The Strategy Catalyst Dispatch

The CY2027 OPPS proposed rule (340B cut, site-neutral imaging), Cassidy's 340B reform discussion draft, and Optum's negotiations to sell New York specialty practices from Crystal Run. 

This week's episode covers the House vote to defund the WISeR prior authorization pilot, Eli Lilly's 340B enforcement actions, Nebraska Medicine's National Quarantine Unit, and an HHS OIG report on Medicare Advantage prior auth denials. 

THMA-Tegria research finds 82% of systems call access a strategic pillar but most have trouble executing. We unpack the finance gap, post-acute blind spots, and the governance structures that separate progress from priority fog.

Resources mentioned in this episode:

• The Access-Driven Enterprise Report from THMA and Tegria
• THMA-Tegria webinar featuring executives from Emory, Sutter, and IU Health
• Access as a Strategic Product case studies and webinar
• Secret Shopping research webinars on urgent care and primary and specialty care access benchmarking

This week's episode covers proposed Medicaid payment caps, insights from chief physician executives, the medical student shortage, Eli Lilly's 340B ultimatum, and a court ruling on Medicare Advantage star ratings. 

This week's episode covers four hard truths shaping AI strategy for 2026, new CMS rules overhauling the ACA marketplaces, Q1 margin recovery, and a six-month moratorium on new home health and hospice enrollment. 

This week's episode covers Q1 hospital earnings, UnitedHealthcare's prior authorization rollback, the proposed CJR-X model, J-1 visa delays, and CMS's Medicaid revalidation push. 

We dig into how St. Charles Health System, a four-hospital not-for-profit in Central Oregon and the sole major provider across a 32,000-square-mile service area, went from seven Medicare Advantage payers down to one and then turned a twenty-year track record of clinical quality into a negotiating tool that cut cancer treatment authorization times from weeks to a single day.

Matt Swafford, CFO, and Mark Hallett, Chief Clinical Officer, walk us through the decision to terminate contracts with six national MA payers, how they used NCCN concordance rates to negotiate instant authorization with PacificSource, and the CFO-CCO partnership model that enabled it all.

This week's episode covers five big ideas from the Spring CSO Forum, CVS's new pharmacy-only stores, Amazon and Walmart's competing GLP-1 programs, Baylor Scott & White's health plan exit, and who's in and out of the CMS ACCESS model. 

This episode recaps three key themes from the 2026 Strategy Catalyst Summit: what it takes to move service line rationalization from theory to action, what a live scenario planning exercise revealed about strategic preparedness, and who should be owning the AI agenda.

Watch our highlight reel from the summit here. And for more on the content referenced in this episode, read our analysis in The Strategist here and check out our Stress Test Scenario Planning Guide here.  

This week's episode covers the finalized Medicare Advantage rate increase, new research on AI scribes, Anthropic's unreleased Claude Mythos model and cybersecurity implications, and MedPAC's findings on Medicare Advantage margins.