Healthcare Payers / Providers

CMS’s Friday release of the CY26 Advance Notice (AN) for Medicare Advantage (MA) insurers [HUM, UNH, CVS, ELV, ALHC, CLOV, CNC] came in better than our net YoY benchmark expectations with a proposed net increase…

With a handful of healthcare provider and insurance companies headed to San Francisco next week for a key investor conference, below we provide a set of significant policy-related questions we would like to see management teams address…

Following Tuesday night’s release of a short-term continuing resolution (CR) funding the government through March 14, we outline some key differences from previously-reported iterations of the healthcare extenders package, involving PBMs [CI, CVS, UNH, ELV],…

While Republicans and Democrats are trying to hash out a healthcare extenders package to add to a short-term government funding measure that needs to be taken up and passed by next Friday, we ascribe just…

Key Takeaways:  While we had expected pharmacy benefit managers [PBMs] to remain in the legislative / regulatory crosshairs during the lame duck and into the Trump administration, recent developments confirm that the anti-PBM sentiment is…

This morning, the Supreme Court (SCOTUS) afforded a win to state laws protecting the use of contract retail, mail-order and specialty pharmacies (WBA, CVS, WMT, UNH, CI, RAD) that arehired by 340B hospitals and clinics…

KEY TAKEAWAYS: We expect the proposed YoY change in the CY26 benchmarks for Medicare Advantage (MA) plans is likely to be relatively flat, with a range between -1% and +1% that excludes coding trend, but…

We could see some short-term positive news for retail, mail-order and specialty pharmacies (WBA, CVS, WMT, UNH, CI) if the Supreme Court decides not to hear the appeal of PhRMA v. McClain, a development that…

Key Takeaways: The risk overhang from potential Medicaid reforms to managed care organizations, hospitals, behavioral facilities, and other providers focused on these low-income enrollees will likely grow as the Trump administration staffs up and Congress…

President Trump’s surprise and unorthodox nomination of Dr. Mehmet Oz to be CMS administrator, whom we presume will likely be confirmed, affords somewhat of a blank slate for others in the administration to fill in…