The Prior Auth “Final Boss” Remains Undefeated, Novo Nordisk Forecasts a Slimmer 2026, and SCAN Health Plan Steals the MA Spotlight

Hey All,

Happy Hump Day! It is a grim indictment of American healthcare that the industry’s most effective gatekeeper is a prior authorization form, with KFF confirming that administrative hurdles are now blocking more care than medical science ever could. While Novo Nordisk panics over revenue projections slimming down faster than a Wegovy patient, the rest of the sector is slowly waking up to the radical idea that treating the sick like liabilities might actually be bad for business. The fact that simply offering basic human connection is now hailed as "disruptive innovation" suggests the bar for quality care has been lowered enough to trip over.

Enjoy the rundown!

Jacob Brody (Cofounder & CEO, ZorroRX)

[KFF] Prior Authorizations Rank as Public’s Biggest Burden When Getting Health Care

A recent KFF Health Tracking Poll reveals that approximately seven in ten insured adults find the prior authorization process burdensome, with 34% identifying it as the single greatest non-cost barrier to accessing healthcare. This administrative hurdle is particularly acute for individuals with chronic conditions, nearly 60% of whom report experiencing insurance-led delays or denials that frequently result in negative impacts on their physical health, mental well-being, and personal finances. It’s heartening to see that the healthcare system has successfully evolved into a thrilling quest where the final boss isn't actually the disease, but a fax machine in an insurance office deciding if your doctor’s medical degree is more than just a decorative wall hanging.

Full Article

[Endpoints News] Novo Nordisk Cites MFN Deal in Disappointing 2026 Forecast

Novo Nordisk projects a 5% to 13% sales decline for 2026, triggering a sharp stock selloff attributed to the negative pricing impact of its "most favored nation" deal with the U.S. government. The forecast reflects lower realized prices from mandated discounts and rebates, along with the loss of semaglutide patent exclusivity in select international markets. It seems Novo is fully embracing the spirit of its own products, proving that dramatic weight loss isn't just for patients—it's for corporate revenue projections too.

Full Article

(Fierce Healthcare) SCAN Health Plan’s Record Medicare Advantage Enrollment Growth

SCAN Health Plan achieved its most successful enrollment period to date, adding 127,000 new members during the Medicare annual enrollment window to reach a total of nearly 440,000 beneficiaries across six states. This 40.6% growth was fueled by high star ratings and a surge in niche plans designed for specific populations, including LGBTQIA+ seniors, women, and Asian communities. As SCAN expands nationally by validating that the healthcare system is broken, the BUCAH behemoths might finally realize that offering a human connection works better than keeping seniors trapped in an automated phone tree purgatory.

Full Article