Insights

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In this episode of The Strategy Catalyst Dispatch, Ricky Bloomfield, MD, Chief Medical Officer at Oura, walks us through the company's partnership with Counsel Health, which connects Oura members to a board-certified physician asynchronously without leaving the app. We cover what Oura was seeing in consumer behavior that pulled the company toward care delivery, why they built the experience around messaging rather than video visits, and Dr. Bloomfield's perspective on how consumers are actually using AI in their own health.

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• This week’s edition offers four predictions about payer mix headwinds, 340B rebates, cybersecurity, and clinical AI.

  • Prediction #1: The ACA Exchange-driven payer-mix hit will keep deepening through H2 2026, and the for-profits' full-year guidance marks the trajectory the rest of the sector is on.

    • Our Call: The H2 2026 self-pay and bad-debt hit could land harder than mid-year budgets assume. The question is whether it's in your FY2027 budget or discovered against it.

  • Prediction #2: By the end of 2026, more drug manufacturers will tie 340B pricing to their own claims-data mandates and enforce by withholding discounts. HRSA will not force a reversal of those policies.

    • Our Call: Health systems betting on a federal rescue from manufacturers’ claims-data mandates are likely to be disappointed. Regardless of whether it’s a drug manufacturer-led process or federal program, hospitals will end up submitting claims data to access discounts they are statutorily owed.

  • Prediction #3: The debate over the HIPAA Security Rule is a distraction from a more urgent reality: AI is about to enable vulnerability discovery and cyberattacks at a scale that health systems simply aren't ready for.

    • Our Call: New AI tools are creating a radically new cybersecurity world. Vulnerability discovery is scaling rapidly, while healthcare remains constrained by its ability to deploy fixes across complex clinical environments. By year-end, the board's cybersecurity question will be, "Of the vulnerabilities we've identified, how quickly can we remediate them? What is the plan for the ones we can't?"

  • Prediction #4: OpenEvidence will add 3+ health system deployments by year-end while staying ad-supported and selective about which terms it agrees to.

    • Our Call: Clinicians aren't waiting for those deals. The individual-clinician Business Associate Agreements leave the system holding the liability while the vendor keeps the ad revenue. Every health system should make a deliberate choice: pursue enterprise integration, stand up a governed alternative (e.g., UpToDate, Doximity), or establish formal guardrails for continued use.

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In this episode of The Strategy Catalyst Dispatch, Shoeb Sitafalwalla, Senior Executive Vice President and Chief Strategy Officer at Advocate Health, walks us through care model engineering, Advocate's approach to designing care models with a product lens across one of the largest health systems in the country. We cover how a post-merger discovery process led his team to rethink what a health system's core product actually is, what it looks like to run care models through a product pipeline with stage gates and a 100,000-patient pilot minimum, and how the reusable architecture they've built took them from a 10-month first product to launching every three to four weeks.

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• This week’s Key Market Dive explores Amazon’s evolving strategy for One Medical and its referral partnerships with health systems.

  • While One Medical’s finances haven’t been publicly reported since the Amazon acquisition, health system partnerships accounted for 25% of the primary care chain’s revenue in 2022.

  • After a slow start in some markets, One Medical is now generating a growing volume of referrals for its health system partners.

  • One Medical is exploring deeper integrations with its health system partners, such as a new clinic located inside one of Montefiore Health System’s largest outpatient facilities.

    • The co-located clinic could facilitate joint and same-day appointments across specialties and might help Montefiore lock in its referral partnership with One Medical.

  • While One Medical has slowed expansion into new markets, Amazon is using the primary care business as a platform for a growing suite of pharmacy, AI, and telehealth offerings.

• This week’s featured graphic showcases a recent survey by Medscape exploring which medical specialties are the happiest and most sustainable.

  • Doctors in specialties with predictable schedules (like dermatology) are happier than doctors in fields with unpredictable schedules and higher acuity (like emergency medicine).

  • To improve retention, health systems need to rethink how work is structured and how tools like AI can be used to reduce tedious administrative work.

• HHS is delaying a proposed update to the HIPAA Security Rule that would tighten cybersecurity requirements.

  • The agency received nearly 5,000 comments—including many from health systems and provider advocates calling for the rule to be withdrawn, citing compliance burdens and unreasonable timelines.

  • The delay gives providers until July 2027 to prepare, but HHS is unlikely to abandon the rule altogether.

  • Health systems are caught between two competing priorities for HIPAA reform: making health information more shareable and accessible, and protecting it from cyberattacks.

This data-driven webinar session translates direct intelligence gathered from 50+ health system leaders into actionable strategy for industry partners — exploring what's actually shaping AI purchasing decisions in health systems right now and how vendors can engage more effectively. Hosted by Thomas Seay, Executive Director of AI Catalyst at The Health Management Academy, and moderator Terrell Sultzer, the session cuts through the noise to examine the real pressures, tradeoffs, and governance dynamics influencing how health systems evaluate and buy AI solutions. It's designed specifically for VP- and C-suite-level commercial, sales, and strategy roles at healthcare technology, life sciences, and services companies.

The Executive Insights Hub is THMA's dedicated research and data center, built to keep industry teams current on healthcare market trends and health system CXO priorities. In this orientation, we walk through everything your membership unlocks — the specific deliverables, tools, and services at your disposal — so you and your team can get the most out of your access.

Logged-in members have access to the full orientation and can start exploring everything their membership unlocks.

Federal Medicaid cuts under H.R.1 and expiring ACA subsidies are expected to add $278 billion in uncompensated care over the next decade, and rural hospitals will absorb a disproportionate share of it. Although Congress introduced $50 billion in Rural Health Transformation Program (RHTP) funding to offset these impacts, estimates show that this money will do little to close that gap. With an uptick in rural hospital closures looming closer, health systems have a window of opportunity to support rural care ecosystems before access challenges compound.

A recent virtual workshop co-hosted by Philips and the Health Impact Alliance brought together 16 health system leaders and 5 industry leaders to discuss one unanswered question: What is actually required to drive sustainable rural health transformation? Workshop participants heard from Madeline Cree, MPH (Associate Director, The Academy Advisors), Dr. Bill Beninati, MD, FCCM (Chief Medical Officer, Virtual Hospital, Intermountain Health), and Mike Lemnitzer (VP, State Government Healthcare, Philips) to explore Rural Health Transformation Program (RHTP) implementation and case studies highlighting Intermountain’s non-extractive “hub-and-spoke” model and Philips’ rural-focused health system partnerships addressing barriers to healthcare access.

Physical therapy has long been treated as a downstream service within the health system— a place patients land after the surgical decision is made. But in a market where well-capitalized competitors are intercepting orthopedic patients before they ever reach a health system, that framing is no longer financially neutral. It represents a measurable leak in volume, market share, and margin.

For executives navigating capital constraints and aggressive ambulatory competition, outpatient PT is an underleveraged strategic asset. When positioned as a consumer-facing access point — in retail corridors, community-dense locations, and high-traffic settings — PT captures patients earlier in the care journey, shapes clinical pathways before a competitor does, and drives referral flow back into high-margin orthopedic services. The build vs. partner calculus, the governance structures that make the model work, and the return on ambulatory access investment are the questions this session is designed to answer.