Gist Weekly: September 18, 2026

In the News

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

Bracing for a shifting uninsurance rate. Health insurance coverage did not statistically differ between 2024 and 2025, according to a U.S. Census Bureau report released Wednesday. The latest data found that employer-based coverage remains the most common form of coverage, accounting for 53.5% of all insured individuals. Medicare followed at 20.1%, then Medicaid at 17.1%. The Census Bureau also found that Medicaid coverage modestly declined for a second year in a row, citing “changes in policy, funding, eligibility and enrollment processes that began in 2020.” The Census Bureau findings come as hospitals report uncompensated care increases over the past year, driven partly by the expiration of Affordable Care Act enhanced premium tax credits. Hospitals are also bracing for reductions in Medicaid coverage as eligibility requirements take hold in 2027.

• The Gist: Affordability and insurance coverage questions loom large across the field. “As hospitals’ payer mix continues to shift, we are seeing pressure from uncompensated care intensify,” said Erik Swanson, a managing director with Kaufman Hall. “While performance has remained relatively stable on the surface, there is considerable variation across hospitals, and those with the thinnest margins are often the ones caring for our most vulnerable populations.” Data from the National Hospital Flash Report this summer showed mounting pressures as hospitals prepare for coverage changes taking effect in 2027. “Proactive planning around resource allocation and expense management will be essential as these pressures continue to build,” Swanson added.

And—what we’re following.

• Twelve independent Arkansas pharmacies sued the pharmacy benefit manager Express Scripts Tuesday for allegedly underpaying for prescriptions.
• Federal health officials last week officially declared the end of the largest cyclosporiasis outbreak.
• The American Medical Association released its 2027 CPT code set last week, including unbundled obstetrics codes and 10 new AI-related codes, among other updates.

Plus—what we’ve been reading.

Pennsylvania races to contain an unprecedented measles outbreak. A recent article in The Washington Post details the effort to combat the country’s largest ongoing measles outbreak in the past 35 years. Public health workers in Pennsylvania are vaccinating families in their homes and “inside fire stations, places of worship and on a neighbor’s front porch.” The strategy is proving critical in Lancaster County, which has 45% of the state’s measles cases and where traditional communities including Amish and conservative Mennonite families often are not reached through conventional vaccination sites. Pennsylvania health centers have administered more than 5,700 measles, mumps, and rubella vaccine doses this year, including more than 600 in Lancaster County since April. State health officials are working with community partners to expand vaccine access through planned outreach and sometimes hastily arranged efforts sparked by residents seeking vaccines for their neighbors. Experts say the outbreak will worsen in the months ahead.

• The Gist: With state officials now reporting a fourth measles-related death, the Pennsylvania effort illustrates a principle articulated more than a century ago by neurosurgery pioneer Harvey Cushing: “A physician is obligated to consider more than a diseased organ, more than even the whole man—he must view the man in his world.” That means recognizing that vaccination is not simply a matter of making doses available. Healthcare decisions are shaped by several factors, including culture and trust. The lesson extends beyond measles: prevention has a better chance of success when organizations understand how communities actually use care and adapt their approach accordingly, particularly as political tensions surrounding public health intensify.

Graphic of the Week

A key insight illustrated in infographic form.

HAIs declined 2015 to 2023: CDC

Healthcare-associated infections (HAIs) declined 27% from 2015 to 2023, according to a recent CDC survey published in the New England Journal of Medicine. The decline was driven by reductions in C. difficile infections, central line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), and non-ventilator-associated pneumonia, while surgical site infections (SSI) rose slightly. HAIs that were not linked to a procedure or device also increased modestly from 60.2% of all HAIs in 2015 to 61.3% in 2023. The decline reflects years of concerted anti-infection interventions across healthcare settings. HAIs remain a key measure of patient safety and influence patient choice, reimbursement penalties, and value-based incentives.

This Week at Kaufman Hall

What our experts are saying about key issues in healthcare.

Healthcare leaders face pressure to adopt AI quickly while weighing its uncertain costs, risks, and effects on patients, employees, and communities.

Health systems should focus AI on meaningful problems, assess its broader consequences, and measure whether it improves outcomes, Kaufman Hall’s Dan Clarin and Terry Hemken wrote in a recent article. They offer four principles for moving from experimentation to a disciplined strategy: build organizational maturity, target big problems, weigh benefits against risks, and define success before deployment.

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, Gist Healthcare Podcast host J. Carlisle Larsen spoke with Kaufman Hall's Kenny O’Neill about why rural healthcare systems should bet on big initiatives, not small pilots, as part of the Rural Health Transformation Program.

Coming up on Monday, JC is joined by The Washington Post reporter Lydia Sidhom to talk about a recent piece she co-authored looking at the more than $270 million pharmaceutical companies paid to doctors and other prescribers connected to GLP-1 drugs.

Thanks for reading! 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