The Gist Healthcare Podcast

President Trump taps a White House health policy aide to lead the Food and Drug Administration. Health insurers denied at least 12% of prior authorization requests across all insurance markets last year. And a breakthrough vaccine could change how cancer is treated. Those stories on today’s episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

Fewer kindergartners were vaccinated during the last school year. A group of senators is calling on the Department of Health and Human Services to restore canceled patient safety grants. And Universal Health Services finalizes its acquisition of Talkspace. Listen to the latest episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

The Food and Drug Administration approves the first mRNA influenza vaccine. More than 20 Democratic attorneys general sue the federal government over Affordable Care Act marketplace changes. And HCA Healthcare expands its Texas footprint with a major urgent care acquisition. Listen to the latest episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

The Centers for Medicare and Medicaid Services finalizes Medicare hospital inpatient payment rates for fiscal year 2027. Two deaths in Michigan have been linked to the nationwide cyclospora outbreak. And a major pharmaceutical merger could be on the horizon. Listen to the latest episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

Improving patient access requires more than new processes. It also requires clinicians, administrators, and healthcare leaders to work toward a shared goal. In Part 2 of our conversation, Victor Hassid, MD,  Associate Vice President of Access Strategic Operations at MD Anderson Cancer Center, discusses how organizations can align teams, overcome operational challenges and begin putting a patient safety approach to access into practice.  You can listen to the first half of the conversation here.   You can find Dr. Hassid's article in JAMA here. (paywall)  Hosted on Acast. See acast.com/privacy for more information.

Humana will reduce its Medicare Advantage footprint again in 2027. The Centers for Medicare & Medicaid Services will end a Medicare Part D premium stabilization program. And the American Red Cross has declared a national blood supply crisis. Listen to the latest episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

No Surprises Act payment disputes continue to rise. Centene raises its full-year financial outlook after a strong second quarter. And the FDA selects the first participant in its digital health pilot program. Listen to these stories and more on today's episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

Healthcare organizations have spent decades working to improve patient safety, but those efforts have traditionally focused on what happens after a patient enters the healthcare system. Dr. Victor Hassid, Associate Vice President of Access Strategic Operations at MD Anderson Cancer Center, joins the podcast to discuss why he believes patient safety begins much earlier and why delays and breakdowns in access should be viewed through the lens of patient safety.  You can find Dr. Hassid's article here. (paywall)  Hosted on Acast. See acast.com/privacy for more information.

The Trump administration limits most student visa stays to four years, potentially affecting foreign medical students. New data show clinics and physician practices drove healthcare bankruptcies in the first half of the year. And confirmed U.S. measles cases have reached a new milestone. Listen to the latest episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

The Trump administration freezes $1 billion in Medicaid funding to California and Minnesota. The Senate blocks an effort to halt Medicare's AI prior authorization pilot. And Eli Lilly expands into the psychedelic drug market. Listen to these stories and more on today's episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

As healthcare affordability remains a top concern for voters, political messaging is taking shape ahead of the 2026 midterms. Michael McAuliff, politics and policy reporter for Modern Healthcare, joins host J. Carlisle Larsen to discuss how candidates are talking about Medicaid, Medicare for All, and other healthcare issues—and what to watch as the campaign season continues. Hosted on Acast. See acast.com/privacy for more information.

A bipartisan bill would tie Medicare physician reimbursement to inflation. A key Senate panel questions President Trump’s nominee to lead the CDC. And more adults are turning to AI for medical advice. Listen to the latest episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

On today's episode of The Gist Healthcare Podcast, Michigan officials narrow the search for the source of a large Cyclospora outbreak, new CMS data show ACO REACH generated nearly $1 billion in net savings to Medicare in 2024, and a new survey finds clinicians continue to face barriers to using data from consumer wearable devices. Hosted on Acast. See acast.com/privacy for more information.

Ascension completes its multibillion-dollar acquisition of ambulatory surgery center operator AmSurg, physician associates sue the Trump administration over federal student loan changes, and nearly one in five privately insured adults faced a coverage denial last year on today’s episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

The Trump administration advances Medicaid work requirement rules, a new report warns hundreds of rural hospitals are at risk of closure, and CVS Health adds Eli Lilly’s weight loss drugs back to its formulary. Those stories and more on today’s episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

The American Hospital Association and West Health Institute have launched a national accelerator focused on helping hospitals scale technology-enabled care solutions.    The initiative will focus on electronic health record optimization, virtual care, and AI integration as health systems work to reduce administrative burden and improve care delivery.   On today’s episode, the AHA’s Chief Physician Executive and Senior Vice President Chris DeRienzo, M.D., returns to the show. We examine what the accelerator could mean for health systems navigating clinician burnout, administrative burden, and growing pressure to modernize care delivery. You can find more information about the program at nationalaccelerator.org. Hosted on Acast. See acast.com/privacy for more information.

On today’s The Gist Healthcare Podcast: a Texas judge dismisses a payer lawsuit against HaloMD, Eli Lilly reports strong results for its next-generation weight loss drug and new research links greater nurse responsibility to higher retention. Hosted on Acast. See acast.com/privacy for more information.

The Trump administration finalizes sweeping changes to the Affordable Care Act marketplaces, HHS launches a new AI-powered fraud audit program, and Providence plans to scale back most of its health plan offerings next year. Those stories and more on today’s episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

On today’s episode of The Gist Healthcare Podcast: health systems join a new federal initiative aimed at streamlining prior authorizations, lawmakers revive legislation that would ban PBMs from owning retail pharmacies, and a judge clears the way for CVS Health to sell its long-term care pharmacy business. Hosted on Acast. See acast.com/privacy for more information.

Medicare pauses home health and hospice enrollment over fraud concerns, a congressional advisory committee calls for more oversight of AI prior authorization in Medicaid, and drug overdose deaths fell for the third year in a row. Coming up on today’s episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

Dr. Marty Makary is out as FDA commissioner. Sanford Health plans to merge with Minnesota-based North Memorial Health. And healthcare added the most jobs in April. Coming up on today’s episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

Today on The Gist Healthcare Podcast: California hospitals sue Anthem, Leapfrog reports patient safety gains, and a study links post-surgery walking to better outcomes. Hosted on Acast. See acast.com/privacy for more information.

Pennsylvania sues an AI company, alleging its chatbots posed as licensed medical providers. Two North Carolina nonprofit health systems plan to merge. And the American Hospital Association is partnering with West Health to expand hospital technology adoption. Those stories and more on today’s episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

Coming up on The Gist Healthcare Podcast: UnitedHealthcare cuts prior authorizations by 30 percent. Healthcare bankruptcies rise in the first quarter. The Trump administration names a new Surgeon General. Hosted on Acast. See acast.com/privacy for more information.

Artificial intelligence in healthcare is already being used in practice—but those tools aren’t perfect.   In the final part of a three-part series, host J. Carlisle Larsen continues her conversation with Dr. Robert Wachter, Chair of the Department of Medicine at the University of California, San Francisco and author of A Giant Leap: How AI Is Transforming Healthcare and What That Means for Our Future.   As these tools move into wider use, Wachter explains how their limitations show up in real-world settings—from questions about reliability to how they’re used by clinicians and patients.   The conversation examines what happens when imperfect systems are used in higher-stakes environments, and what that means for how AI is adopted going forward.  You can listen to Part 1 here. And Part 2 here.   Hosted on Acast. See acast.com/privacy for more information.

CMS to require state audits of Medicaid providers, the Trump administration plans faster Medicare coverage for breakthrough devices, and a new survey shows physician burnout declining, on today’s episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

UnitedHealthcare eliminates a majority of prior authorizations for rural providers, the White House taps a new CDC director, and Michigan lowers the measles vaccine age in some counties, coming up on today’s episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

Artificial intelligence in healthcare is often discussed in terms of what it might do. But, in some areas, it’s already being put to use. In Part 2 of a three-part series, host J. Carlisle Larsen continues her conversation with Dr. Robert Wachter, Chair of the Department of Medicine at the University of California, San Francisco and author of A Giant Leap: How AI Is Transforming Healthcare and What That Means for Our Future. This episode focuses on AI scribes—one of the first use cases gaining traction across health systems—and what they reveal about how this technology is being adopted in practice. Wachter explains why scribes have emerged as an early success and what they signal about where AI may go next. You can listen to the first half of the conversation here.   Hosted on Acast. See acast.com/privacy for more information.

New drug prior authorization rules are under consideration, physician pay rose slightly in 2025, and proposed legislation would count direct-to-consumer drug purchases toward deductibles. Those stories and more on today’s episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

Medicare inpatient pay edges up, measles cases top 1,700, and vaccine confidence slips, on today’s episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

Artificial intelligence is being positioned as the next major transformation in healthcare, but the industry has seen similar waves of technological change before.   In Part 1 of a three-part series, host J. Carlisle Larsen speaks with Robert Wachter, M.D., Chair of the Department of Medicine at University of California-San Francisco and author of A Giant Leap: How AI Is Transforming Healthcare and What That Means for Our Future, about how to understand this moment in AI.   Drawing on lessons from the rollout of electronic health records, Wachter explains why previous efforts to digitize healthcare often fell short of expectations and what may be different this time.  Hosted on Acast. See acast.com/privacy for more information.

Jefferson Health sues Aetna over a so-called Medicare Advantage "down coding" policy, CMS raises MA rates next year, and healthcare affordability tops domestic concerns, on today’s episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

The White House proposes a 12% cut to HHS, insurers report further reductions in prior authorization, and a new study links AI scribes to modest documentation time savings, on today’s episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

Advanced practice providers are a growing part of the healthcare workforce, but many organizations aren’t necessarily seeing the productivity gains they expected. On today’s episode, we examine new Kaufman Hall insights on why traditional physician-APP models often underperform, and how redesigning team roles, incentives, and compensation could yield better outcomes for clinicians and patients alike. Bonnie Proulx, DNP, APRN, PNP-BC, FAAN, Senior Vice President with Kaufman Hall and a member of the firm’s Physician Enterprise practice, joins the podcast to explain more.   You can read Bonnie’s blog post here.   This interview first aired on Monday, January 26, 2026.   Hosted on Acast. See acast.com/privacy for more information.

HHS forms a new healthcare advisory committee, the FDA approves Eli Lilly’s oral weight loss pill, and a Senate bill targets insulin price caps in private plans, those stories and more coming up on The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

HHS tightens hospital nutrition standards, ACA marketplace enrollment dips 5 percent, and one in three people turn to AI chatbots for health questions, on today’s episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

As healthcare organizations respond to the cyberattack on Stryker, the focus is shifting from what happened to how decisions are made in the moment. Gist Healthcare Podcast host J. Carlisle Larsen speaks with Phil Englert of Health-ISAC about navigating uncertainty during an incident, how these events shape perceptions of medical device risk, and what it takes for organizations to coordinate under pressure.  You can listen to the first half of the conversation here.   Hosted on Acast. See acast.com/privacy for more information.

CVS Health reaches a proposed insulin pricing settlement with the Federal Trade Commission. The Trump administration misses a deadline to name a new director of the Centers for Disease Control and Prevention. And a new study finds sepsis is linked to 18 percent of pediatric hospital deaths. Those stories coming up on today’s episode of the Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

In this episode of The Gist Healthcare Podcast, the Federal Trade Commission launches a new healthcare taskforce, CMS advances efforts to move away from fax and mailed claims, and new data shows coverage gaps for some ACA marketplace enrollees. Hosted on Acast. See acast.com/privacy for more information.

A cyberattack on Stryker disrupted operations across one of the largest medical device companies in the world, affecting ordering, manufacturing, and shipping and prompting hospitals to assess potential impacts.   Unlike most healthcare cyber incidents, this was not a typical ransomware attack. In this episode, Gist Healthcare Podcast host J. Carlisle Larsen speaks with Phil Englert of Health-ISAC about what made the incident unusual and what it reveals about how healthcare organizations may need to rethink their response when an attack is focused on disruption rather than payment.  Hosted on Acast. See acast.com/privacy for more information.

Sutter Health and Allina Health announce plans to merge. The Leapfrog Group will remove hundreds of hospital safety grades following the Tenet Healthcare decision. And a new survey finds physicians are concerned about the accuracy of AI tools. Those stories and more—coming up on today’s episode of the Gist Healthcare podcast. Hosted on Acast. See acast.com/privacy for more information.

A judge blocks recent changes to federal vaccine policy, a new report finds oversight could reduce Medicare Advantage overpayments, and a cyberattack disrupts Stryker’s ordering system. These stories and more on today’s episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

Healthcare policy has taken a back seat on Capitol Hill so far in 2026, as lawmakers focus on other matters. But several issues are still unfolding, including Medicaid work requirements, a potential Surgeon General confirmation battle, and policy proposals that could advance or stall as Congress heads toward the midterms. Michael McAuliff, who covers politics and policy in Washington, D.C. for Modern Healthcare, joins host J. Carlisle Larsen to break down what to watch.  Hosted on Acast. See acast.com/privacy for more information.

A cyberattack tied to Iranian hackers hits a large medical device manufacturer. A new analysis links Medicare Advantage overpayments to higher premiums for seniors. And CVS Health partners with Google on a new consumer health engagement platform. That's coming up on today's episode of the Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

In this episode of The Gist Healthcare Podcast, we cover the FDA’s top vaccine official stepping down, a federal ruling involving Leapfrog and Tenet hospitals, and a new agreement between Novo Nordisk and Hims and Hers. Hosted on Acast. See acast.com/privacy for more information.

As reimbursement levels shift under site-neutral payment, health systems must move from strategy to execution. On today's episode of the Gist Healthcare Podcast, we hear the second part of host J. Carlisle Larsen’s conversation Kaufman Hall Managing Director Joyjit Choudhury about what cost restructuring looks like in practice. That includes rethinking business and operating models, integrating site-neutral planning into broader enterprise strategy and aligning finance, operations and clinical leadership around a sustainable path forward. Be sure to check out Joyjit's recent blog about this topic. You can find the first part of our conversation here. Hosted on Acast. See acast.com/privacy for more information.

Amazon introduces a new agentic AI tool designed for healthcare. States signal plans to invest Rural Health Transformation Fund grants in value-based care initiatives. And Eli Lilly launches a direct-to-employer platform for weight loss drugs. That's coming up on today's episode of the Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

Elevance Health’s Medicare Advantage plans face federal sanctions. The University of Mississippi Medical Center clinics reopen after a ransomware attack. And the FDA warns telehealth companies about marketing compounded weight loss drugs. That's coming up on today’s episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.

Site-neutral payment is shifting from policy debate to operational reality. With drug administration services now included in the Medicare 2026 final rule and additional changes potentially ahead, health systems face growing uncertainty around reimbursement, site-of-care strategy and margin impact.  In this two-part conversation, Gist Healthcare Podcast host J. Carlisle Larsen speaks with Joyjit Choudhury, Managing Director with Kaufman Hall in the firm’s Strategy and Business Transformation practice, about his recent blog piece examining site-neutral payments and how hospitals and health systems can build a plan amid uncertainty.   Hosted on Acast. See acast.com/privacy for more information.

President Trump highlights healthcare reforms in this year’s State of the Union. Fifteen states sue HHS over changes to the federal childhood vaccine schedule. And Medicare Advantage margins outperform other lines of business in 2024. Listen to the latest episode of The Gist Healthcare Podcast. Hosted on Acast. See acast.com/privacy for more information.