ABOUT THE STANDARD
By RaeAnn • Founder & CEO, HLTHWORKS
COVER STORY
The Standard / Article 12
THE ECONOMICS OF HEALTHCARE • NO. 12
Centene and the Limits of Discipline
Congress removed the patient from the transaction and left the price to arbitration. Six years later, a federal appeals court has confirmed what the numbers already showed. The failure was in the design.
JULY 2026 • 8 MIN READ • PAYER STRATEGY, VBC, HEALTHSPAN
The Economics of Healthcare
A serialized argument, in order. Start at the beginning or jump to any article.
03
The Economics of Health, and the missing Accountability Factor
How more than half a trillion Medicare Advantage dollars move through five sets of hands, and why none is paid for the member’s health span.
READ >>
04
Four capitation structures, who captures the upside, and why revising 2027 budgets and designing 2028 contracts around whole-person care is the real fix.
05
06
07
From Value-Based Care to Whole-Person Care
08
Who Owns Artificial Intelligence?
Ask four executives in the same organization and you will get four answers. Not because they disagree, but because the agenda is attached to people rather than to structures, and the people are moving.
09
The Chief Transformation Officer
Healthcare has adopted the title faster than it has defined the job. Four organizations using the same two words mean four different things, and the difference is not stylistic. It follows the margin.
10
Medicare Advantage Mass Exit for 2027
The cost curve moved up as the premium factors moved down. Everything else in the Medicare Advantage exits follows from that.
11
The Hemsley Turnaround Model
The fourth largest company in the world spent a year deliberately getting smaller. Revenue held flat. Operating earnings rose fifty five percent. Wall Street re-rated it.
13
No Surprises, No Ceiling
15
AI in Health Plan Member Experience Is a Risky Venture
16
Healthcare AI Survey: Deployment Is Outpacing Governance
What 133 Healthcare Companies Reported
FROM THE ARCHIVE
Analysis, commentary, and field notes across payer, provider, and policy.
Healthcare AI Survey: Deployment Is Outpacing Governance – What 133 Healthcare Companies Reported
Across health plans, health systems, physician groups, and the vendors serving them, deployment is running…
AI in Health Plan Member Experience Is a Risky Venture
Three regulations already on the books were written on the assumption that member outreach is…
Nothing to Inspect
The compliance function was built to verify that a process was followed. Artificial intelligence produces…
No Surprises, No Ceiling: The Design Flaw in the Law That Worked
Congress removed the patient from the transaction and left the price to arbitration. Six years…
Centene and the Limits of Discipline
A company can do everything the turnaround literature asks of it, three years early and…
The Hemsley Turnaround Model
The fourth largest company in the world spent a year deliberately getting smaller. Revenue held…
READ THE STANDARD FIRST
New editorials on the economics and redesign of healthcare, delivered as they publish.