
...

By Alexis Kayser
Healthcare Editor
0
Share
Newsweek is a Trust Project member
See more of our trusted coverage when you search.Prefer Newsweek on Googleto see more of our trusted coverage when you search.
This is a preview of the April 16 edition of Access Health—Tap here to get this newsletter delivered straight to your inbox on Thursday mornings.
Good morning. This week reminded me of a certain movie trope. You know when the cast list for the school play is posted on the bulletin board, and everyone crowds around to read it? There’s always a shakeup: the slated star ends up in the ensemble, or the freshman takes the lead. The theater kids peel off slightly baffled, but assuring one another that they’ll put on a good show.
Read More on Health Care
That was the general mood this week when CMS dropped the list of over 150 ACCESS participants—some chatter about questionable casting decisions, a consensus that the show must go on.
What stood out most, beyond the sheer number of participants, was how uneven the resumes looked. Some organizations have spent years operating inside Medicare Advantage, ACOs or other CMS models, with compliance teams, clinical workflows and data infrastructure built for exactly this kind of experiment.
Others are coming in from the adjacent edges of health care, bringing experience in consumer tech, remote monitoring or analytics—but far less familiarity with Medicare’s rules of engagement. It is an unusually mixed cast for a federal model that, historically, has favored incumbents who already know how to navigate the system.
That diversity is intentional. CMMI set lower barriers to entry here than they have for past outcomes-based models, and the potential payoff is attractive enough to encourage application from companies looking to crack the health care market.
But it also introduces tension. The ACCESS model is asking participants to deliver measurable clinical outcomes for patients with chronic conditions, under tighter margins, while coordinating with a provider ecosystem that is facing financial and technological pressures of its own.
It’s a difficult but familiar challenge for those organizations that are already steeped in value-based care. For newer entrants, some industry leaders fear a learning curve.
Yesterday, I spoke with Dr. Ashul Govil—medical director of Story Health by Innovaccer, and one of the companies greenlit for ACCESS—about his initial reactions to the list.
“What surprises a lot of us is just the sheer number of companies,” Govil said. “I mean, it's great to see that kind of interest. At the same time, I think we’ve just got to be careful. These are real patients, real lives and real clinical outcomes we're talking about. And not everyone's equipped to actually positively influence the outcomes for these patients.”
“My hope is that everyone does their piece, but also knows where their limits are.”
I also posed the question to several health care leaders who were in Chicago for the Becker’s conference this week. They tended to fall into three camps:
- Those who believe the mix of experience will accelerate innovation;
- Those who believe it will expose fault lines between companies who understand Medicare as a system, and companies that are approaching it more like a market;
- And those who are leery of any initiative that promises to “transform care delivery,” bringing receipts from the early ACO and shared savings models.
Regardless of where industry stakeholders fall on that spectrum, they do tend to agree that something needs to change. Patrick Sheehan, VP of value-based care at Withings—another ACCESS participant—suggested that some skeptics are missing the forest for the trees.
“I think many people are thinking about the outcomes-based payment model, but that's really an enabler,” Sheehan told me. “I think that's table stakes. I think the core piece of ACCESS is patient choice.”
“Core to that patient choice is the understanding that the average Medicare beneficiary is also a consumer, and consumer demand for wearables, for connected devices, is something that Medicare beneficiaries are seeking out,” he continued. “ACCESS is a great opportunity to provide that level of technology in a way that's responsible. It's being done with health systems, with ACOs. It's affordable, it's free to Medicare beneficiaries and it's deflationary in nature for the Medicare program."
Participants I spoke with also emphasized that ACCESS will hinge on provider cooperation just as much as, if not more than, consumer participation. Some say they already have the infrastructure in place to integrate seamlessly with health systems. Others have spent the past several months building and refining it.
It’s important for the handoffs to work, because the whole thing hinges on traditional care modalities buying in. If health systems question whether tech companies are truly there to collaborate or—as some providers have evinced—to gain a foothold in the Medicare market, they may hold back.
Govil told me his phone has been ringing nonstop with providers that are eager to partner. But he’s unsure how many will actually commit to ACCESS.
If health systems "choose to sit on the sidelines," Govil said, “it's really going to be a bunch of commercials on TV trying to recruit patients to participate in some digital health company's product.”
And if that’s the outcome, it’s going to be a long 10 years.
What are your thoughts? Let me know at a.kayser@newsweek.com.
In Other News
Major health care headlines from the week
-
This is a big week for HHS Secretary Robert F. Kennedy Jr., who is both launching his podcast and testifying in multiple Congressional hearings about HHS’ budget proposal—the Health Chief’s first Capitol Hill appearance since that tense hearing on (anti-)vaccine policy and his agency leadership ousting spree last fall.
- We’re only a few months away from the November midterms, so Kennedy’s remarks are expected to land as much in the political arena as the policy one. Today’s appearances before the House Ways and Means Committee and the House Appropriations health subcommittee will likely signal how health care will be framed and fought over in the months ahead.
- Kennedy’s written testimony is already available and focuses on “MAHA” wins, including updated dietary guidelines. However, his missteps have taken center stage this week after a Washington Post investigation revealed that the CDC delayed publication of a report detailing the COVID vaccine’s benefits, and a progressive health care advocacy group released a 27-page report making the case for his resignation.
- The marathon continues with a subcommittee hearing tomorrow and multiple sessions next week. We’ll debrief in next week’s newsletter intro, but I want to hear your thoughts as the updates unfold; email me at a.kayser@newsweek.com.
-
Merck’s cancer drug Keytruda can generate staggering bills in the U.S., with one patient charged more than $162,000 for a 400 mg “double dose,” per a joint investigation by USA TODAY and the International Consortium of Investigative Journalists. While patients often pay only a fraction out of pocket, the broader costs are absorbed through higher insurance premiums, employer spending and taxpayer-funded programs.
- The reporting shows that Merck has used a range of legal and market strategies to sustain high prices, including building an extensive patent portfolio, lobbying against Medicare price negotiations and maintaining dosing practices that some researchers say exceed what is clinically necessary. These approaches are common across the pharmaceutical industry and can delay lower-cost competitors for years.
- Prices for Keytruda vary widely depending on where and how patients receive care. Hospital-administered treatments often cost significantly more than those delivered in physician offices, according to data examined in the report.
- Merck has listed a single 200 mg dose of Keytruda at $12,031. Since 2014, the drug has generated almost $163 billion for the company.
- Newsweek has reached out to Merck for comment and will update the web version of this newsletter if/when they reply. Read the full report here.
-
Abridge announced content partnerships with the publishers of NEJM and JAMA yesterday. The agreement allows content from the New England Journal of Medicine, JAMA, JAMA Network Open and JAMA’s 11 specialty journals to inform Abridge’s Clinical Decision Support system.
- Abridge is one of the leading AI-powered clinical conversation platforms in the nation right now, with roots in 250 U.S. health systems. (Check out my December interview with the company’s CEO for more info).
- The NEJM and JAMA content integrations “will become generally available in the coming months,” Abridge said in a news release.
-
In the first quarter of 2026, hospital and health system dealmaking reached its highest first-quarter level since 2020, according to a recent Kaufman Hall report.
- The 22 recorded M&A transactions included three mega-mergers and a surprisingly low proportion of transactions including a financially distressed party (18 percent). For comparison, 2025 set a record for the highest number of deals involving a financially distressed seller (43.5 percent).
- These trends evidence “an industry undergoing transformation,” Kris Blohm, managing director and co-leader of Kaufman Hall’s M&A practice, said in the report. “Health systems are repositioning by withdrawing from underperforming or non-core markets, building capital to invest in new capabilities, proactively seeking partners to increase resilience or enhance access to care and services and placing big bets on new combinations of resources and capabilities.”
Pulse Check
Executive perspectives on key industry issues

...
This week, I connected with Ketul Patel, president and CEO of Wellstar Health System, while he was visiting Chicago.
The former Virginia Mason Franciscan Health CEO started at Wellstar in October. Six months into his tenure, we had a lot to discuss—including his goals to establish a lean corporate structure, a renewed focus on quality and a close-to-home expansion strategy that does right by rural patients.
Find a portion of our interview below.
Editor’s Note: Responses have been lightly edited for length and clarity.
Oftentimes, when a leadership transition occurs, staff see it as an opportunity to bring up some of the things that they've been dissatisfied with. What would Wellstar’s workforce like to see change during your tenure?
The biggest thing that I've heard from our staff is commitment to quality—people are saying it becomes even more important when you see [the effects] for yourself. We have to be committed to quality. We are committed to quality. We are a clinical destination, and people from all over the Southeast are coming here for care.
But staff said that over time, as we’ve grown as a health system, they’ve seen [an impact on] the speed to get things done. I've made a commitment to our staff and our leaders, particularly closest to bedside, that we want to have decision making done closest to the patient. Over time, we're going to evolve our operating structure and delivery model to make sure that those types of decisions are made with the people closest to the work, closest to the bedside, closest to the patient.
What does agility look like at a system of Wellstar’s scale? How do you plan to maintain consistency while allowing decisions to be made at different levels of the organization?
First and foremost, you have to listen [as a leader]. That's really important, because listening allows you to understand what the issues are.
I believe we have to be a lean organization, because when you have “democratized” an organization, speed and agility are just not there. You need to have a lean corporate and operative structure so that the resources are closest to where the work is being done, and more importantly, closest to the bedside.
Part of that is allowing people closest to the work, closer to the bedside, to be able to make changes and eliminate waste, reduce steps in their own workflows. That's a big part of what we will do in the future.
Expanding across Georgia and the Southeast region is also a priority for Wellstar. What do you consider the best growth pathway at this time, in this market: building, acquiring, partnering?
I'm still new here, so we're still assessing where we're going to go and where we're going to be over time. We know there's a lot of interest throughout the state and outside the state, with [other entities] actually coming to Wellstar.
But to me, a partner is always going to be aligned with our values of quality. We have very clear expectations that if you're part of Wellstar, you have to be in the top decile for quality. Every team member needs to be a chief safety officer. Every team member needs to be a chief experience officer.
Right now, we're in the process of building and opening two new hospital sites: one in Columbia County, another in Ackworth. Columbia County will open in August.
Also, our digital strategy is going to allow us to be a lot more expansive. That would not limit us to geography, so we can do a lot more. We're looking to see how much we can truly scale to allow patient care to be closer to home, and then referring [acute care] to one of our destination facilities, whether in Augusta or Marietta, Georgia.
Last, we are going to take a look at the outer landscape of our health system to see if there are hospitals, physician groups or outpatient centers that we want to acquire. That decision may be related to the things I talked about earlier: quality, safety, patient experience, alignment with our culture and whether they are a fit geographically.
Last year, more than 43 percent of mergers and acquisitions involved a financially distressed party.
*Laughs* Yeah, that sounds about right.
I mean, it’s a gloomier metric than cultural fit or quality commitment—but how does the seller’s financial situation factor into your acquisition decisions?
Quality and safety culture is our outcome. We're not going to accept anything or express interest in an organization that [doesn’t prioritize those things], because at the end of the day, we're here to take care of patients, and we've got to do it in a way that we're proud of.
I think when you look at financial distress, there's a variety of different hospitals around the country that don't make that choice until it’s too late. It usually comes down to deep financial challenges. We want to make sure that we are going to provide value to the region, and we're going to be deep, good community partners for that region.
So there's an opportunity for us to raise the operating performance of the organization. The reality is that we have scale that allows us to be able to do that. But we're not an open door for everyone.
C-Suite Shuffles
Where health care leaders are coming and going
-
Fabian Tenenbaum is the new executive vice president and chief venture officer at UPMC Enterprises, the commercialization arm of Pittsburgh-based UPMC.
- He most recently served as CEO of Nectin Therapeutics, a biotech company specializing in immunotherapy with headquarters in Jerusalem, Israel, and Fort Lee, New Jersey.
-
Former Humana executive Oraida Roman is joining Aledade as chief commercial officer.
- Roman was formerly the senior vice president of national provider strategies and operations at Humana.
- In her new role at the value-based care company Aledade, she’ll lead its health plan partnerships strategy.
-
Midstream Health just announced four new senior hires to support its expansion into major health systems.
- The financial action platform—used by the likes of Houston Methodist, CommonSpirit Health and Mount Sinai—named Lyft Healthcare co-founder Omar Nagji its chief commercial officer.
- Kelsey Mellard, a health care entrepreneur and angel investor, will serve as chief customer officer.
- Aneesh Kulkarni, former chief technology officer at STRIVR (the company responsible for AI-powered work intelligence platform WorkWise), was selected as vice president of engineering.
- And Anisha Mocherla, most recently a group product manager at the self-driving vehicle company Cruise, will be Midstream Health’s head of product.
- These are all new roles at the company, a spokesperson confirmed to Newsweek. All leaders started full-time in their roles in February or March of this year.
Before you go, check out Newsweek's profile of Prof. Yitshak Kreiss, director general and CEO of Sheba Medical Center in Ramat Gan, Israel: one of the highest-ranking hospitals in the world.
Kreiss is also a member of Newsweek’s CEO Circle—click here for more information.
This is a preview of the April 16 edition of Access Health—Tap here to get this newsletter delivered straight to your inbox on Thursday mornings.
View 0 Comments
Submit Correction
View Editorial & AI Guidelines