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: October 9, 2025
This week’s episode covers the ongoing federal government shutdown and its implications for health systems, including lapses in telehealth and hospital-at-home flexibilities, paused Medicaid payments, and the potential loss of coverage for millions if ACA subsidies expire. It also explores major insurers’ contraction in Medicare Advantage markets, Evolent Health’s sale of its ACO to Privia Health, and new visa fees that could intensify physician shortages by restricting international medical hiring.
This is the strategist in brief. For October 9th, 2025, the federal government shut down on October 1st after Congress failed to meet a funding deadline, the shutdown could last for multiple weeks with Senate lawmakers deadlocked over the extension of enhanced a CA marketplace. Subsidies. Disruptions for health systems include the expiration of telehealth, flexibilities, and hospital at home waivers. A pause on certain supplemental Medicaid payment. Federal agency furloughs. If the enhanced a CA subsidies are not extended, nearly 4 million Americans could become uninsured. The shutdown underscores the importance of proactive scenario planning, programmatic resilience, and open communication with patients and providers. Moving on to our second story, UnitedHealth CVS and Humana are shrinking their Medicare advantage footprints by dozens of counties and CMS forecasts a fall in Medicare Advantage enrollment next year. The major carriers are responding to rising utilization, following reimbursement and financial distress. As the new version 28 reduction in Medicare rates goes fully into effect next year. The retreat of major carriers could be a boon for regional plans that could be potential partners for health systems, but those plans are also dealing with their own financial struggles. United Health's push to move members from PPO to HMO plans could disrupt continuity of care and create additional administrative frictions. Moving on to our third story, Evolent Health has agreed to sell its a CO to Privia Health for$100 million. The transaction highlights how some disruptors are leaning into distinct areas of specialization, privia, and value-based primary care, and evolent in value-based specialty care. Privia offers independent physicians in alternative to health system employment, but several health systems have also partnered with the company to extend their reach in new markets. And now our final story. The American Medical Association, leading medical societies and nursing recruitment agencies are lobbying the Trump administration for exceptions to the new$100,000 fee for H one B Visa applications. The fee threatens to make hiring new foreign trained physicians prohibitively expensive. The greatest impact could be in central states where a higher share of physicians are H one B Visa holders. That concludes this week's edition. Be sure to check out the full version on the web@hmacademy.com. Thanks for listening.