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Articles & Blogs
Weekly dispatches from the healthcare trenches—strategy insights, market analysis, and practical intelligence for operators and investors.
The US healthcare industry doesn't stand still—and neither do we. Check back regularly to see a breakdown of new policy changes and what they mean for your business, explore emerging trends and technologies reshaping care delivery, and share investment strategies informed by our team's 250+ years of collective experience. Whether you're navigating regulatory shifts, evaluating new market opportunities, or planning your next move, you'll find analysis that cuts through the noise and delivers actionable insights.
Topics
Walmart's Better Care Services: Its Version of One Medical or a Completely Different Bet?
Walmart launched Better Care Services, a digital platform that connects customers to a curated network of third-party telehealth (Teladoc) providers for urgent care and behavioral health such as Doctor on Demand, BetterHelp, Curai Health, and Wheel. Walmart has also inked an agreement with Eli Lilly's for direct access to LillyDirect.
Mike Rawaan
Jul 88 min read
Medicare in 2026: A Summary of Major Policy Changes in the First Half of the Year
The first half of 2026 delivered more Medicare policy movement than most years see in their entirety. Payment rate changes, drug price negotiation milestones, eligibility restrictions, Star Ratings overhauls, and a landmark proposed rule on drug negotiation all landed between January and June.
Mike Rawaan
Jul 710 min read
Half a Million Will Lose Affordable Health Coverage Due to Section 71109 of OBBBA
On June 18, 2026, CMS published implementation guidance for Section 71109 of the One Big Beautiful Bill Act, which rewrites eligibility rules for federally funded Medicaid and CHIP. The effective date is October 1, 2026, and it’s the next major coverage cliff on the Medicaid calendar.
Mike Rawaan
Jun 258 min read
State Medicaid Demonstrations Must Prove Budget Neutrality Beginning January 1, 2027
Beginning January 1, 2027, CMS will not approve new demonstrations, renewals, or amendments unless the CMS Chief Actuary certifies that the demonstration project is not expected to increase federal spending compared to the state’s Medicaid program without the demonstration.
Mike Rawaan
Jun 245 min read
Medicaid Under Fire: A Flood of Federal Policy Changes - and What States Must Do to Comply with the New Rules
CCMS has announced or deployed an overwhelming volume of policy changes affecting Medicaid since June 1, 2026. In this article, we assess how work requirements changes impact states.
Mike Rawaan
Jun 233 min read
Medicaid's Blank Check Just Got Canceled: CMS's Crackdown on SDP
CMS cracks down on Medicaid State-Directed Payments, which is projected to save $775 billion over 10 years, including $510 billion in federal savings.
Mike Rawaan
May 214 min read
A Teaser of the First Episode of Our Podcast, The Outer Shell
Deep conversation on Healthcare lobbying: How it works, what it costs, who pays for it, who it benefits, and what's the true impact.
Mike Rawaan
May 171 min read
ACA Marketplace: The Real Enrollment Story
TrumpRx.gov is a federal direct-to-consumer (DTC) drug pricing portal launched on February 6, 2026. It does not sell medications directly; rather, it functions as a coupon aggregator and referral hub that connects cash-paying patients with manufacturer discount programs and direct-to-consumer purchasing channels.
Mike Rawaan
May 154 min read
A Comprehensive Analysis of TrumpRx
TrumpRx.gov is a federal direct-to-consumer (DTC) drug pricing portal launched on February 6, 2026. It does not sell medications directly; rather, it functions as a coupon aggregator and referral hub that connects cash-paying patients with manufacturer discount programs and direct-to-consumer purchasing channels.
Mike Rawaan
Feb 139 min read
Where Should Healthcare Investors Look in 2026?
Healthcare offers several attractive sectors to investors — GLP1 and weight-loss ecosystem, Healthcare AI, Value-Based Care, Behavioral Health, Home Health, and Biosimilars/Generic drugs. The real work for institutional investors is revisiting asset allocation models with updated expected returns across asset classes, acknowledging that the 60/40 portfolio conversation has legitimate merit again.
Mike Rawaan
Feb 104 min read
CMS Releases 2027 Medicare Advantage and Part D Advance Notice: What Plans Need to Know
February 05, 2026 | Medicare Advantage & Part D Policy Update Mike Rawaan , Founder and Managing Director On January 26, 2026, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year 2027 Advance Notice of Methodological Changes for Medicare Advantage Capitation Rates and Part C and Part D Payment Policies. [1] This annual announcement outlines proposed payment rate updates and technical changes that will significantly impact how Medicare Advantage
Mike Rawaan
Feb 65 min read
CMS Announces New VBC Model for Advancing Chronic Care with Effective, Scalable Solutions (ACCESS)
Just when we thought telehealth was dead since the COVID-19 pandemic-era telehealth flexibilities expired on Oct. 31, 2025, and just when we though remote patient monitoring RPM was going to meet a similar fate when United Healthcare announced it will significantly limit RPM reimbursement effective Jan. 1, 2026, CMS drops a new VBC model with the potential to revive them both. Below is a quick summary of the new ACCESS (Advancing Chronic Care with Effective, Scalable So
Mike Rawaan
Jan 233 min read
States Must Act Swiftly to Receive Their Share of the RHTP funds
𝗦𝘁𝗮𝘁𝗲 𝗵𝗲𝗮𝗹𝘁𝗵 𝗱𝗲𝗽𝗮𝗿𝘁𝗺𝗲𝗻𝘁𝘀 𝗺𝘂𝘀𝘁 𝗔𝗖𝗧 𝗡𝗢𝗪 to have a shot at receiving their share of a $50B fund allocated to improve rural health over the next 5 years as part of the Rural Health Transformation Program ( RHTP ). Interesting read on POLITICO (link below) about the deadline for states to apply for their slice of the $50 billion fund for rural health care. Section 71401 of the One Big Beautiful Bill Act (OBBBA) outlines how these funds can be use
Mike Rawaan
Jan 31 min read
Trends in the U.S. Healthcare Industry, Part 4: Healthcare Providers
We are seeing fewer providers where we need them the most, specifically in rural regions of the country, and we are witnessing slower growth in primary care providers compared to other specialties, which is very alarming.
Mike Rawaan
Jun 12, 20251 min read
Trends in the U.S. Healthcare Industry, Part 3: Employer-Sponsored Health Benefits and Plans
The year-over-year cost of the employer-sponsored insurance has grown by 7% over the past two years and is projected to grow by 8% in 2025. In 2025, employers will pay an average of $25,000 to cover the average American family
Mike Rawaan
May 15, 20251 min read
Trends in the U.S. Healthcare Industry, Part 2 (continued): CMMI
Although CMMI has not announced any new programs or demonstrations, there is optimism in Abe Sutton, who has close ties with Adam Boehler, CMMI Director during President Trump’s first term in office, being appointed as CMMI Director. If Mr. Bohler's tenure in CMMI, where he launched 16 new models, is an indication of what we'll see from Abe Sutton, then expect more value-based models.
Mike Rawaan
May 9, 20252 min read
Trends in the U.S. Healthcare Industry, Part 2 (continued): Medicare Part D
As prescription drug costs continue to rise, the federal government continues to explore ways to contain the cost. Methods such as the Medicare Drug Price Negotiation have yielded positive results. In contrast, other programs, such as 340B, seem to be helping provider organizations more than beneficiaries and the low-income patients the program was designed for.
Mike Rawaan
May 7, 20251 min read
Trends in the U.S. Healthcare Industry, Part 2: Medicare
Our Founder and Principal Consultant, Mike Rawaan , discusses trends impacting the U.S. Healthcare industry, focus ing on Medicare....
Mike Rawaan
Apr 21, 20251 min read
Trends in the U.S. Healthcare Industry, Part 1: Medicaid
Our Founder and Principal Consultant, Mike Rawaan , discusses the impacts of the anticipated federal budget cuts to the Medicaid program,...
Mike Rawaan
Mar 17, 20251 min read
Quick Announcement on Our New Short Video Series on the State of the U.S. Healthcare Industry.?
Covalence Health is excited to launch a new series of videos—and mini podcasts in the near future—as part of our new approach to sharing...
Mike Rawaan
Mar 10, 20251 min read
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