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By RaeAnn • Founder & CEO, HLTHWORKS
COVER STORY
The Standard / Article 06
THE ECONOMICS OF HEALTHCARE • NO. 06
Whole-Person Care: The Benefits Are Already There
We do not need new benefits to protect HealthSpan. We need to stop administering the ones we already have on separate tracks.
Weaving supplemental, behavioral, and pharmacy into a single care journey makes care more accessible, affordable, and preventive, and the research shows every one of those lowers total cost of care. Collaborative behavioral care returns roughly$6 for every $1 spent; medication adherence cuts CHF costs 23 percent; a $20 ride prevents an ER visit.
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.
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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
Contracting That Pays for Whole-Person Care
The value-based mechanism that funds whole-person care and holds it accountable. The payoff to the case built across Articles 3 through 6.
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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.
12
Centene and the Limits of Discipline
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13
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 later, a federal appeals court has confirmed what the numbers already showed. The failure was in the design.
FROM THE ARCHIVE
Analysis, commentary, and field notes across payer, provider, and policy.
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…
The Hemsley Turnaround Model
The fourth largest company in the world spent a year deliberately getting smaller. Revenue held…
Medicare Advantage Mass Exit for 2027
The cost curve moved up as the premium factors moved down. Everything else in the…
The Chief Transformation Officer
Healthcare has adopted the title faster than it has defined the job. Four organizations using…
Who Owns Artificial Intelligence?
Ask four executives in the same organization and you will get four answers. Not because…
The Audit Mandate Comes to Healthcare AI
A single state just made independent AI audits the law. The reach will not stop…
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