Health Services

Health Insurers, Physicians, Hospitals and ASCs / Freestanding Facilities

Capitol Street monitors, analyzes and details the healthcare policy actions and trends that impact health plans and health systems / services.

Our Health Services Expertise

  • Health Insurance. Medicare Advantage, Medicaid, Individual, Small Group and Commercial lines of business.

  • Health Systems. Hospitals, Surgery Centers, Post-Acute as well as freestanding Emergency Department and Clinics.

  • Physician-Led Companies. We know the market for primary care physician-led companies, a segment in the spotlight during Covid and operating at times akin to health plans.

How Capitol Street Clients Use Our Health Insurance and Provider Research

We identify impactful payment and regulatory trends that are often lost on experts, and those that simply look at one or two aspects of healthcare.

We provide real-time and in-depth analysis of healthcare legislation, trends among payors and healthcare stakeholders, and policies that originate from healthcare agencies (CMS, FTC, DOJ), think tanks and other bodies (MedPAC, BPC, AEI, Brookings) and Capitol Hill.

We also preview, review and analyze Supreme Court and lower court case proceedings that are relevant to our healthcare clients.

For example, our clients use Capitol Street to piece together Part D and Medicare Advantage rate notices, along with CMMI demonstrations. We weave together the health insurance plan communications, along with the actions of the national health insurance trade organizations. We track NAIC (National Association of Insurance Commissioners) discussions and recommendations, along with Medicaid Directors and policy implementation on the State level. We also look to the viability of federal policies that may be more pie-in-the-sky like a Public Option or Medicare for All, along with specific impact on hospitals, providers and health plans.

Our Health Services research include:

Monitoring and analysis of relevant policy, legislation, Executive Orders, and policy recommendations from MedPAC, other bodies, along with likelihood of implementation or finalization

Deep-Dive reports on key policy actions and trends including Medicare, MA, Commercial, Individual & Small Group Market & Medicaid. CMS CMMI Pilots and other Regulations impacting the Physician, Acute Care Hospital and Health Plan communities such as MA & Part D Rate Notices, RADV, Star Bonuses, & Landscape Files; Hospital IPPS, OPPS, & Surgery Center (ASC), PBM & Supply Chain Regulations

Forward looking weekly Healthcare Policy catalysts and events

Timely communication including discussions on specific issues

Markets Analysis

Capitol Street helps clients assess competitive position in their industry, along with the macro trends and capital markets perspectives on Healthcare Services companies, both public and private. Our Markets Analysis services for Insurers & PBMs/Hospitals/Physicians include:

Analysis of public companies earnings calls & communications

Review of capital markets’ perspective on industry trends, what is likely to be impactful or relevant going forward based on our policy expertise, political winds (i.e., is there an upcoming election), must-pass legislation & other sometimes seemingly irrelevant inputs.