The Strategy Catalyst Dispatch
The Strategy Catalyst Dispatch brings healthcare strategy professionals into the room with leading health system executives to explore how innovation, clinical leadership, and enterprise strategy intersect. Designed for strategy executives, physician leaders, and healthcare innovators, the podcast offers actionable takeaways to help organizations drive both clinical and financial impact.
The Strategy Catalyst Dispatch
The Strategist in Brief: March 20, 2025
This episode covers insights from the Strategy Catalyst Summit (Feb 2025), covering direct-to-employer healthcare partnerships, Washington policy shifts under Trump, cybersecurity threats, and urgent care strategies for improving payer mix. The episode also discusses Novo Nordisk and Eli Lilly's direct-to-consumer GLP-1 delivery platforms, conservative estimates of $1.1 trillion in Medicaid improper payments over the past decade, and UnitedHealth Group's legal victory against DOJ allegations of $2 billion in Medicare Advantage overpayments.
This is the strategist in brief for March 20th, 2025. For this week's key market dive, we're distilling our favorite insights from the Strategy Catalyst Summit held last month in Arlington, Virginia, a session on direct to employer efforts. Featured a panel with leaders from Vanderbilt University Medical Center, Northwell Direct and Main Health. The panelists emphasized the importance of building partnerships with employers, third party administrators, PBMs, and other regional providers. In another session, attendees discuss the shifting policy agenda in Washington. While healthcare reform isn't a top priority for the Trump administration, more marginal reforms and collateral effects from other policies will still have a major impact on non-profit health systems. A Summit participants heard a presentation from a representative for clear about the company's partnerships with health system. New technologies like the dark web and generative AI are supercharging security threats for health systems. In another session, previewing strategy Catalyst's, urgent Care, secret Shopping Results, attendees discussed how appointment scheduling and strategic locations can help systems influence their payer mix and capture downstream revenue. And now this week's market scam. Drug maker Novo Nordisk launched a new direct to consumer delivery platform for its GLP one weight loss medication. Wegovy in partnership with Humana's Center well pharmacy business. Separately, rival drug maker Eli Lilly recently announced partnerships with telehealth providers, Teladoc Health and Life, md. The company's direct to consumer efforts highlight the growing importance of online pharmacies and shifting consumer expectations. Eli Lilly's service is more of a direct threat to health system sponsored weight management programs because it offers to connect patients with providers offering prescriptions while Novo service is aimed at patients who already have prescriptions. In other news, two conservative think tanks widely seen as influential With the Trump administration released a paper estimating that Medicaid made$1.1 trillion in improper payments. Over the past decade, the paper could bolster efforts by Republicans in the house to reduce the federal budget deficit gOP lawmakers in the Senate have said they're opposed to deep Medicaid cuts, potentially creating an opening for health system lobbying. In another piece of news, UnitedHealth Group scored a major victory in its years long legal battle with the Department of Justice over allegations of more than$2 billion in overpayments Through Medicare Advantage, a court appointed special master determined that the government is lacking any evidence in its claims against UHG. The ongoing case highlights the technical and legal complexity associated with challenging payer practices through the courts. Lawmakers and regulators have expressed continued interest in scrutinizing these practices at a recent hearing, Trump's nominee for CMS administrator, Dr. Meme Oz pledged to regulate the practice of upcoding in Medicare Advantage. That concludes this week's edition. Be sure to check out the full version on the web@hmacademy.com. Thanks for listening.