The Latest

  • Logo of HCA Houston Healthcare on the top of a modern hospital building under a clear blue sky.
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    Alamy
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    HCA cuts 2026 earnings forecast on insurance coverage losses

    Payer mix changes, mostly from people dropping out of Affordable Care Act plans, caused HCA to lose $400 million in the second quarter — much more than the company (or its investors) had expected.

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    Unai Huizi Photography/Shutterstock.com and ModMed via Gemini 

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    Sponsored by ModMed

    Flipping the script on payer denials and downcoding

    Tired of skyrocketing payer denials? Here is how medical practices can finally fight back with AI.

  • A concrete sign outside of a building reads "Department of Health & Human Services" wrapped around the HHS logo.
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    Kayla Bartkowski via Getty Images
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    ‘The system is undeniably broken’: More insurers sue CMS over Medicare Advantage stars

    SCAN Health Plan and Alignment Healthcare both filed lawsuits against the CMS last week after regulators refused to recalculate industry-wide MA scores using the same methodology as for Clover Health.

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    HHS watchdog says it’s targeting Medicaid, Medicare Advantage fraud

    The HHS Office of Inspector General removed over 1,200 people and entities from federal programs between October and March as the Trump administration ratchets up oversight into healthcare fraud.

  • Happy doctor greeting a coworker with a handshake at the hospital
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    Hospital M&A sustains momentum in Q2: report

    Hospitals and health systems recorded 18 transactions in the second quarter after a lull in dealmaking early last year as providers partner up in a bid to bolster their finances.

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    Kayla Bartkowski via Getty Images
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    Soon-to-expire ACO REACH generates more savings for Medicare

    The model, which is set to sunset at the end of this year, generated $988 million in savings for Medicare in 2024, according to new CMS data. That’s up from almost $695 million in savings from the year prior.

  • A sprawling hospital with "Memorial Hermann" on its facade.
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    Retrieved from Memorial Hermann on July 10, 2026
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    Memorial Hermann exits commercial insurance business

    The Houston-based nonprofit is the latest integrated system to throw in the towel on some of its insurance plans amid a tough cost and policy environment.

  • Patients wait to check-in at a line of kiosks to get vaccinated.
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    Sergio Flores/Getty Images via Getty Images
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    Tracker

    Tracking healthcare data breaches

    A data breach at a New Jersey lab testing provider may have exposed the information of more than 540,000 people.

    Updated July 13, 2026
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    Permission granted by The Economic Club of Washington, DC/Gary Cameron
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    CVS CEO says Aetna has a handle on medical costs in advance of Q2 earnings

    David Joyner’s assurances, which come about a month before CVS is scheduled to report its second quarter results, will likely be welcomed by investors wary after a difficult few years for insurers.

  • A sign displaying Brigham and Women's Hospital
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    Darren McCollester/Getty Images via Getty Images
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    Strikes boil at Mass General Brigham, Mount Nittany

    About 4,500 workers at Mass General Brigham are striking this week, while employees at Mount Nittany Medical Center in Pennsylvania said they would take to the picket line later this month.

  • A gavel rests on a pile of money wrapped with a stethoscope.
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    Getty Images
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    Whistleblower lawsuit accuses Alignment of accounting fraud

    A former executive is claiming that the MA insurer recorded millions of dollars as capital expenditures that should have been operating expenses, inflating its value. Alignment strongly denied the allegations.

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    Getty Images
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    Physicians’ wearable data use hampered by reimbursement, workflow barriers: survey

    “We have all this data that’s available, but it’s actually not actionable because we don’t have a way to get it into clinical workflow,” said American Medical Association CEO Dr. John Whyte.

  • A CPAP device, lamp and smartphone sit on a nightstand.
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    Courtesy of Resmed
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    Resmed to sell software business MatrixCare to private equity firm

    Selling the unit, which provides an EHR for post-acute care, will allow the respiratory device maker to shift more resources to faster-growing parts of its portfolio.

  • A modern office building facade with blue-tinted windows and a curved design. A sign near the roof reads “Centene Corporation” in blue and gray lettering.
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    Alamy
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    Centene exits Arkansas Medicaid expansion program, citing funding challenges

    ARHOME represents a small portion of Centene’s overall membership and premiums. But the exit shows how insurers are rejigging their businesses in advance of Medicaid work requirements, one analyst said.

  • UnitedHealth Group office
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    Courtesy of UnitedHealth Group
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    External audit of UnitedHealth senior home visits finds most diagnoses supported by medical data

    Almost 97% of diagnoses found in HouseCalls visits were backed up by patients’ medical records, vindicating the program’s integrity, UnitedHealth said.

  • A flag reading "Obamacare" and with the exchanges' logo waves in front of an insurance agency.
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    Joe Raedle via Getty Images
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    ACA premiums set to spike again in 2027

    Insurers are proposing a median premium increase of 14% for 2027, according to KFF, suggesting another year of double-digit premium hikes as policy upheaval and rising costs continue to roil the marketplaces.

  • A piggy bank rests near a stethoscope.
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    Ascension to buy Tennessee system Williamson Health in $1B deal

    Ascension beat out other offers, including from HCA and Optum, to give Williamson a financial lifeline amid serious challenges facing regional hospital operators. The deal is expected to be final by 2028 at the latest.

  • Epic's logo on top of its booth at HIMSS23.
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    Rebecca Pifer/Healthcare Dive
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    Epic president to step down this summer

    Sumit Rana’s departure could be a significant leadership shakeup for Epic, as the president was viewed as a potential successor to the EHR vendor’s 82-year-old CEO.

    Updated July 8, 2026
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    AdaptHealth discloses patient data was stolen in cyberattack

    The medical device supplier said that a threat actor accessed company systems through a social engineering attack.

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    Getty Images
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    Private equity may skirt oversight with nonprofit healthcare joint ventures

    The investment firms are leaning on joint ventures with nonprofits to expand in the healthcare sector, according to a new report from the Private Equity Stakeholder Project.

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    Opinion

    Healthcare faces congressional oversight heading into 2026 midterms and beyond

    Democrats are planning investigations into major healthcare topics if they win majorities in Congress this November. Healthcare firms should prepare for increased oversight now, write lawyers with Holland & Knight.

  • A gavel rests on a pile of money wrapped with a stethoscope.
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    Getty Images
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    Elevance sues CMS after Medicare Advantage stars recalculation

    Regulators recalculated plans’ quality scores last month after losing a lawsuit to Clover Health. But they used a different methodology for Clover than its peers, causing Elevance to lose out on $115 million, the insurer told a court.

  • The exterior of Medtronic's Minnesota operational headquarters is shown along with its reflection in a pool of water.
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    Courtesy of Medtronic
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    Medtronic starts to notify people affected by cyberattack

    The medtech giant said it currently has no evidence that the accessed data has been posted to the internet.

  • A concrete sign outside of a building reads "Department of Health & Human Services" wrapped around the HHS logo.
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    Kayla Bartkowski via Getty Images
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    Medicare slashes 340B payments, broadens site-neutral policies in proposed 2027 payment rule

    The rule, released Thursday, builds on Trump administration’s priorities, including cutting Medicare reimbursement for drugs in the controversial 340B program and equalizing payment between sites of care.

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    Getty Images
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    Medicare Advantage bonuses will exceed $13B this year, KFF finds

    Medicare is spending more on quality bonuses despite fewer enrollees in eligible plans, the health policy research group said — a concerning trend putting more stress on Medicare’s coffers that could amplify calls for reform.

  • Heritage Valley Health System
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    Courtesy of Allegheny Health Network and Heritage Valley Health System
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    Allegheny Health Network, Heritage Valley finalize combination in Pennsylvania

    The deal brings Highmark Health-owned AHN’s hospital count to 16. The combined system will invest about $285 million over the next decade to bolster Heritage Valley’s facilities.