What healthcare-related news we're reading this week (late January edition)
- Eric Fontana
- 1 day ago
- 8 min read
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 has been flicking through.
Jordan Peterson, Research Consultant
What’s an article that caught your eye in the last week?
Why did this article resonate with you?
I’ve been tracking updates on the distribution of the Rural Health Transformation Program as I prep for our 2026 Health Policy Watchlist Board Briefing (now available on demand for members). This article crystallizes many of the common concerns that industry experts have flagged related to the fund and its potential to cushion rural provider margins. As a reminder, the Rural Health Fund was explicitly framed as a way to help backfill losses from deep Medicaid and ACA-related cuts in the One Big Beautiful Bill Act—which are expected to hit rural states the hardest—yet the $50 billion fund is markedly smaller than the expected share of those reductions and, notably, states are not legally required to pass funds directly to rural hospitals, a point that has emerged as a central concern among provider leaders. The article frames the problem as a short-term patch for a long-term problem: the fund does not meaningfully change the trajectory of financial risk facing rural hospitals as permanent federal payment cuts phase in.
What are you watching for next related to this issue?
I am watching how states operationalize this funding and position themselves for the inevitable fiscal cliff when the Rural Health Fund expires. We know that all 50 states applied and received awards. Half of the funding was distributed among all states with approved applications, while the other half was allocated entirely at the discretion of the CMS Administrator, Mehmet Oz. The administration is giving larger awards to more rural states and states that have pledged to back policies aligned with Make America Healthy Again (MAHA) priorities. But we’re still waiting on states to release how they plan to deploy the dollars. I’m interested to see how states balance transformational needs (as encouraged through the funding allocation) and foundational needs (to better prepare for the future after the funding lapses).
Amanda Berra – Executive Vice President
What’s an article that caught your eye in the last week?
Dan Diamond’s piece in the Washington Post, Jan 16: “Trump bets on rural health as a winning midterm message”
Why did this article resonate with you?
I’m with Jordan—I too am watching to see what will happen with the Rural Health Fund. But in addition to seeing how the awards and initiatives (and vendor partnerships!) play out, I think this article is an important exploration of the political angle. How is the Rural Health Fund being positioned politically, and how is it being received so far? It's a big dollar amount, and we hear that the existence of the fund is catalyzing new activities and ideas at the state level. It's also well known in the industry that rural providers will be losing far more than they are gaining in total when you compare the size of the fund to the projected impact of Medicaid enrollment cuts—but, that takes some explaining, and, as they say, in politics, “When you’re explaining, you’re losing”.
What are you watching for next related to this issue?
The midterm elections, for starters. Both sides of the political spectrum will work to make healthcare in general, and rural healthcare in particular, a campaign issue. Can they manage to put healthcare into the spotlight, with so much other political upheaval right now? If yes, whose narrative is going to win out?
Eric Fontana – Senior Vice President
What’s an article that caught your eye in the last week?
“Bullshit” — The new way health giants hide billions released Jan 6th by Hunterbrook Media. It was tough to whittle this down to one article, because there’s a LOT of juicy stuff to talk about right now (for instance, United Health Group's Earnings—more to come on that later; FDA issuing new guidance on AI and wearables; new guidance on the responsible use of AI; Chuck Grassley’s MA report; Massachusetts state investment in funding to keep insurance premiums down).
Why did this article resonate with you?
Other than the article title being tonally reminiscent of a track listing from a Murder Ballads-era Bad Seeds album, this expose by Hunterbrook is yet another reminder of the staggeringly creative efforts vertically-integrated payers will invest in loophole methods to extract profits from the healthcare ecosystem. The article highlights how several major PBMs created distinct organizations: Zinc (Caremark-CVS), Ascent (Express Scripts-Cigna) and Emisar (Optum-UHG), to effectively syphon off rebate payments for some fairly thin services and rebate negotiations, passing a smaller amount of money through to PBMs while posturing as if the PBMs were passing “100%” of dollars back to the plan sponsor (such as the employer or health plan) as rebates. The author goes to great lengths to visit the international offices of Ascent and Emisar—including a close encounter with Swiss Polizei—showcasing how these shell-like entities are designed to work, with seemingly very little benefit to anyone except the profiteering organizations. If you’ve been around the healthcare block once or twice you may find yourself a little desensitized to the narrative. However, as the piece clearly points out, there are many parties impacted by this model (such as employers on the receiving end of skyrocketing costs) that are clearly disgruntled and want to see change. Since its release on January 6, the Hunterbrook piece has already garnered some prominent readers, as its findings were used by Congress just three weeks later, in a direct line of inquiry to United CEO Steve Hemsley, who uttered nary a word on the topic in response.
What are you watching for next related to this issue?
There’s a paucity of issues that Republicans and Democrats seem to agree on these days, but healthcare middlemen are one topic that consistently draws a good amount of bipartisan agreement. It feels like we might be approaching a boiling point, where patient and system affordability concerns, unbridled intermediary profiteering, and the federal government’s willingness to meddle with someone’s pot of money ultimately congeals in ways that result in change, including the potential for further spillover scrutiny into other aspects of the vertically-integrated-payer healthcare landscape. As I've mentioned previously in this blog, my predictive abilities sometimes aren't always the greatest, so I'll refrain from calling out any potential next moves. All I can say is: "I'm watching".
Chris Loumeau, Research Consultant
What’s an article that caught your eye in the last week?
Congress unveils bipartisan health bill, funding deal (Note: Modern Healthcare, may require subscription)
Why did this article resonate with you?
It wasn’t any singular provision. Rather, it was how clearly it reflects where healthcare policy consensus does and does not exist right now. It shows healthcare policy drifting toward slow, infrastructure-level change rather than headline-grabbing reform—changes that often matter most to operators & investors alike once they compound over time.
On the “does” side: telehealth, hospital-at-home (HaH), PBM transparency, and MA directory accuracy. These are areas where payer, provider, and patient interests overlap just enough to allow incremental progress. Extending telehealth and HaH coverage acknowledges how embedded these care models have become operationally, even if Congress still stops short of making them permanent. Likewise, PBM transparency continues to move forward because it’s one of the few bipartisan issues that reliably frustrates everyone.
On the “does not” side: anything that meaningfully reopens the Medicare physician payment system or expands federal subsidies for coverage. The intentional omission of ACA exchange subsidy extensions and broader physician reimbursement reform reinforces how politically radioactive those topics remain—even in an expedited bipartisan package.
It also highlights Congress’ increasing preference for enabling mechanisms over mandates as a policy device. Requiring separate OP department identifiers for site-neutral analysis doesn’t force industry change, but it does set the stage for it. This feels like Congress signaling intent without yet picking a fight with hospitals over revenue compression.
What are you watching out for related to this piece?
I'll be monitoring how various industry stakeholders respond to the longer runway for HaH programs relative to telehealth. Does that catalyze additional capital investment and operational scaling in home-based acute care, especially among integrated health systems that have been hesitant to commit? I’m also paying attention to how MA carriers operationalize the provider-directory requirements. While modest on paper, the enforcement mechanisms around inaccurate directories could meaningfully affect network management behavior. Finally, I’ll be tracking what wasn’t addressed to resurface later in the year (e.g., ACA subsidies, prior auth reform, the PFS).
Sydney Lufsey, Senior Director, Member Services
What’s an article that caught your eye in the last week?
In Fierce, this piece discussing Biosimilar executives' optimism about future for US biosimilars
Why did this article resonate with you?
The drug pipeline right now is genuinely impressive and has the potential to significantly improve patient outcomes—but it also points to a future defined by very high-cost therapies. Biosimilars stand out as one of the most practical levers for addressing that affordability challenge at scale.
What resonated most was the clear alignment among biosimilar manufacturer CEOs—particularly coming out of JPM—around the need to fill what they described as a growing “biosimilar void.” I also found it notable that several executives pushed back on the idea that patient preference is the primary barrier to biosimilar adoption. As one CEO put it plainly, “The patients are not the ones deciding… I think patients would prefer the lower-cost drug.” Instead, the real challenge they highlighted is the complexity of the U.S. market and the difficulty of aligning incentives across the many stakeholders involved.
What are you watching for next related to this issue?
I’ll be watching closely to see whether manufacturers like Sandoz can translate this optimism into real market impact and deliver on what they are calling a “golden decade” for more affordable drugs. While the financial opportunity in biosimilars is clear, success in the U.S. will hinge on policy and regulatory execution.
In particular, we’ll be tracking whether draft FDA guidance aimed at reducing the need for additional clinical trials for biosimilars is finalized and implemented. Manufacturers appear optimistic, and if those changes materialize, they could meaningfully accelerate biosimilar development and adoption.
Marina Renton, Research Consultant
What’s an article that caught your eye in the past week?
The latest CMS information on U.S. healthcare spending in 2024 via Health Affairs.
Why did this article resonate with you?
The most recent available data shows that healthcare spending increased by 7.2% YoY in 2024, the second year in a row of spending growth above 7%. This growth outstrips the rate of GDP growth, meaning that healthcare spending accounted for a new high of 18% of U.S. GDP in 2024. Also noteworthy: increased spending wasn’t driven by higher prices but by higher use and intensity of healthcare goods and services consumed. In other words, people are now using healthcare at rates higher than pre-pandemic levels.
At Union, we’re looking to understand trends in healthcare economics and, while we often look at specific sectors in healthcare (see our recent writing on insurer performance or GLP-1s as just a couple of examples), it’s useful to zoom out and see the big picture. If healthcare spending growth isn’t being disproportionately driven by inflation, then there are other patterns that merit attention.
What are you watching out for related to this piece?
There are a few questions I’m keeping in the back of my mind as we move forward:
Will these trends persist, or do they reflect a continued catch-up period from low volumes during the worst of the COVID-19 pandemic?
How will insurers adjust networks and cost-sharing in response to higher utilization? And what dynamics ultimately play out as a result of that?
Will there be a meaningful margin impact for healthcare providers driven by increased utilization, or will that be suppressed by other policy factors (and business-cost realities) eating into margins?