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Peaks, Troughs & Trends

The pulse of healthcare markets, policy, and innovation.

Weekly strategic intelligence for healthcare executives, investors, and operators. The signals that matter — curated, analyzed, delivered.

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What's Inside

Peaks

What's accelerating — funding, adoption, policy tailwinds, and market momentum shaping competitive advantage.

Troughs

What's slowing or breaking — workforce strain, reimbursement pressure, regulatory drag, and systemic risk.

Trends

What's quietly reshaping the landscape — emerging shifts to position around before they're consensus.

Latest Edition

The Split

April 9, 2026 · Issue No. 8

The healthcare system is splitting in two. Federal institutions that guided policy for decades are weakening while AI platforms achieve autonomous clinical capabilities. The divide between automated innovation and dismantled foundations is widening.

  • AI crosses prescription threshold — autonomous renewals now legal in Utah
  • 19 health systems abandon Medicare Advantage contracts
  • RFK Jr. rebuilds vaccine advisory panel with new appointees
  • CMS eliminates fax machines, saves $781M annually
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Issue No. 8

Archive

April 9, 2026 • Issue No. 8

The Split

Healthcare divides as AI gains autonomy while federal institutions weaken simultaneously.

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April 2, 2026 • Issue No. 7

The Convergence

Three pressure points converge: massive AI deployment, pharma's patent cliff scramble, and Medicaid restructuring.

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March 19, 2026 • Issue No. 6

The Baseline Document

Peterson-KFF maps the cost crisis as workforce shortages and federal infrastructure fracture.

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March 12, 2026 • Issue No. 5

The Decade Bet

Healthcare's last pillar cracks as the jobs engine stalls and federal health infrastructure fractures.

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March 5, 2026 • Issue No. 4

The Last Engine Running

Healthcare remains America's jobs engine, but the foundation shows cracks as February brings first losses in years.

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February 18, 2026 • Issue No. 3

Access Is Being Rebuilt

Oral GLP-1s, home healthcare growth, MA exits, and care delivery decentralization.

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February 12, 2026 • Issue No. 2

Access Under Pressure

ACA subsidy cliff, employer affordability crisis, and healthcare's first AI labor fight.

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February 6, 2026 • Issue No. 1

The Middle Is Getting Squeezed

PBM reform, hospital consolidation, and why the shortest distance wins.

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