TrustWorks On Call: iBlood Pressure

Behind the Headlines

Unpacking the forces driving healthcare's biggest stories.

1. Kaiser Permanente to joint venture with Renown Health.

Last Wednesday, Kaiser Permanente (KP) and Renown Health, an integrated delivery network and the largest health system based in Reno, NV, announced a joint venture to operate a health plan and outpatient care delivery system in northern Nevada.
The joint venture, called Kaiser Permanente Nevada, will sell health plan coverage to employers and residents in northern Nevada and provide multispecialty, ambulatory care, using both new and existing clinics.
The deal, targeted to close in early 2026 pending regulatory approval, involves KP buying a majority stake in Renown’s health plan, Hometown Health, which will operate with KP’s technical and purchasing support but with no other immediate changes; Renown Health will continue to operate independently, as well.

TrustWorks Take: Unlike KP’s Risant Health, which is slowly acquiring value-minded systems across the country, this joint venture with Renown offers a quicker integration of KP’s health plan business into a new, adjacent market. KP Nevada will be able to offer employer, individual, and Medicare Advantage plans that target the significant overlap in people living, commuting, working, and vacationing between KP’s northern California and Renown’s northern Nevada base, whose population growth has been fueled in large part by California transplants. Both Risant and this joint venture represent KP’s attempts to expand its footprint in less-regulated, high-growth states, while staying true to its longstanding commitment to value-based care. As for Renown, its solid financial footing allowed it to be selective in finding a partner, as it reportedly spent several years vetting options before choosing KP to help it better serve large employers that cover an ever-increasing percentage of the northern Nevada workforce.

2. Trump admin releases children’s health report.

Last Tuesday, the Make America Healthy Again (MAHA) Commission, a team of top Trump administration healthcare and social policy officials, published its Make Our Children Healthy Again Assessment, outlining how different government agencies, including the Departments of Health and Human Services, the Department of Agriculture, and the Environmental Protection Agency, could work to improve the health of American children.
The report included 128 recommendations, which are not binding but could influence future regulatory actions, targeting the four primary drivers it identified as contributing to the rise of chronic disease in children: poor diet, chemical exposure, inadequate physical activity, and overmedicalization.
Environmental groups and MAHA allies have criticized the report for failing to propose new pesticide regulations, while the report's directive to develop a new “vaccine framework” for children has stoked fears that newly reconstituted Advisory Committee on Immunization Practices (ACIP) is going to weaken the childhood vaccine schedule.

TrustWorks Take: This grab-bag list of nonbinding policy ideas lacks a coherent implementation plan, and it is only important insofar as it reveals the (sometimes competing) priorities of the Trump administration. In many cases, the report identifies real problems, such as poor nutrition and excess chemical exposure. However, the administration has demonstrated little credibility to tackle these problems, as evidenced by Congress’s recent cuts to federal food aid and the report's weakened stance on pesticide regulations. Meanwhile, its proposals around childhood vaccines could have directly negative consequences by promoting disproven safety concerns that undermine the already shaky vaccine confidence among parents. (The New York Times is reporting that ACIP, when it meets this Thursday, is “widely expected” to limit its hepatitis B shot recommendation to only the babies whose mothers are known to be infected.) And finally, there are the topics the report refuses to touch due to political inconvenience, such as the two leading causes of adolescent deaths: gun violence and car crashes.

3. FDA clears Apple Watch to detect hypertension.

Last week, the Food and Drug Administration (FDA) granted regulatory clearance for Apple Watches to use optical heart sensors to detect signs of hypertension.
Apple shared that this feature, which will collect and review data over a 30-day period before notifying users of potential hypertension, is now available on its latest smartwatch models.

TrustWorks Take: Among the nearly half of US adults with hypertension, less than one in four have their blood pressure under control, while over half of adults with uncontrolled hypertension don't even know they have it. Apple’s hypertension detection feature, which is not meant to replace a clinical diagnosis, is targeted at those tens of millions of Americans for whom a push notification might be the warning they need to seek formal diagnosis and treatment. Removing the barriers between patients and their own health information should be a good thing, especially given primary care access shortages; however, access to those next steps remains a challenge. Should your watch notify you of your hypertension risk, you’ll still need to find a healthcare provider, confirm the diagnosis, and commit to a treatment that works for you. These wearable tech biometric assessments will only unlock their potential to move the needle on Americans’ health once they’re connected to the infrastructure of care delivery. The real measure of success won’t be how many watches send notifications, but how well those alerts are translated, via action inside the health system, into improved outcomes for its users.

Beyond the Whiteboard

Visualizing key trends from the healthcare industry

Medicare’s Ever-Growing Physician Pay Gap
Every year, we see the same song and dance play out: the proposed Medicare physician fee schedule (PFS) includes an unacceptable cut, lobbying groups work frantically to either change the final rule or get Congress to intervene, and when the net result is essentially the maintenance of last year’s levels, physicians almost feel like they’ve won. What that process obscures is how, over the last 25 years, the Medicare PFS conversion factor, used to assign dollar values to the services for which physicians bill Medicare, has declined 9 percent, while the Medicare Economic Index, which measures practice cost inflation, has increased 59 percent. Health Secretary Kennedy has signaled a willingness to reform how Medicare pays its physicians, but it seems unlikely this administration would do away with relevant budget neutrality requirements in order to make physicians feel whole. Instead, physician groups have been left to sort out rising costs and flat-lined payments on their own, leading to workforce instability, widening specialty shortages, and downstream access problems for patients, especially in rural and safety-net settings where Medicare is the dominant payer. These issues of cost and revenue may seem operational on the surface, but they have deep implications for strategy and governance. Such a threat to the survival of the physician group, and the viability of its underlying operating model, should demand the entire organization’s attention, from the C-suite and boardroom down to the clinic floor, back office, and supply room.

Dialing In

Sharing insights from our work with clients

Holding a Mirror to the Board
One of the physician enterprises we work with recently completed its first board self-assessment. On the surface, the exercise was simple: a structured survey about board composition, meeting effectiveness, decision-making, and process, combined with a few interviews and a report on the findings. However, the process gave board members a rare chance to look in the mirror and evaluate their own performances, as individuals and a collective.

They generally liked what they saw, but the discussion touched on both areas that were easily addressable (too much time spent on report outs and not enough on strategy, lack of regular education regarding the larger environment, etc.) and bigger issues that needed attention (unclear lines between board oversight and management execution). It helped foster among board members a greater clarity on their roles, renewed trust in one another, and a stronger sense of shared accountability. Most importantly, they found tangible connections between how effectively they were governing and the impact on overall organizational performance.

Nothing sinks an organization quicker than bad governance, but board self-assessments are still rare in many medical groups. One reason for this is that many groups (and boards) view governance work as a chore that is tacked onto their busy schedules, rather than as an essential aspect of a high-functioning organization. When balancing the demands of growth, sustainability, strategic direction, risk, and alignment with other market players, board self-assessments can be a catalyst for productive conversations well-worth their time on the calendar, which is why this group already scheduled another one for next year.

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