The Strategy Catalyst Dispatch

The Strategist in Brief: July 9, 2026

Strategy Catalyst Season 1 Episode 50

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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 is the Strategist in Brief for July 9th, 2026, your quick audio rundown of the top headlines from Strategy Catalyst newsletter. Here's what health system strategists should know this week. In its annual update to the OPPS payment rule, CMS is proposing a significant reimbursement cut for 340B-acquired drugs. Because the changes are budget neutral, for-profit health systems and hospitals with low 340B uptake could see a boost to their payments. Unlike a similar effort in 2018, this proposed cut might survive legal challenges because the Trump administration recently undertook a survey of hospital drug acquisition costs. The proposed rule also includes site-neutral reform for imaging services. Separately, Senator Bill Cassidy unveiled draft legislation that would reform the 340B drug discount program by letting drug manufacturers choose whether they want to offer providers upfront discounts or rebates. Providers can opt for a different payment mechanism if they voluntarily pass all 340B savings on to patients. The draft is intended to solicit industry feedback and is not immediately headed through the committee markup process. The proposal's chances to pass this year are somewhat limited, with slim congressional majorities in a midterm election year. Restrictions on eligible prescriptions, contract pharmacies, and out-of-pocket costs would reduce the savings that health systems realize under 340B, and new data reporting requirements could increase scrutiny by the media and policymakers. Moving on to our next market scan, Optum is negotiating with several New York health systems to sell orthopedic, general surgery, and urology practices attached to Optum Medical Care and Crystal Run Healthcare. Optum is effectively unbundling Crystal Run, not retreating from the market entirely. Optum is keeping control of the primary care panels, and UnitedHealthcare controls benefit design above them. Once these specialty practices leave that ecosystem, United might steer these volumes to lower-priced providers. This week's featured graphic comes from a new JAMA study showing that patient messages to providers have steadily continued to increase since the pandemic. Female patients, patients between the ages of 40 and 64, and patients in affluent neighborhoods were the most likely to send messages to providers. The trend is worth watching because inbox fatigue is a major driver of burnout and turnover among physicians. That concludes this week's edition. Be sure to check out the full version on the web at hmacademy.com. Thanks for listening.