Patients are already cutting back to afford care, and the coverage losses haven’t fully hit yet

By Christopher Kerns Margin challenges have been afflicting both plans and providers—in different ways but for interconnected reasons. And it’s worth reflecting on why this is true, and how unusual it is. Historically, the usual tug-of-war from the payment/revenue cycle tends to more favorable to payers or providers in any given year. But over the past two years, a strange quagmire has developed: health plans have struggled with outlays that have exceeded their internal actua

Before we dive in today, a quick plug: We recently launched "The Margin Initiative," a dedicated effort to support health system leadership via insight and analysis. This initiative includes a customizable analysis, access to our latest margin research, and a seat at our upcoming health system executive collaborative where we'll present our latest, future-focused research and provide a secure, closed space for confidential, non-competitive sharing. Seats are on a "first-in,

Health systems and insurers usually move in opposite directions. Not this quarter.

The next forced efficiency leap is here. Find out where healthcare AI is delivering proven ROI — and what the data says about getting the investment right.

Health system leaders are increasingly telling us they're not satisfied with their third-party vendor volume forecasts. Learn what's driving their challenge.

For those in healthcare, and revenue cycle especially, your newsfeeds undoubtedly provide a consistent stream of stories illustrating abundant payer-provider friction. Few would argue the most visible of these tensions has been around health system and clinician reimbursement for services, which has catalyzed a rapid investment into AI-tech on both sides, often described by one of many possible wartime analogies, although yet to have reached the point that either party appea

All the major for‑profit health systems have hosted their fourth set of earnings calls for 2025, sharing both their Q4 2025 performance and their 2026 outlook. These players function as a near‑real‑time “dashboard” for demand, pricing power, cost pressures, and strategic bets across the delivery system—offering helpful intel on the direction of the healthcare industry as a whole (even if they occupy a somewhat unique position within the provider world, as we'll discuss more t

The Union Healthcare Insight research team recently got together in Chicago with an experienced group of health system leaders, technologists, and consultants to dig into some of our latest research: “Six insights for revenue cycle leaders in 2026” . It was an open and generative day of discussion where attendees had the chance to sit with some hard questions facing the industry, knock around some practical ideas for moving the needle on their most stubborn challenges, and en

In our January post , we covered the structure of the ACCESS model—its four clinical tracks, its outcome-aligned payment (OAP) logic, and the questions that remained unanswered (chiefly, what the payment amounts are and what the improvement targets are) as applications opened. Well, we now have some answers. CMS just released 21 pages of more detail about ACCESS model payments and targets for the first performance period (July 5, 2026-December 31, 2027). And on February 12,

Practically every organization in every sector of healthcare routinely needs market-sizing models to guide high-stakes strategic decisions, such as where to invest and where to be cautious. The problem: In the rush to check all the planning boxes, it is all too easy for leaders to accidentally end up with—and even bet the strategy on—'models' that are not really models at all, but simply numbers . Numbers with unexamined, opaque, and sometimes wildly inaccurate underlying as

January 2026 has slipped away like a Nor'easter through the Northeast—fast, furious, and leaving everyone wondering what just happened. And much like those of you who got snowed in, we've spent the month mostly indoors, heads down, reading everything we could get our hands on about the flurry of health industry and policy developments that have swept through Washington and across the healthcare landscape. Let's go around the horn and touch on just a sliver of what our team h