Gist Weekly: July 24, 2026

In the News

What happened in healthcare recently—and what we think about it.

1. Major Medicare physician payment overhaul on the horizon? The Centers for Medicare & Medicaid Services (CMS) last week released its proposed 2027 Medicare Physician Fee Schedule, which included policy proposals that would revise physician payment and a request for public input on a range of issues to inform future rulemaking. One notable request for information seeks feedback on alternatives to the American Medical Association’s (AMA) Current Procedural Terminology (CPT) coding system, which has long served as the foundation for physician reimbursement. CMS also requested feedback on other coding and payment frameworks, with specific questions about alternatives for “a more objective process” and “challenges associated” with CPT-4 licenses. The public has until Sept. 14 to comment.
   • The Gist: Drastic changes to the Medicare physician coding system would be a lengthy regulatory process. But the request for information may signal the Trump administration’s interest in overhauling aspects of Medicare physician payment due to concerns about the AMA’s influence. Critics cite AMA’s longstanding influence over physician payment recommendations and the royalties of more than $300 million annually that it generates from its CPT codes. Alternatively, Congress is also paying attention to different physician payment reform approaches. If Medicare physician reimbursement is really on the table, then health systems may need to rethink everything: from compensation and workforce models to service line strategy.
2. Half of young adults forgo primary care physicians. Just 71% of adults ages 18-29 have a primary care physician (PCP), compared with 97% of adults 65 and older, a national survey published last month found. Even among those who do have a PCP, only about half have had a checkup in the past year, according to the national poll of 1,006 adults commissioned by Ohio State University’s Wexner Medical Center. Instead of calling their PCP for non-emergency issues, more than a third of young adults head to urgent care first, compared with 68% of older adults who go to their regular doctor. This comes as results from the Medical Group Management Association’s MGMA Stat poll this month found that 28% of new patient appointment wait times were longer than they were last year.
   • The Gist: For Gen Z, waiting to see a physician may not be on the table. Urgent care means walk in, get seen, and get out—an option that appeals to a Gen Z audience that finds the prospect of a weeks-long wait for an appointment distasteful. But that convenience has a cost. Primary care is built on the long view of tracking a patient across years or, ideally, decades, so gaps don’t slip through. Skip that relationship and routine screenings, vaccinations, and bloodwork may also get skipped. For hospital and health systems, connecting patients with PCPs is an investment in patient loyalty and engagement, especially as they age out of pediatric care.
3. U.S. measles cases hit 35-year high. Measles cases in the United States have surpassed all of last year’s total, according to a tracker from Johns Hopkins University released Thursday. The tracker, which draws from state and county-level data, shows 2,295 cases so far this year. That’s higher than the 2,289 cases confirmed for the entirety of 2025, making 2026 the worst year for measles in the United States since 1991, when 9,643 cases were reported. The Centers for Disease Control and Prevention (CDC)’s update last week puts the confirmed case count at 2,260, with 34 new outbreaks so far this year—with the discrepancy coming from different dates and different methodologies. The CDC also found that 93% of this year’s cases are outbreak-associated, meaning that measles is no longer just isolated cases coming from abroad. The majority of measles cases are in unvaccinated people.
   • The Gist: The surge is straining a healthcare system that hasn’t dealt with measles at this scale in decades. Many clinicians today have never seen a measles case since the disease was eliminated domestically in 2000, so they’ve had to dust off diagnosis and treatment protocols they thought were no longer needed. It appears that the nation’s measles elimination status, which is up for review in November, is at serious risk. This would constitute a public health failure, as vaccine hesitancy and wavering patient trust have eroded a once robust infectious disease infrastructure. The return of measles, which can lead to permanent brain damage and on average kills 1 to 3 of every 1,000 affected children, may be a harbinger of even more dangerous infectious diseases that should be preventable. The question is, how do we rebuild the infrastructure needed before that occurs?

And—what we’re following.

• Cyclosporiasis continues to wreak havoc for Americans, with growing case counts, a new outbreak, and continued uncertainty over the source of infection.

Plus—what we’ve been reading.

4. Accurate genetic prediction depends on representative data. A recent New York Times article examines both the promise and current limitations of polygenic risk scores, a genetic measure of disease risk that can estimate a person’s likelihood of developing common diseases using thousands of genetic variants. These emerging risk models show promise in preventing disease and providing genetically personalized care. However, their performance depends on the data used to develop them. These tools work best when they are built using genetic data from a diverse population; but many of the leading reference datasets are limited, with whites comprising up to 94% of the sample population. To address this, researchers are pulling data from a variety of sources, using international samples, and growing biobanks to diversify genomic risk model sampling.
   • The Gist: Polygenic risk scores underscore a fundamental principle of precision medicine: predictive models are only as good as the data used to develop them. Researchers are expanding genomic repositories, refining statistical methods, and incorporating data from broader cohorts of patients. But improving the model will take time. Representative genomic datasets need investment to increase their reliability. These genetic models hold great promise, but they remain limited. Hospitals and health systems with personalized medicine programs, and those with cell/gene programs that wish to adopt genetic risk modeling, will need to improve their ability to identify important variants to develop stronger prevention and therapeutic approaches.

Graphic of the Week

A key insight illustrated in infographic form.

Ambulatory, care at home projected to outpace acute care

Ambulatory and home health growth outpace acute care, according to the latest Vizient Impact of Change report. Health system growth opportunities are anchored in the ambulatory space, which is expected to grow 20% by 2036. Ambulatory growth is attributed to strong shifts in site of care, such as surgical procedures moving to hospital outpatient departments and ambulatory surgery centers. Capturing this growth will be an imperative for health systems, and addressing access challenges and care fragmentation for patients will be key to success.

This Week at Kaufman Hall

What our experts are saying about key issues in healthcare.

As federal funding pressures and rising capital needs reshape healthcare finance, hospital leaders may need to rethink the long-held goal of achieving the highest possible credit rating.

Lisa Goldstein’s latest blog explores why financial strength is best measured by an organization's ability to invest strategically, remain resilient, and fulfill its mission—not by ratings alone.

On Our Podcast

The Gist Healthcare Podcast—all the headlines in healthcare policy, business and more, in 10 minutes or less every other weekday morning.

Earlier this week, host J. Carlisle Larsen spoke with Modern Healthcare’s Michael McAuliff about how healthcare issues are playing a role in this year's midterm elections.

This Monday, Victor Hassid, M.D., of MD Anderson Cancer Center joins JC to discuss why patient safety should begin before a patient ever reaches the bedside. Drawing on a recent JAMA piece, he explains why delays and breakdowns in access should be viewed through the lens of patient safety and what that shift could mean for healthcare organizations.

In the meantime, you can subscribe on Apple, Spotify, Google, or wherever podcasts are available.

Thanks for reading! Please stay tuned for next week and check out our Gist Weekly archive for past editions. We also have all our recent Graphics of the Week available here.

Best regards,
The Gist Weekly team at Kaufman Hall, a Vizient company