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The U.S. healthcare system is approaching a major inflection point. Nearly $1 trillion in Medicaid cuts are set to take effect in January 2027, driven by new work requirements, more frequent eligibility checks, and tighter limits on state financing. While the policy changes are months away, their consequences are already clear: millions of Americans are at risk of losing coverage, and provider organizations — many operating on margins near zero — will absorb the downstream impact through rising uncompensated care. In this episode, hosts Rae Woods and Abby Burns are joined by former Optum Executive Director of Product and Strategy Sunay Shah to help healthcare leaders move from “scramble” to strategy. Drawing on lessons from past Medicaid shifts, including redeterminations and state level work requirement experiments, they explain why administrative disenrollment —not ineligibility — is the biggest threat facing patients and providers alike. Together, they break down what health systems can do now to keep eligible patients covered: redesigning workflows earlier in the patient journey, using technology more thoughtfully, partnering with community organizations, state agencies, and operational support partners, and rebuilding trust with patients during moments of vulnerability. We’re here to help: Episode | 288: Health policy update: VBC, site-neutral payments, and 340B Playlist | Radio Advisory health policy playlist Ready-to-Use Resource | Your guide to CMMI’s 25+ innovation models Expert Insight | How policy changes will impact your bottom line White Paper | Navigating the next era of Medicaid On-Demand Webinar | Adapting to the changes in Medicaid policies Want to learn more about how Optum can help? Connect with our team today Register today for the 2026 Advisory Board Summit in Washington, D.C. 2026 State of Healthcare Procurement: Cost, Quality, Resilience A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

In this bonus episode of Radio Advisory, managing producer Chris Phelps and host and executive producer Rae Woods compare notes from the 2026 ViVE digital health conference. They break down what stood out on the main stage and the show floor—from where AI is over and under hyped, to why point solutions keep falling short, to what it actually takes to scale technology in healthcare. They also surface the big questions they still have about the healthcare industry’s digital future. We’re here to help: Podcast | Ep. 294: Live from ViVE: How payers can reduce friction when the rules change Podcast | 276: The AI gold rush is changing how humans (and clinicians) make decisions Research | How to succeed using AI: Lessons from 4 leading organizations Expert Insight | Inside CMS' final rule changes for 2026 Podcast | Ep. 205: Live from ViVE 2024: Four leaders on how technology is redefining clinical work A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

Payers are operating at the center of converging pressures: rising costs, accelerating utilization, heightened public scrutiny, and a wave of CMS reforms that are reshaping expectations around transparency, interoperability, prior authorization, and accountability. Medicare Advantage has become the front line for these shifts—exposing tensions between regulatory oversight, margin compression, and growing demands for better member and provider experiences. Against this backdrop, health plans are being asked to do more with less—while proving real value through measurable outcomes, trust, and access. In this episode, recorded in February at the ViVE digital health and healthcare innovation conference, Rae Woods moderates a conversation with payer and technology leaders on how AI and data are being used to reduce payer–provider friction, rethink prior authorization, and improve the member experience—without losing sight of accountability or return on investment. Panelists include: Ali Khan, MD, Chief Medical Officer, Medicare at Aetna (a CVS company) Kay Judge, MD, Chief Medical Officer, Medicare at Blue Shield of California Syed Mohiuddin, MD, Head of Healthcare, Anthropic We’re here to help: Podcast | 276: The AI gold rush is changing how humans (and clinicians) make decisions Research | How to succeed using AI: Lessons from 4 leading organizations Expert Insight | Inside CMS' final rule changes for 2026 Learn more about the ViVE conference Register today for the 2026 Advisory Board Summit in Washington, D.C. Updating COVID-19 management protocols may help address long-term impacts A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

Academic medical centers (AMCs) sit at the heart of U.S. healthcare, driving scientific discovery, providing crucial clinical care, and training the next generation of clinicians. They also face mounting financial pressures and a shifting policy landscape that threatens their ability to sustainably deliver on this tripartite mission. And their complex structures make rapid business model transformation tough — at a time when it has become essential for survival. In this episode, host Abby Burns invites Advisory Board expert Wes Campbell to provide an update on how AMCs are doing amidst the current climate, unpack how and why policy shifts hit AMCs differently than their non-academic peers, and discuss what it will take for AMCs to adapt. We’re here to help: Listen | 285: How Rush University Medical Center is closing the 'death gap' Listen | 264: Research funding is being slashed. What’s the real industry impact? Read | How research funding cuts are impacting healthcare (and how to respond) Use our tool | How policy changes will impact your bottom line Check out | Advisory Board resources on Philanthropy Register today for the 2026 Advisory Board Summit in Washington, D.C. A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

Employer-sponsored insurance is reaching a tipping point. What was once a predictable 2–4% annual increase in employer health spending has given way to double digit growth, driven by surging drug costs, rising utilization across all age groups, and escalating provider rates. For many employers—especially smaller organizations with less margin for error—absorbing these costs is no longer viable. As economic conditions shift and the labor market cools, the balance of power between employers and employees is changing, opening the door to more aggressive cost-control strategies. In this episode, host Rachel (Rae) Woods is joined by Advisory Board expert Sally Kim to unpack what’s behind the spike in employer health costs—and what employers are doing about it. They walk through the full “menu” of options now on the table, from benefit redesign and navigation tools to network strategy, direct contracting, and alternative funding models. The conversation explores what these moves mean for health plans and providers competing for commercial lives—and why understanding employer behavior is no longer optional. We’re here to help: Ready-to-Use Slides | Market outlook for employer-sponsored insurance Listen | Ep. 232: The rise of ICHRAs: Why some employers are turning to the individual market Listen | Ep. 286: A Medicare Advantage reset — and what comes next Expert Insight | How employers are combating the ‘new normal’ for benefits costs with unconventional measures How UT Southwestern closed genomic testing gaps in prostate cancer care A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

For life sciences companies, access and adoption of clinical products is no longer as simple as demonstrating strong outcomes at a fair price. As payers and providers face mounting financial pressure and operational complexity, they are scrutinizing their partners more closely — expecting clearer evidence, more relevant value narratives, and support that reflects real world constraints. In this episode, host Rachel (Rae) Woods sits down with Advisory Board experts Gina Lohr and Nick Hula to unpack how med tech and pharma companies should adapt their product and partnership strategies. Together, they explore why a single value story no longer works — and how life sciences organizations can better align their products, evidence, and engagement strategies to meet the rising expectations of payers, health systems, ambulatory leaders, clinicians, and patients. We’re here to help: Expert insight | The top 5 trends impacting med tech strategies in 2026 Expert insight | 5 trends shaping pharma strategy for 2026 (and how to adapt) Podcast | Ep. 242: How you should rethink your life sciences-health system partnerships How Highlands Oncology expanded access to oral oncolytics treatment A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

As health systems pursue growth beyond traditional avenues, the role of the strategic planner is becoming increasingly complex. High level directional data is no longer enough — achieving meaningful, differentiated growth now requires leveraging granular, sophisticated data to inform investment decisions. In this episode, host Rachel Woods sits down with Advisory Board experts Sebastian Beckman and Ellie Wiles to explore how health systems can rethink strategic planning for 2026 and beyond. Together, they unpack what it should actually look like to democratize data, why data governance matters just as much as data access, and how service line leaders can partner with planners to make faster, more precise, margin savvy decisions. We’re here to help: Podcast | 289: What are health systems doing in 2026? Results from our survey are in. Playlist | Radio Advisory Provider Strategy and Financial Outlook Playlist Case Study | How UT Southwestern closed genomic testing gaps in prostate cancer care ICYMI: Webinar | The top 10 trends impacting health systems in 2026 Tools | Check out Advisory Board’s Market Scenario Planner and other Advisory Board analytics and data tools to inform your strategy for growth, cost control and more. Comprehensive women’s healthcare: Redefining the standard of care A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

How did health systems perform in 2025, and which strategic growth priorities are top-of-mind for 2026? Health systems have entered the year with both momentum from buoyed volumes, and mounting pressure as those volumes don’t necessarily translate to healthy margin. This week, host Abby Burns sits down with Advisory Board expert Marisa Nives and Optum consulting expert Alex Kist to unpack results from Advisory Board’s annual Strategic Planner Survey. They explore how health systems are—and aren’t—running at growth, and what separates the systems that are able to turn volumes and revenue into margin, from those that aren’t. Be sure to catch next week’s episode, when Advisory Board experts discuss the data that planners need (and often lack) to make these strategic decisions with confidence in 2026. We’re here to help: Webinar | The 5 growth levers to help make your health system stronger (not just bigger) ICYMI: Webinar | The top 10 trends impacting health systems in 2026 Report | 6 ways to reduce referral leakage from primary to specialty care Report | 3 ways to pursue differentiated growth for your service lines Episode | Ep. 225: Patients are back – so why aren't hospital margins? Playlist | Radio Advisory Provider Strategy and Financial Outlook playlist Expert Insight | 3 trends shaping healthcare in 2026 (and how to respond) Connect with an Optum expert | https://optum.co/3vrzyw Real-time transparency infographic A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

After a turbulent 2025, the early months of 2026 are proving that the policy landscape isn’t quieting down. Federal agencies are rolling out new payment models, lawmakers are revisiting long debated rules, and courts continue to shape what policies move forward and which stall. From value based payment to drug pricing and site of care policy, leaders are navigating a fast shifting environment with real implications for finances, operations, and long term strategy. In this episode, host Abby Burns invites three Advisory Board experts to break down the major policy forces that leaders need to watch now: [1:35] Clare Wirth explains the newest wave of value based payment models out of CMMI, and what they signal about this administration’s posture toward value-based care. [10:20] Nick Hula explores how site neutral payments, the return of inpatient only list changes, and state level certificate of need laws could accelerate site of care shifts. [20:51] Chloe Bakst unpacks the chaos surrounding 340B — from the halted rebate pilot to impacts of HR1 and emerging state reporting requirements — and the decisions leaders must make today to prepare for what’s coming next. We’re here to help: Webinar | How to be successful under TEAM Cheat sheet | 340B Drug Pricing Program Ready-to-Use Resource | Policy Scenario Impact Calculator Expert Insight | How policy changes will impact your bottom line Expert Insight | Inside CMS' final rule changes for 2026 Stay Informed | Healthcare Policy Updates Timeline Radio Advisory’s Health Policy playlist Webinar | Join Optum Advisory experts at this upcoming webinar to learn how optimizing patient access unlocks the value of digital innovations and drives long-term sustainability A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

Infusion services make up a roughly $150 billion market in the U.S., and underpin the financial stability of major service lines, especially oncology. Historically, health systems have enjoyed strong volumes, favorable reimbursement, and access to 340B discounts that keep their infusion business profitable. But rising competition, payer and employer driven site of care shifts, and looming policy changes are putting pressure on what many leaders have relied on as a stable, margin accretive business. In this episode, host Abby Burns sits down with Advisory Board expert Chloe Bakst to break down what’s actually happening in the infusion market — and why every health system leader should be paying closer attention. Together, they explore how new competitors are capturing leakage you may not even see, how payers and employers are steering patients away from hospital outpatient departments, and how upcoming 340B reforms and Medicare drug price negotiations could reshape the economics of infusion over the next three years. Chloe also shares the strategies forward thinking systems are using to protect their infusion business and prepare for rapidly emerging headwinds. We’re here to help: Webinar | The top trends in today’s infusion market Tool | Market Scenario Planner Ready-to-Use Resource | Policy Scenario Impact Calculator Expert Insight | The 3 trends reshaping the specialty drug pipeline today Podcast | 270: Service line snapshot: What every health leader needs to know Webinar | Join Optum Advisory experts at this upcoming webinar to learn how optimizing patient access unlocks the value of digital innovations and drives long-term sustainability. Expert Insight | How data-driven risk reduction protects patients and providers A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

Once a high growth, high margin line of business for health plans, Medicare Advantage (MA) is now in the middle of a financial reset. Growth has slowed, margins have turned negative, and federal financial support is eroding — with CMS proposing a near flat reimbursement increase for 2027. As a result, plans are exiting markets, tightening benefit designs, and shifting their focus toward Special Needs Plans (SNPs). At the same time, seniors are facing rising costs, fewer perks, and more frequent plan changes. To cut through the noise and understand what’s really happening beneath the headlines, host Rachel (Rae) Woods speaks with Advisory Board experts Sally Kim and Aaron Hill about the new divide emerging in MA: between plans equipped to manage the intensive needs of high cost seniors and execute on SNP strategies — and those that will be forced to exit markets or rethink their MA ambitions entirely. Listen as they break down how MA’s financial and clinical headwinds are reshaping payer–provider relationships — and why future success depends on disciplined focus, deeper provider partnerships, and new investments in technology and cross benefit management. We’re here to help: Tool | Medicare Market Explorer Webinar | Medicare Advantage: Insights on today’s more competitive market Webinar | Medicare Advantage: The latest on product design and growth Podcast | Ep. 227: The changing tide of Medicare Advantage Expert Insight | 3 data-driven insights on Medicare Advantage Star Ratings Ready-to-Use Slides | Medicare Advantage market outlook 2026 Advisory Board Summit Washington, D.C. A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

As financial pressure mounts and the healthcare safety net continues to strain, academic medical centers are drawing on their culture of innovation to pursue better outcomes — and narrow life expectancy gaps in the communities they serve. In this episode of Radio Advisory, host Rae Woods sits down with leaders from Rush University Medical Center to explore how health systems can stay focused on results amid tightening margins, political scrutiny, and ongoing uncertainty in grant funding. Dr. Omar Lateef, President and CEO of Rush, and Dr. David Ansell, Senior Vice President for Community Health Equity, describe how Rush treats gap-reduction as a long-term operating strategy rather than a moral or messaging exercise. They share practical examples of how local partnerships, targeted investments, and day-to-day operational choices can improve outcomes while still making financial sense — and why avoiding battles over language helps keep the focus squarely on results. We’re here to help: How Rush University Medical Center is addressing the root causes of social determinants of health 264: Research funding is being slashed. What’s the real industry impact? How research funding cuts are impacting healthcare (and how to respond) 12 things CEOs need to know in 2026 Healthcare Policy Updates Timeline Tool: How policy changes will impact your bottom line Who gets the chance to be healthy? | Rush The Rush Center for Community Well-Being at Sankofa Wellness Village | Rush Health disparities in Chicago and the work to solve them with Rush University Medical Center (AMA) The Anchor Strategy — A Place-Based Business Approach for Health Equity | New England Journal of Medicine Rush Signs on as First Partner for Local Laundry Service | Rush David Ansell Books – New: The Death Gap 2026 Advisory Board Summit Washington, D.C. A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

Pediatric hospitals are one of the most important segments in the industry to watch right now. Although children’s hospitals make up only 5% of total hospital market share, more than 40% of U.S. children rely on Medicaid, leaving pediatric organizations disproportionately exposed as the Medicaid-related provisions of the One Big Beautiful Bill Act take effect. The pressures inside pediatric care were mounting even before this moment. After years of outperforming adult hospitals, children’s hospitals have seen margins fall from double digits to just 1% last year. Rising bad debt, higher supply and labor costs, a rapid shift toward lower margin outpatient care, and emerging challenges like declining birth rates and vaccine policy upheaval have created a perfect financial storm. While some of these dynamics are unique to pediatrics, the sector also offers an early warning signal for the rest of healthcare — and an opportunity to translate lessons across both worlds. In this episode, host Abby Burns and Advisory Board expert Vidal Seegobin break down why pediatric leaders must simultaneously manage immediate-term margin pressure, prepare for a more ambulatory-dominant model, and futureproof their organizations amid shifting demographics. Vidal also shares actionable steps leaders can take now, along with the critical lessons pediatric hospitals offer the wider healthcare ecosystem. We’re here to help: 5 insights on the state of pediatric hospitals today 12 things CEOs need to know in 2026 The State of the Healthcare Industry in 2026 Read Advisory Board's 2026 research agenda 3 trends shaping healthcare in 2026 (and how to respond) 278: Dr. Emily Oster on fighting misinformation and rebuilding trust in healthcare 277: Patient distrust is costing you. Here’s how to rebuild it. Learn how outpatient shifts can impact your organization by using Advisory Board’s Market Scenario Planner tool. Sign up today for this Optum Health Webinar: Scaling your EHR: How Optum Health built an enterprise platform to redefine care delivery. A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

GLP-1s have quickly become a cornerstone of obesity and metabolic care — but the real challenge isn’t whether they work, it’s how the healthcare system uses them. Leaders are grappling with tough questions around hype, access, safety, cost, and long-term sustainability. In this episode, recorded live at the 2025 HLTH conference, Rae Woods moderates a candid conversation with four physician leaders: Angela Fitch, MD: Co-founder and Chief Medical Officer at Knownwell Florencia Halperin, MD: Chief Medical Officer at Form Health Spencer Nadolsky, MD: CEO and Founder of Vineyard Nathan Wood, MD: Director of Culinary Medicine at Yale Drawing from frontline clinical experience and emerging data, the panel explores why medication only approaches fall short, how wraparound care improves outcomes and adherence, and what it will take for GLP 1s to deliver true value for patients, employers, and payers. We’re here to help: Ep. 229: Live from HLTH: What Can’t GLP-1s Do? Ep. 248: Drugs, surgeries, and shortages: the state of obesity care in 2025 Ep. 222: It's not just GLP-1s; here's what comprehensive weight management looks like Ep. 279: ‘Food as medicine’: What it is, why it matters, and how to do it right 5 trends shaping pharma strategy for 2026 (and how to adapt) Innovative solutions to today’s obesity care challenges From reactive to proactive care: 4 key takeaways about today's COVID-19 landscape A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

In Part 1 of Radio Advisory’s What CEOs need to know in 2026 series, we explored how responsibility for protecting access is diffusing as the safety net continues to fray. But that’s only one way control over healthcare delivery is shifting. In Part 2, we turn to other subtle — but significant — ways power is moving away from traditional centers of influence. As utilization and costs rise, purchasers are reaching the limits of their traditional approaches to spend management. In 2026, new players are stepping in as purchasers seek specialized solutions for specific treatments and conditions, increasingly delegating outcomes management to third party vendors. At the same time, a growing ecosystem of advisors and external voices is reshaping the options available to patients and clinicians alike. In this episode, hosts Rachel (Rae) Woods and Abby Burns are joined once again by Advisory Board experts Natalie Trebes and Max Hakanson. Together, they break down how the diffusion of ownership over rising healthcare costs — and the expanding influence of new players on clinical decisionmakers — are redefining the power dynamics every healthcare leader must navigate. Missed part one? Be sure to subscribe to Radio Advisory so that you never miss an episode! We’re here to help: Explore Advisory Board's 12 Things CEOs Need to Know in 2026 for strategies to help your organization thrive. 281: What CEOs need to know in 2026 (Part 1) Read Advisory Board’s 2026 research agenda The State of the Healthcare Industry in 2026 3 trends shaping healthcare in 2026 (and how to respond) Healthcare Policy Updates Timeline 280: The questions Advisory Board is asking in 2026 [Webinar] State of the Industry: Managing spend amid rising costs [Webinar] State of the Industry: Shaping care decisions amid diffusing influence We want to hear from you. What are your challenges? Where are you seeing opportunities? Email us at [email protected] Explore Advisory Board's 12 Things CEOs Need to Know in 2026 for strategies to help your organization thrive. Not a member? Access a complimentary excerpt today. A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.