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The Strategist in Brief: October 15, 2026 · The Strategy Catalyst Dispatch

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  Anika: This is the Strategist in Brief for October fifteenth, twenty twenty-six.
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  Anika: Your quick audio rundown of the top headlines from Strategy Catalyst newsletter.
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  Anika: Here's what strategy leaders should know this week How system leaders at the Health Management Academy's Fall 2026 CEO Forum discuss the policy pressures and financial realities that are forcing systems to rethink business as usual.
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  Anika: Affordability was a major theme.
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  Anika: CEOs discussed how policymakers sometimes frame the debate around the price of a single service, not the total cost of care.
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  Anika: Limited emergency department and inpatient bed capacity is pushing some systems to make greater use of value-based care strategies.
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  Anika: Mandatory CMS payment models and direct-to-employer offerings are accelerating the trend.
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  Anika: CEOs worry that stacking too many AI point solutions will make overall workflows less efficient, even if each individual use case has a positive return on investment.
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  Anika: Labor costs are pushing systems to reimagine how care is delivered, but CEOs say culture and clinician training remain major obstacles.
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  Anika: Turning to 340B, the Health Resources and Services Administration named 10 drug makers and 21 high-cost drugs for its reworked 340B rebate pilot, set to launch January 1st.
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  Anika: Drugs eligible for the pilot account for less than five point five percent of 340B purchases, but a successful rollout could pave the way for a broader shift away from upfront discounts.
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  Anika: The American Hospital Association and other provider groups have once again sued to block the pilot, arguing annual administrative costs could top one billion dollars, nearly double HRSA's five hundred and thirty-seven million dollar estimate.
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  Anika: In other 340B news, a growing number of health systems are suing CVS, alleging the company withheld nearly three hundred million dollars in 340B savings.
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  Anika: On the Medicaid front, five Democratic governors asked the Department of Health and Human Services to delay the January 1st deadline for Medicaid work requirements, citing new frailty definitions and verification rules that states say they can't implement in time.
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  Anika: Medicaid coverage losses will build gradually through 2027, with a different timeline in each state depending on the specifics of implementation And finally, this week's featured graphic tracks the recovery and health system operating margins with new data from Strata Decision Technology.
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  Anika: After dipping below zero early in the year, The median health system margin climbed to zero point seven percent in June.
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  Anika: That's still below the one percent to one point five percent range seen throughout much of the second half of twenty twenty-five.
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  Anika: Be sure to check out the full newsletter to see the graphic.
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  Anika: That concludes this week's edition.
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  Anika: Be sure to check out the full version on the web at hamacademy.com.
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  Anika: Thanks for listening.