Elevance Health recently reported that it expects to lose more than 180,000 fully insured group plan enrollees in 2026, with its CFO describing the strategy as “prioritizing disciplined pricing and margin integrity over volume.” UnitedHealth has made similar statements. Both are effectively walking away from the fully insured employer market, where administrative complexity no longer justifies the economics.

At the same time, private equity is pouring capital into …

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Recent federal policy discussions have introduced a framework that would place health care affordability dollars into individual-controlled accounts rather than routing them through insurers or employer benefit plans. Still at the framework stage and requiring legislative action, the architecture being explored signals a potential shift in how health care purchasing power flows through the system.

Whether or not this specific framework advances, the direction of travel is clear. Health care …

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Even the most “affordable” DPC models struggle in lower-income markets because the behavioral economics of these populations create high churn and unstable revenue. Practices that succeed in underserved areas nearly always diversify into employer partnerships, institutional contracts, or expansion into higher-income neighborhoods. Without understanding these behavioral and economic realities, physicians risk building a model the community cannot sustain long-term.

I previously argued that physicians must answer five market questions before …

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Physicians tell me they want out of the insurance grind, but they’re terrified to actually do it. That fear is costing them years of autonomy they could already have.

As someone who supports both DPC and concierge physicians, I believe in the purity of the DPC model, but I also believe in practical pathways to get there. Hybrid models aren’t the compromise position; they’re the strategic bridge that makes the transition …

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