Gist Weekly: July 31, 2026

In the News

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

1. For-profit quarterly earnings: canaries in the coal mine? Second-quarter earnings announced this week by HCA Healthcare, Universal Health Services (UHS), and other for-profit hospital companies point to headwinds in the wake of the Affordable Care Act (ACA) exchange enrollment declines and more uncompensated care. Executives from UHS, HCA, Tenet Healthcare, and Community Health Systems (CHS) report that patients losing ACA exchange coverage are becoming uninsured at much higher rates than anticipated, dragging down profits. Operational performance for UHS and HCA exceeded analyst expectations, with both companies reporting continued demand for hospital services but lower demand for surgical procedures—all while staffing costs remain high. Not every system was affected the same. Tenet raised its overall outlook for 2026 (crediting strong operating performance), HCA and UHS tempered earnings expectations, and CHS said the developments were unlikely to change its outlook for the year. Company executives expect fairer weather ahead, with longer-term investments, pending acquisitions, and capital investments to expand capacity.
   • The Gist: If HCA sneezes, it's a sign that everyone may be catching a cold, notes Lisa Goldstein, a managing director in Kaufman Hall’s Treasury and Capital Markets practice. “Everyone should sharpen their pencils,” she says. “HCA is the largest for-profit hospital operator and the second-largest hospital operator after Kaiser Permanente. Because it is so large and operates in so many high-growth markets, it is considered a bellwether of the industry. If HCA underestimated the impact of the shift from ACA exchange coverage to uninsured, then we should all take note.” For-profit executives anticipated that patients losing ACA marketplace coverage would transition to employer-sponsored insurance rather than becoming uninsured. With a rising uninsured population, hospitals must double down on healthcare affordability with durable performance improvement measures. Medicaid supplemental payments may offset some of these headwinds, but Q2 results may be a troubling early sign.
2. America’s blood shortage. The nation’s blood supply shortage has been deemed a crisis by the American Red Cross for the second time in 150 years, the organization announced Monday. Blood donations fell to a four-year summer low, prompting the Red Cross, which provides 40% of the national blood supply, to limit distributions of type O blood to hospitals and urge donations. Because donated blood must be used within 42 days, blood supply cannot be stockpiled long-term. The shortage is compounded by higher need this year, with the Red Cross distributing 3,500 more units than typical this time of year.
   • The Gist: If you haven’t noticed a dwindling supply in your hospital yet, chances are you will soon. Hospitals have been scheduling about 65% of their anticipated blood needs ahead of time to provide greater flexibility and avoid running out. That may be harder to achieve if donations don’t keep pace with demand. A national shortage forces hospitals to prioritize the most urgent patient needs, creating bottlenecks and delaying care, and potentially leading to worse outcomes. Hospitals and health systems may wish to help by raising awareness and hosting or sponsoring blood drives.
3. Hypertension during pregnancy is becoming more common. Rates of high blood pressure in pregnancy, known as gestational hypertension, increased dramatically between 2016-2024, according to a Centers for Disease Control and Prevention (CDC) report published Wednesday. The gestational hypertension rate shot up 73% over that period, from 1 in 17 to 1 in 10, the CDC reported. Pre-eclampsia and other hypertensive disorders of pregnancy lead to high-risk pregnancies. While the newly reported figures do not include pre-pregnancy hypertension (which is also rising), hypertension in pregnancy increases women’s lifelong heart disease risk.
   • The Gist: Maternal care is becoming more complex. Earlier recognition of gestational hypertension means more patients need high-risk obstetric care, changing where they can safely deliver and increasing the need for team-based care. For patients, that experience can be a whirlwind, with more questions and more visits. For care teams, higher complexity means more follow-up to provide tailored care, higher stakes, and higher risk. That may translate into greater demand for remote blood pressure monitoring, maternal-fetal medicine, neonatal intensive care, and comprehensive maternal care programs to manage preterm birth, perinatal loss, and longer-term postpartum and cardiovascular complications.

Plus—what we’ve been reading.

4. What’s in a name? A recent STAT article explores the impact of the recent name change of a condition formerly known as polycystic ovarian syndrome (PCOS), a polygenic endocrine condition. The article describes how the nomenclature of PCOS was limited in ways that led to delayed and under-diagnosis and documented gaps in clinicians’ awareness. The delay in diagnosis, compounded by access and insurance coverage barriers, makes care for patients with the condition a “roller coaster” with sadness, confusion, pain, and mood swings, according to the article. The new name, polyendocrine metabolic ovarian syndrome (PMOS), brings hope for change, particularly for women of color for whom prevalence of disease is twice that of white women. Women of color are also more likely to experience severe symptoms like hypertension and severe metabolic complications. With an estimated more than 70% of patients with PMOS currently undiagnosed, the name change holds promise to address the gap.
   • The Gist: The name change on its own—which was introduced in May in The Lancet following panel discussions with clinicians, researchers, and patient advocates, may not appear to be a big deal. But for patients and their care teams, it’s a step toward clarity and a potentially more straightforward patient journey. By framing the condition as a multisystem disorder rather than primarily a reproductive one, the name change may accelerate diagnosis—and with it, demand for care. With more than a third of physicians incorrectly believing that PMOS is only associated with ovarian cysts because of the old name, under-diagnosis meant circuitous patient journeys, delayed treatment, and, often, complications. The name change also more closely aligns with current diagnostic guidelines that highlight the endocrine, cardiovascular, and metabolic changes that patients experience. As awareness grows, health systems may need to build multidisciplinary care models to support the 1 in 8 women with PMOS who require more coordinated care.

Graphic of the Week

A key insight illustrated in infographic form.

Non-labor expense is a major cost driver, increasingly tied to access, throughput, and where care is delivered

Vizient projects a 3.54% increase in pharmacy inflation and a 3.39% average increase for supply chain overall, including a 4.73% inflation for indirect spend and purchased services, according to the Summer 2026 Spend Management Outlook. The Vizient report, which published Monday, finds that price inflation, utilization, reimbursement, innovation, workforce pressures, and site-of-care changes influence one another—and together affect care delivery planning, resource allocation, risk management, and organizational outcomes. The report found that as the drivers of health spending continue to evolve, the need to manage clinical and operational non-labor expenses becomes increasingly interconnected.

This Week at Kaufman Hall

What our experts are saying about key issues in healthcare.

Patient trust has become a strategic asset for healthcare organizations. As consumers gain more choices about where they receive care, trust increasingly influences not only patient experience but also loyalty, reputation, and long-term growth.

A new article examines why trust has eroded, what patients value most, and how health systems can rebuild confidence.

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, we shared the first part of host J. Carlisle Larsen’s conversation with Victor Hassid, M.D., of the MD Anderson Cancer Center, on why patient safety begins before a patient reaches the bedside.

This Monday, the second part explores what it takes to turn that idea into action. Dr. Hassid discusses how healthcare organizations can align clinical and administrative teams, overcome operational barriers, and begin putting a patient safety approach to access into practice.

You can subscribe to the Gist Healthcare Podcast on Apple, Spotify, Google, or wherever podcasts are available.

Thanks for reading!

Publishing hiatus: The Gist team is going fishin’ 🎣 for the first two weeks of August.

We will return August 21. In the meantime, please 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