On June 1, 2026, the Centers for Medicare & Medicaid Services (CMS) released the long-anticipated Interim Final Rule (IFR) on Medicaid Community Engagement Requirements (CER). This IFR constitutes one of the most significant modifications to the Medicaid program since the Affordable Care Act (ACA) and ranks among the most substantial Medicaid regulations in years.
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In this episode of Policy Prescriptions, host Gary Jacobs sits down with Patrick J. Kennedy and Healthsperien founder Tom Koutsoumpas to discuss why America’s future depends on protecting the health of our brains.
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In this episode of Policy Prescriptions, Gary Jacobs sits down with Aisha Pittman, Senior Vice President of Government Affairs at National Association of ACOs, and Ray Quintero, Managing Partner at Healthsperien, for a deep conversation about the future of healthcare policy, Medicare reform, and accountable care organizations (ACOs). They break down how value-based care works, why fee-for-service medicine creates problems, and how new models like ACO LEAD are reshaping the health care system.
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CMS recently released a letter to State Medicaid Directors that provides implementation guidance for the requirement that states redetermine eligibility for Medicaid expansion adults every six months instead of annually, beginning in 2027.
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The Pharmaceutical Care Management Association (PCMA) commissioned Healthsperien to conduct a survey examining employer experiences with prescription drug benefit management and their relationships with pharmacy benefit managers (PBMs). The survey was designed to capture employer priorities when designing drug benefit programs, how employers evaluate PBM partnerships, and how employers perceive PBM performance across financial management, plan design, and additional services.
Healthsperien designed and implemented an employer survey to capture employer experiences managing prescription drug benefits and working with PBMs.
Healthsperien collaborated with PCMA to refine the survey instrument which focused on several key areas:
Healthsperien then administered the survey, analyzed results, and summarized key findings in a comprehensive chart pack. The results of the survey provide a data-driven perspective on how employers evaluate PBM partnerships and the role PBMs play in helping organizations manage prescription drug benefits.
Survey findings suggest that employers view themselves as informed decision-makers
Key survey findings include:
of employers reported confidence in their organization’s ability to make decisions regarding prescription drug benefits.
of employers said access to a wide network of pharmacies is an important factor when selecting a PBM.
of employers reported satisfaction with the data, reporting, and analytics tools provided by their PBM.
of employers reported satisfaction with the accessibility of pharmacy networks provided by their PBM.
of employers that received rebates reported using them to lower employees’ out-of-pocket prescription drug costs.
The survey was conducted online by Healthsperien between January 9 and January 21, 2026, among 1,035 U.S. employers involved in decision-making or oversight of employee health benefits. Respondents were recruited through an online panel and were required to work for organizations that offer health insurance coverage and prescription drug benefits administered through a PBM. Recruiting from an online panel may introduce panel-specific biases. Individuals who participate in online panels may differ from the broader employer population in terms of engagement, digital literacy, or attitudes toward surveys.
Participants represented a range of industries and organization sizes and included human resources leaders, executive leadership, and other benefits decision-makers. It is important to note that the sample skews toward mid-size and large employers, whose experiences with PBMs may differ from smaller employers with fewer benefits management resources.
The 37-question web-based survey, accessible across devices, examined employer experiences with PBM contracting, drug benefit design, rebate use, and satisfaction with PBM services. Some questions were asked only of employers who contract directly with PBMs, resulting in varying base sizes across survey questions. Survey responses reflect self-reported employer perspectives, which may be influenced by recall bias or subjective perceptions. The study used a convenience sample and results were not weighted, meaning findings are reported as collected. The use of the convenience sample means results may not be fully representative of the broader population of employers.
Former U.S. Representative Patrick J. Kennedy has been named as a Partner with the firm and will establish and lead a new national mental health and addiction policy practice. Rep. Kennedy will bring his decades of national leadership, advocacy, and expertise in mental health to advise a diverse array of clients, focusing on mental health and addiction, community-based services and supports, and the need for health system transformation.
Continue readingCMS recently released a letter to State Medicaid Directors that provides implementation guidance for the requirement that states redetermine eligibility for Medicaid expansion adults every six months instead of annually, beginning in 2027.
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Andrew MacPherson, Founding Principal and Managing Partner of Healthsperien, has been appointed to the Board of Directors of the Elisabeth Kübler-Ross Foundation, a global nonprofit dedicated to advancing compassionate care for individuals facing serious illness, death, and grief.
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Entering 2026, U.S. health policy is defined by federal reform spanning behavioral health, drug pricing, Medicaid restructuring, Medicare Advantage modernization, rural investment, and expanded value-based care—reshaping delivery, financing, and oversight nationwide.
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Healthsperien is proud to announce the launch of two new Centers of Expertise—the Center for Medicare & Medicaid Design Solutions and the Center for Patient-Centered Transformation—expanding and rounding out our Centers of Expertise to better support our clients and partners as they navigate an increasingly complex health care environment.
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