The Grand Roundup: Q3 earnings special — the C-SNP land grab, Nebraska’s Medicaid warning sign, the big three PBMs hold, AI’s quiet earnings role, and more

Earnings season is here, and Kevin and Martin preview what they’re listening for in Q3, starting with government programs. They discuss Medicare Advantage plans pruning PPOs in favor of C-SNPs and D-SNPs, the growth outlook for Humana and Alignment, and Clover’s five-star rating heading into AEP. On Medicaid, they cover plans’ view that 2026 is the trough and early disenrollment data from Nebraska’s work requirement rollout.

On the commercial side, they get into UnitedHealthcare’s commentary on trend above 11% and No Surprises Act IDR payments as a share of medical spend. They also talk through Omada and Hinge’s selling season, the state of the ACA market, the big three PBMs’ outlook, and state laws separating PBMs from specialty pharmacy.

The conversation then turns to hospital operators, covering affordability, delayed elective procedures, and uninsured rates, alongside cash-pay consumer models. The episode closes with value-based care and how AI is showing up on public company earnings calls.

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Links referenced

STAT report on IDR arbitrator profitability: https://www.statnews.com/2026/10/19/no-surprises-act-billing-arbitration-profits-stat-investigation/

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