Sign up for our daily briefing

Make your busy days simpler with Axios AM/PM. Catch up on what's new and why it matters in just 5 minutes.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Stay on top of the latest market trends

Subscribe to Axios Markets for the latest market trends and economic insights. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Sports news worthy of your time

Binge on the stats and stories that drive the sports world with Axios Sports. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Tech news worthy of your time

Get our smart take on technology from the Valley and D.C. with Axios Login. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Get the inside stories

Get an insider's guide to the new White House with Axios Sneak Peek. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Catch up on coronavirus stories and special reports, curated by Mike Allen everyday

Catch up on coronavirus stories and special reports, curated by Mike Allen everyday

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Denver news?

Get a daily digest of the most important stories affecting your hometown with Axios Denver

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Des Moines news?

Get a daily digest of the most important stories affecting your hometown with Axios Des Moines

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Twin Cities news?

Get a daily digest of the most important stories affecting your hometown with Axios Twin Cities

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Tampa Bay news?

Get a daily digest of the most important stories affecting your hometown with Axios Tampa Bay

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Charlotte news?

Get a daily digest of the most important stories affecting your hometown with Axios Charlotte

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Geisinger Medical Center in Danville, Pennsylvania. Photo: Lisa Lake/Getty Images

There's some noteworthy language in a recent financial report from Geisinger, the large Pennsylvania system that owns hospitals, doctors' practices and a health insurance company: "Geisinger seeks to grow high-acuity, fee-for-service business by increasing penetration for these services in Geisinger's expanded service area."

The big picture: Former President Barack Obama once hailed Geisinger as a model for health delivery reform. But Geisinger's embrace of "fee-for-service" — a scorned phrase in health policy circles that describes providers getting paid for every treatment and procedure — indicates health care may not be fundamentally changing.

By the numbers: Geisinger is doing well. Its operating income soared 38% in the first nine months of its fiscal year.

I spoke with Geisinger's retiring chief financial officer, Kevin Brennan, to explain the language in the report.

On the current system:

  • "We recognize that not everybody is going to have Geisinger Health Plan," Brennan said, referencing the system's insurance company. "We want to make sure that we don't ignore them and want to welcome and treat them regardless of their insurance source. It's growth and market share that's the most important."
  • He also said physicians don't get higher paychecks if there are more admissions.

On whether fee-for-service will ever go away:

  • "There's increasing talk about whether the current model is sustainable. Can our country really afford this, or do we fundamentally need to undergo some other form of major change?" Brennan said. "I hear more than whispers of some form of a single-payer. I don't know if that's the answer, but it speaks to the difficulty of operating under conflicting incentive systems."

Flashback: Lobbyists and insiders who have been working in health care for decades are often skeptical about whether the industry will really change the status quo on its own. "We're not going to move that far away from fee-for-service," Chip Kahn, CEO of the Federation of American Hospitals, said at an industry conference in 2016.

Go deeper

N.Y. Times faces culture clashes as business booms

Illustration: Sarah Grillo/Axios

New York Times columnist David Brooks' resignation from a paid gig at a think tank on Saturday is the latest in a flurry of scandals that America's biggest and most successful newspaper company has endured in the past year.

Driving the news: Brooks resigned from the Aspen Institute following a BuzzFeed News investigation that uncovered conflicts of interest between his reporting and money he accepted from corporate donors for a project called "Weave" that he worked on at the nonprofit.

America rebalances its post-Trump news diet

Illustration: Annelise Capossela/Axios

Nearly halfway through President Biden's first 100 days, data shows that Americans are learning to wean themselves off of news — and especially politics.

Why it matters: The departure of former President Trump's once-ubiquitous presence in the news cycle has reoriented the country's attention.

2021 sees a record number of bills targeting trans youth

Illustration: Annelise Capossela/Axios

Republicans in at least 25 states have introduced over 60 bills targeting transgender children — a legislative boom since January that has beaten 2020's total number of anti-trans bills.

Why it matters: LGBTQ advocates say the unprecedented push was catalyzed by backlash to Biden's election and the Supreme Court ruling that workers cannot be fired for being gay or transgender.