HMA Vital Viewpoints on Healthcare

The Coverage Gap Grows: ACA Changes Reverberate Across Healthcare

https://youtu.be/jd7ahzxb3lw?si=qymi-InQgJeYox80 This episode of Vital Viewpoints on Healthcare explores the growing coverage gap across the health insurance landscape and the pressures shaping affordability, enrollment, and access to care. The discussion covers coverage churn between Medicaid and ACA Marketplace plans, the operational and financial realities faced by states, and the warning signs emerging for consumers, providers, and health plans alike. Zach Sherman, managing director at Health Management Associates and former head of state marketplaces in PA and RI, shares his perspective on current state challenges for insurance affordability and coverage pressures, and the policy decisions that could shape the next phase of healthcare coverage across Medicaid, Marketplace, and employer-sponsored insurance.

Medicare’s “Inpatient Only” Rule Is Going Away. Now What?

https://www.youtube.com/watch?v=LaIwujyoGyo This episode of Vital Viewpoints on Healthcare explores how evolving Medicare payment policy is reshaping where and how care is delivered. The discussion covers the phase-out of the inpatient only list and the operational and financial challenges tied to shifting procedures into outpatient settings. Zach Gaumer, regional director at Health Management Associates, shares his perspective on the policy mechanics, provider behavior, and market signals emerging from CMS rulemaking; while Rachel Stewart, senior consulting actuary at Wakely (an HMA Company), explains how plans are modeling uncertainty, navigating contract dynamics, and assessing the downstream impact on costs and quality across the healthcare system.

How Do Life Sciences Companies Keep Innovating When the Rules Keep Changing?

https://www.youtube.com/watch?v=QUpHAdaPkMY&list=PLKpkKZ4OxkU7kgB8MVqDoo-t_K17673tF&index=1&t=9s This episode of Vital Viewpoints on Healthcare unpacks the rapidly evolving regulatory landscape for pharmaceuticals. The discussion covers the challenges to innovation, such as the growing unpredictability in FDA policy, the challenges with reimbursement, and the increasing role of real-world evidence in bringing therapies to market. Julie Tierney, principal at Leavitt Partners (an HMA Company) shares her expert perspectives on rare disease innovation and upcoming user fee negotiations; while Ben Shand, vice president at Health Management Associates, talks about why organizations must actively engage to navigate risk, identify opportunity, and ultimately improve patient access to care.

The Power of Alliances: Finding Consensus In Healthcare Policy

Eric Marshall, principal at Leavitt Partners, an HMA company, shares how collaboration, not competition, is the way to move healthcare policy forward in a polarized environment. In this episode of Vital Viewpoints on Healthcare, he discusses how multi-sector alliances are advancing solutions to common pain points that too often impede progress on issues like drug pricing, supply chain security, and rural health access. Drawing on years of experience bringing stakeholders together, Eric explains why consensus-building is essential to creating durable, effective policy solutions and how trust, persistence, and shared purpose can overcome even the deepest divides in Washington and beyond.

No Wrong Door: Aligning Hospitals and Community Care for Sustainable Health

In this episode of Vital Viewpoints on Healthcare, Robert Ross and Warren Brodine from HMA’s Delivery Systems practice explore how hospitals and community health centers can work together to strengthen access, improve health outcomes, and improve financial sustainability across the healthcare system. Drawing from decades of leadership in safety-net hospitals, FQHCs, and integrated care models, they discuss the real-world challenges of fragmented incentives, payer mix, and regulation and share bold ideas for building a truly interdependent and patient-centered delivery system.