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Perspectives

Insights from the field.

Built with our Aequalis data platform using full market datasets, not samples.

Market Perspectives

Elevance Named Its Own Medicaid Exit Test. Four States Fail It.

Elevance told investors it will exit more Medicaid markets but named none. On the same call it named its own test: alignment with duals, the one leg outsiders can score on public data. Measured that way, four active states fail outright, the same zero DC and Nebraska carried out of the market. A watchlist built from what the company said, not what it left unsaid.

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Medicare Advantage

AEP 2026 Analysis and Databook

MA growth has structurally slowed to just +1.0% YoY, becoming increasingly concentrated as the Top 5 carriers still control ~70% of enrollment while several large nationals retreat through margin-driven retrenchment. Growth is rotating toward focused operators and regionally entrenched PSPs, with C-SNP specifically outpacing D-SNP growth at a rate of nearly 3:1, creating a differentiated entry wedge for clinically integrated plans and condition-focused startups.

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Medicare Advantage

MA Landscape Analysis at Start of Year 2026

A visual and data-driven analysis of the Medicare Advantage market heading into 2026, including enrollment rankings across the Top 25 health plans, year-over-year rank movement, and emerging growth patterns among regional plans and startups. Built with the Aequalis Payer Insights Platform.

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HospiceNew

Where Risk and Opportunity Sit in the Hospice Market

In a market-segmentation analysis for an investor weighing a hospice roll-up, we mapped the entire Medicare-certified hospice universe in the Aequalis platform and tied each agency to its true economic owner. The clinical risk doesn't sit with the large platforms drawing headlines; it concentrates in a small corner of fast-growing micro-portfolios that flag across most of their agencies. A clear risk-and-opportunity map for anyone underwriting scale in hospice.

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Urgent CareNew

The Quiet Unwinding of Capital-First Care Delivery

The urgent-care land grab didn't stop; it changed hands. Venture- and retail-backed operators are retreating (Optum from ~190 centers to 34; VillageMD off the list entirely) while health systems quietly took the top of the market through joint ventures. A majority of the 100 largest operators' locations now sit inside a hospital affiliation. Built from four years of JUCM Top 100 rankings, extracted and analyzed by 3Pillars.

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PACE

PACE Operating Performance Opportunities

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What's Working in VBC

Value-Based Care

What's Working in VBC: Cardiology AI

Cardiology AI is moving beyond generalist tools toward specialist disease phenotypes, with applications spanning democratized echo acquisition, automated interpretation, and signal-based screening via ECG and digital stethoscopes. This market intelligence brief maps the competitive landscape across echo automation leaders, signal-based screening, and virtual-first care models, and outlines the strategic implications for VBC bundling, hardware-agnostic deployment, and payer partnerships.

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Value-Based Care

What's Working in VBC: Care Navigation

Care navigation has become the central operating system bridging fragmented benefits and actual healthcare delivery, with 76% of employees indicating they don't understand their benefits. This market intelligence brief maps the competitive landscape from full-stack platform giants to emerging agentic AI models, and identifies the strategic shift from flat PMPM contracts toward performance-based pricing tied to medical cost reduction.

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How We AI

AI TransformationNew

Why AI Transformation Needs a Strategic Management Office

Most health plans adopt AI by accumulating use cases, cataloguing 200 to 300 candidates as progress, then reaching for a PMO to manage them. We challenge whether that structure fits the task. AI transformation is exploratory, business-led, and realized only when a workflow actually changes. This perspective makes the case for a Strategic Management Office (SMO): a lightweight, forward-deployed strategy-and-execution function that concentrates on the few initiatives that move a P&L and embeds AI agents alongside operators.

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AI TransformationNew

The Five Levels of AI Maturity in Healthcare

The most expensive AI mistake is not buying the wrong tool. It is buying for a level you do not yet operate at. This perspective lays out the five-level AI maturity ladder, from consumer tools used on the side through AI embedded in the operating model, and shows why most healthcare organizations sit between Levels 0 and 1 while buying as though they were at Level 3. Operating well at each level is more valuable than skipping to the next one.

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AI Transformation

Measuring Realized Value from AI Transformation

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What We're Hearing in the Market

Star RatingsNew

The Star Ratings Ruling Removed Less Than the Commentary Suggests

Since late May, much of the Medicare Advantage quality community has treated a federal court ruling as though it retired twenty Star measures. Traced through the ruling, the CMS memo, and the published 2027 measure set, that reading is wrong in the direction that costs a plan money: nineteen of the twenty are back for 2027, several heavier, and work underway now lands in the 2028 ratings. A read on what actually changed and where the risk really sits.

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Rural Health

Rural Health Transformation Opportunities for Care Coordination Vendors

An analysis of the structural challenges facing rural healthcare delivery and specific opportunities for care coordination vendors to create measurable value, from virtual care and remote monitoring to care navigation platforms serving rural health systems and payers.

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Field Notes

Field Notes: What Operators Are Telling Us Now

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