A nonpartisan institute for healthcare market design.
Pegasus Health Institute is a nonpartisan research, education, and convening institute under Helping Health, Inc., a 501(c)(3), focused on the incentives, policy mechanics, payment systems, and market structures that shape healthcare affordability, access, quality, and sustainability.
Why Pegasus exists
Healthcare affordability remains one of the most persistent challenges facing families, employers, public programs, and policymakers. Yet much of the policy debate focuses on coverage expansion, mandates, or ideological models while overlooking the structural incentives embedded within healthcare markets.
Pegasus exists to study those mechanics: how payment systems, regulation, market design, capital flows, administrative infrastructure, and stakeholder incentives shape real-world outcomes. The institute helps decision-makers move beyond surface-level debate and understand how the system actually behaves.
From consumer assistance to market design
Helping Health, Inc. was originally launched during the COVID-19 pandemic to assist families navigating Medicaid and CHIP eligibility as employment and coverage disruptions affected millions of Americans. Through that work, it became clear that many consumer challenges are not simply enrollment or coverage problems. They often flow from deeper structural incentives built into the healthcare system itself.
Pegasus Health Institute represents an expansion of Helping Health's mission: moving upstream from individual consumer assistance to the policy, regulatory, and market-design forces that shape affordability nationwide.
Mission
Pegasus Health Institute exists to improve the design and function of healthcare markets so the system can better support longer, healthier lives, fewer avoidable complications, greater affordability, and sustainable access to care.
Healthcare policy often struggles because the goals are easy to name but difficult to balance. People want better health outcomes, fewer avoidable complications, affordable care, and a system that works efficiently. At the same time, healthcare markets depend on real-world participation from providers, insurers, employers, innovators, advisors, and public programs. Pegasus analyzes the incentives, rules, payment systems, and market structures that shape those tradeoffs, then develops nonpartisan analysis and practical policy ideas aimed at better alignment between public needs and sustainable market behavior.
Evidence-driven analysis
Pegasus studies healthcare markets through data, source materials, policy documents, operational realities, and stakeholder experience.
Practical policy solutions
The institute focuses on proposals, frameworks, and explanations that can help improve market design, affordability, program integrity, and system sustainability.
Constructive public engagement
Pegasus translates complex healthcare mechanics into clear analysis for policymakers, market stakeholders, supporters, media, and the public.
What Pegasus studies
Healthcare affordability and cost drivers
Payment and incentive design
Insurance market dynamics
Public program mechanics
Regulatory incentive structures
Medical Loss Ratio and insurer behavior
Vertical integration and market consolidation
Subsidy structures and market behavior
Exchange governance and program integrity
Employer coverage and reimbursement-based models
Interoperability, data infrastructure, and administrative systems
Fraud, waste, abuse, and structural arbitrage
Founder
Joshua Brooker, REBC®, ABHP, ASFC
Joshua Brooker is a health policy strategist, benefits professional, and founder of Pegasus Health Institute. He has worked at the intersection of ACA policy, individual market enrollment, ICHRA strategy, broker operations, and health finance since the early implementation of the Affordable Care Act.
Joshua's path into healthcare began with a personal experience being double-billed during the birth of his eldest son, which led him into direct consumer advocacy and health insurance navigation. With a Bachelor of Science in Finance and a strong background in economics, he has applied financial analysis, policy interpretation, and practical market experience to both consumer-level assistance and broader healthcare policy work.
Throughout his career, Joshua has engaged with federal agencies including CMS, CCIIO, IRS, and OMB, as well as members of Congress, state-based marketplaces, industry stakeholders, and media outlets. His work has been cited by national media including The Wall Street Journal, Kaiser Family Foundation/KFF Health News, Associated Press, NPR, and U.S. News.
His analysis focuses on how policy decisions affect consumers, markets, public programs, and the professionals responsible for making the healthcare system work in practice.
Fellows and Contributors
Pegasus will add fellows, advisors, and contributors as formal programs are launched.
Interested in contributing?Operating principles
Nonpartisan by design
Pegasus explains market mechanics without advancing a party, campaign, or stakeholder class.
Institutional in tone
Research and programming are built for serious decision-makers who need clarity without hype.
Ecosystem-wide
Pegasus studies how incentives interact across payers, providers, employers, policymakers, innovators, consumers, funders, and intermediaries.
Practical and evidence-driven
The institute connects policy design to operational reality, using source materials, market data, regulatory analysis, and practitioner insight.
Independence matters
Pegasus may work with supporters, donors, sponsors, and institutional partners, but its role is education and analysis, not sponsor-controlled conclusions.
Clear about limits
Pegasus does not provide investment, securities, legal, tax, actuarial, lobbying, or pay-to-play policy access services.
Independence and limits
Pegasus Health Institute provides nonpartisan research, public education, and market mechanics analysis. Pegasus does not provide investment, securities, legal, tax, actuarial, lobbying, or pay-to-play policy access services.
Build shared understanding across healthcare.
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