a U.S. initiative to address the global HIV/AIDS epidemic. The program has largely had bipartisan support on the Hill since it was first introduced in 2003 under then-President George W. Bush's administration. However, in recent m...

Walmart strikes a deal with Orlando Health, its first health system partnership. CMS backtracks on proposed home health Medicare payment cuts. And, infant mortality in the United States rose for the first time in two decades, according to a new report. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more information.

Health tech unicorn Olive AI winds down its operations and sells its assets. Ransomware attacks on healthcare organizations have cost the U-S economy more than $77 billion in downtime alone. And, new analysis from the Lown Institute finds that nearly a quarter of hospital stent procedures are unnecessary and drive up costs. That’s coming up on today’s episode of Gist Healthcare Dail...

The Department of Health and Human Services is proposing new penalties for providers that engage in information blocking. A new executive order from President Biden zeroes in on artificial intelligence, particularly in healthcare. And, pharmacists and workers at the nation’s largest pharmacy retail chains go on strike. That’s coming up on today’s episode of Gist Healthcare Daily. Ho...

The Department of Health and Human Services reverses its COVID-era 340B off-site clinic policy. The Biden Administration proposes an overhaul of the No Surprises Act’s independent dispute resolution process. And, the federal government will stop covering COVID drugs this week. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy for more in...

At this year’s HLTH conference in Las Vegas, Nevada, JC sat down with Sachin Jain , MD, CEO of SCAN Health Plan, a not-for-profit provider of Medicare Advantage plans based in Long Beach, California. They discuss SCAN’s planned merger with Care Oregon and broader competition in the MA market as well as the growing tension between providers and MA plans. Hosted on Acast. See acast.com/privacy for m...

Walmart expands a pilot benefit program that provides doula care for postpartum employees nationwide. CVS pulls some decongestants from shelves that were recently found to be ineffective. And, a new survey finds that healthcare is still unaffordable, even for those with insurance. That’s coming up on today’s episode of Gist Healthcare Daily. Hosted on Acast. See acast.com/privacy fo...

The CDC recommends rationing a RSV shot for babies due to shortages. The Senate HELP committee advances President Biden’s National Institutes of Health nominee, Dr. Monica Bertagnolli. And, a new survey finds that the number of healthcare workers experiencing workplace harassment doubled in 2022, and is negatively impacting their mental health. That’s coming up on today’s episode of Gist...