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Season 1 | Episode 59 - Oct 15, 2026

The Strategist in Brief: October 15, 2026

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.

Headshot of a smiling woman with long wavy dark hair, wearing a green sweater, standing outdoors in front of a brick building.

About Our Host

Anika Rasheed

Anika is a Senior Analyst on the Strategy Catalyst team.

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