Episode Description
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Health system leaders at The Health Management Academy’s Fall 2026 CEO Forum discussed the policy pressures and financial realities that are forcing systems to rethink business as usual.
Affordability was a major theme. CEOs discussed how policymakers sometimes frame the debate around the price of a single service, not the total cost of care.
Limited ED and inpatient bed capacity is pushing some systems to make greater use of value-based care strategies. Mandatory CMS payment models and direct-to-employer offerings are accelerating the trend.
CEOs worry that stacking too many AI point solutions will make overall workflows less efficient, even if each individual use case has a positive return on investment.
Labor costs are pushing systems to reimagine how care is delivered, but CEOs say culture and clinician training remain major obstacles.
HRSA named ten drugmakers and 21 high-cost drugs for its reworked 340B rebate pilot, set to launch January 1. Drugs eligible for the pilot account for less than 5.5% of 340B purchases, but a successful rollout could pave the way for a broader shift away from upfront discounts.
The AHA and other provider groups have once again sued to block the pilot, arguing annual administrative costs could top $1B, nearly double HRSA’s $537M estimate.
In other 340B news, a growing number of health systems are suing CVS, alleging the company withheld nearly $300M in 340B savings.
Five Democratic governors asked HHS to delay the January 1 deadline for Medicaid work requirements, citing new frailty definitions and verification rules that states say they can’t implement in time.
Medicaid coverage losses will build gradually through 2027, with a different timeline in each state depending on the specifics of implementation.
This week’s featured graphic tracks the recovery in health system operating margins, with new data from Strata Decision Technology.
After dipping below zero early in the year, the median health system margin climbed to 0.7% in June. That’s still below the 1.0%–1.5% range seen throughout much of the second half of 2025.

About Our Host
Anika Rasheed
Anika is a Senior Analyst on the Strategy Catalyst team.