Physicians are facing a Medicare pay cut again in 2025 and are calling on Congress to fix the issue. Virtual mental health provider company Cerebral has reached an agreement with the federal government to pay fines tied to allegations that it overprescribed controlled substances, like Adderall. And, a smaller proportion of healthcare workers have received the latest COVID shot. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast. 

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Medicare’s largest accountable care program saved the federal government more than $2 billion dollars last year. CVS bucks the retail-healthcare contraction trend and announces expanded primary care services for its Aetna members at its MinuteClinic locations in certain markets. And, Cigna’s CEO brushes off Humana purchase rumors in a call to investors. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast. 

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A government watchdog finds that Medicare paid health insurers billions for what it says were questionable home diagnoses. UnitedHealth and home healthcare company Amedisys are reportedly appealing to regulators in an effort to finalize their proposed multi-billion-dollar merger. And, Novo Nordisk wants to block compounding pharmacies from creating Ozempic knockoffs. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast. 

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The Medicare Advantage market has seen unprecedented growth in recent years, with a majority of Medicare eligible beneficiaries enrolling in one of these privately administered plans in 2024. But over the past couple of years, the industry has experienced some growing pains—ranging from more regulatory scrutiny to higher costs associated with members utilizing more healthcare services.  

In the second half of their conversation, Joyjit Saha Choudhury, Managing Director of the Kaufman Hall’s Strategy and Business Transformation practice, joins host J. Carlisle Larsen to talk about the potential worst-case scenario for the market.  

You can find the first part of their conversation here. 

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The February cyberattack on Change Healthcare could have compromised the data of 100 million people, making it the largest healthcare data breach reported to the federal government. The Cleveland Clinic and Amazon to partner on primary care clinics in Ohio.  And, Senators want more information from Eli Lilly and Pfizer about their direct-to-consumer platforms. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast. 

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Cigna and Humana have reportedly resumed merger talks after abandoning plans late last year. Walgreens is looking at a healthcare future without VillageMD as a key component. And, Blue Cross Blue Shield will pay roughly $2.8 billion to settle a class action antitrust case brought by providers. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast. 

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Enrollment in Medicare Advantage plans surpassed 54 percent for the 2024 plan year, as more eligible seniors seek to take advantage of the privately administered health plans. Though MA plans have become increasingly popular, the industry has had some growing pains, ranging from increased regulatory pressures and higher consumer medical utilization. 

On today’s episode of the Gist Healthcare podcast, Joyjit Saha Choudhury joins host J. Carlisle Larsen to talk about his recent piece, Preparing for Medicare Advantage’s Make-or-Break Moment.  

The second part of their conversation will be available on Monday, October 28.

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UnitedHealth Group’s stock tumbles as it reveals a jump in medical costs hurt its 2025 profit outlook. More than 1,500 physicians call on the Trump campaign to release an outline of healthcare plans after the former-president said he wants to replace the Affordable Care Act. And, the Food and Drug Administration halts the clinical application of Novavax’s combination COVID-influenza shot, following a report of a significant reaction from a trial participant. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast. 

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Medicare Advantage star ratings drop for the 2025 plan year, as expected. Walgreens plans to close more stores as the company continues to right its finances. And, the largest maker of IV fluid in the United States looks to import fluid from abroad to mitigate a hurricane-related shortage. We’ll get that story—and more—coming up on today’s episode of the Gist Healthcare podcast. 

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