Hinge Health’s S-1 released last week, here. Read my breakdown here.
The pharma direct to patient trend continues as the GLP-1 compounding saga winds down - Novo Nordisk with NovoCare, and Eli Lilly and LillyDirect powered by Ro, and Teladoc, and LifeMD
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Now that the shortage is over, the power of distribution shifts back to Novo and Lilly. They control the spice on Arrakis, so to speak. The Harkonnens are back in control, and the Atreides’ influence has slipped (Hims & Hers). Still, as we know, the Atreides are a scrappy and tenacious bunch. With that in mind, the price of GLP-1s continues to drop - but $500 / month is pretty steep for cash paying customers.
Walgreens is going private with plans to divest VillageMD.
Duke & Novant: Two major North Carolina systems, Duke Health and Novant Health, announced a “transformative” partnership. The two “said they will work together to develop new locations across the state to improve health outcomes. No specific projects or financial details were mentioned in a press release issued today.”
A slew of CMS and policy / reimbursement updates:
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CMS looks at 2026 changes: CMS is considering policy updates for the 2026 Medicare Advantage and Part D plans, including changes to star ratings, prior authorization, and supplemental benefits.
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Cracking down on enrollment abuse: CMS announced new rules to reduce improper enrollments in ACA marketplaces and enhance program integrity.
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Medicaid cuts = hospital pain: If proposed Medicaid cuts move forward, Fitch Ratings warns not-for-profit hospitals could see margin pressure due to rising uncompensated care.
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ICHRA movement grows: The individual coverage HRA (ICHRA) model continues to gain traction as a way for employers to offer health benefits more flexibly, according to the Future of ICHRA initiative.
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Loosening license rules: States are easing licensing requirements for foreign-trained doctors to help address ongoing physician shortages.
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California CPOM overhaul: New legislation, SB-351, could tighten California’s corporate practice of medicine rules and impact MSO business models.
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Medicaid managed care primer: KFF published 10 key facts about Medicaid managed care, covering how plans work and where challenges remain.
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ABA therapy under pressure: State-level rules are starting to cap therapy hours and reduce rates for autism care, signaling growing regulatory scrutiny.
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VBC programs sunset: CMS Innovation Center announced changes to its model portfolio, including sunsetting underperforming programs and tightening guardrails around new pilots.
General Catalyst eyes IPOs: The VC firm behind many digital health bets, General Catalyst, is preparing for a potential IPO.
Ortho boom = ASC growth: Surgery Partners is expanding its ambulatory surgery center footprint, capitalizing on the explosive growth in orthopedics.
Providence + Compassus: Providence and Compassus launched a joint venture to deliver home-based care in Alaska, Texas, and Washington.
AI-powered voice assistant: Microsoft’s Dragon Copilot aims to streamline clinical workflows with launching the ‘first unified voice AI assistant for healthcare.’
VBC outlook for 2025: Advisory Board’s value-based care update outlines the current state, expected trends, and the pressure on providers to shift financial models.
MA dealmaking expected to rise: Ardent’s CEO predicts that funding cuts will drive more M&A activity as struggling hospitals seek lifelines.
Kidney care JV in Texas: Monogram Health and Memorial Hermann formed a joint venture to expand value-based kidney care in Texas.
23andMe going private: Anne Wojcicki offered $74.7 million to take 23andMe private, signaling a new chapter for the embattled genetics company.
Fierce 15 list: Fierce Healthcare released its “Fierce 15” spotlighting startups bringing innovation to areas like AI, behavioral health, and care delivery.
Biograph launches: A new clinic longevity concept championed by Peter Attia called Biograph is positioning itself as the world’s most advanced preventive care and diagnostics center.
Humana & Thyme Care: Humana announced a value-based oncology partnership with Thyme Care to improve cancer patient navigation and care coordination.
