The Latest

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    Humana rolls out AI support tool for call centers

    Agent Assist, developed with Google Cloud, summarizes conversations between workers and beneficiaries while highlighting relevant information, like enrollees’ benefit and eligibility details.

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    Sponsored by Elavon

    As self-pay increases, healthcare leaders look to retail for inspiration

    Rising costs, low reimbursement, and staffing shortages challenge small medical practices. Learning from the retail industry can help them stay profitable.

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    Medicare Advantage prior authorization requests rise in 2024: report

    Nearly 53 million prior authorization requests were sent to insurers in 2024, compared with nearly 50 million in the prior year, according to KFF. Almost 8% of those requests were partially or fully denied.

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    Alamy
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    Tenet regains full ownership in RCM subsidiary Conifer as CommonSpirit exits

    CommonSpirit, angling to insource its revenue cycle management functions, is offloading its minority share in Conifer back to Tenet. Tenet said the deal will create almost $2.7 billion in value.

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    Win McNamee via Getty Images
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    Telehealth flexibilities, hospital-at-home waivers lapse amid partial government shutdown

    The Senate passed a spending package Friday, but the measure is still awaiting House approval. House Speaker Mike Johnson said the partial shutdown should be brief.

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    Healthcare bankruptcies fall in 2025, but providers still face headwinds: report

    Bankruptcy filings dropped 21% compared to 2024, according to Gibbins Advisors. Still, the sector’s financial outlook is unsteady due to pressures from Medicaid cuts and other policy changes.

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    Labor Department wants to strong-arm PBMs into being more transparent with employers

    The DOL proposed a rule that would force pharmacy benefit managers to share a broad range of pricing and compensation information with their employer clients, calling it the most significant proposed PBM reform in decades.

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    Healthcare industry outlook for 2026: Providers, insurers, IT companies look to stability

    Companies are hoping to reshore finances and double down on efficiency initiatives this year as several policy sea changes threaten to upend the industry.

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    Top healthcare conferences to attend in 2026

    These are the events healthcare leaders should plan for this year, covering topics like digital health, rural care and financial management.

    Updated Jan. 30, 2026
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    CMS finalizes rule cracking down on Medicaid provider taxes

    The rule puts limits on states levying higher taxes on Medicaid businesses. The CMS argues the tax arrangements allow states to shift costs onto the federal government, but providers say they’re integral for covering the cost of care.

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    Deep Dive

    Health insurers brace for impact in 2026

    Profits will start to tick up after reaching trough levels. Washington will play nice. M&A and AI adoption will accelerate. We asked experts to look into their crystal balls on what the coming year means for a beleaguered industry.

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    Medicaid contractors strike deals with CMS to help states execute work requirements

    Ten Medicaid systems vendors have agreed to provide low- or no-cost services to states over the next two years. The Trump administration said the agreements would save $600 million.

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    ACA enrollment backslides to 23M in 2026

    That’s down 5% from last year. But it’s not the nosedive some market watchers predicted, and a handful of states — notably, Texas — saw robust growth.

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    Opinion

    The healthcare claims system is ready for transformation. Here are 5 ways to prepare in 2026.

    Artificial intelligence could rework the claims and reimbursement process, allowing faster decision-making, reduced errors and billions in savings, according to an Optum executive.

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    HCA could lose $1B from ACA subsidy lapse, Medicaid state payment decline

    The for-profit hospital operator said it’s implementing a resilience plan to offset losses. Still, HCA anticipates its earnings this year will skew closely to or exceed 2025 figures.

  • Teladoc CEO Chuck Divita
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    Permission granted by Teladoc Health
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    Q&A

    Chuck Divita on why 2026 is Teladoc’s ‘execution year’

    The CEO sat down with Healthcare Dive to discuss the company’s move to accept insurance at BetterHelp, its M&A strategy and how Teladoc is using artificial intelligence.

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    Drugs for cancer, arthritis and HIV on Medicare’s list for 2028 price cuts

    Still, the medications in the latest round of negotiations — which now includes Part B drugs given in doctor’s offices — draw very limited revenue from Medicare, an analyst pointed out.

  • A sign reading 'Elevance Health 220 Virginia Ave' in front of a large office complex on a clear day.
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    Alamy
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    Elevance expects lower revenue, earnings, membership in 2026

    This year should see improvements in Medicare Advantage and Affordable Care Act plans but continued pressure in Medicaid, Elevance executives warned investors.

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    CMS official defends flat Medicare Advantage rate proposal for 2027

    Medicare director Chris Klomp said the Trump administration is “massively” in support of MA as health insurers cry foul over the meager rate update.

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    Alex Wong via Getty Images
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    CMS proposes excluding chart reviews from MA risk scoring in 2027 payment rule

    The proposal would eliminate the financial motivation insurers have to mine their members’ charts for additional diagnoses. Regulators also proposed a flat rate update for 2027, prompting anger from insurers.

  • Nurses wearing surgical masks look at a computer in a hospital
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    Win McNamee via Getty Images
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    Interconnectedness, extortion risk make cybersecurity a healthcare C-suite priority

    A new report from Trellix reviews the biggest breaches, describes the most effective defenses and profiles the most dangerous attackers.

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    Courtesy of UnitedHealth Group
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    UnitedHealth revenue climbs in 2025, though profit continues to fall

    The healthcare behemoth posted its lowest profits since 2018 last year, largely thanks to continued Medicare Advantage challenges. Executives warned how regulators’ “disappointing” rate update might further contract MA.

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    Surprise Billing

    No Surprises disputes increasing even as arbiters catch up, CMS says

    The agency released new data on independent dispute resolution in the first half of 2025. Roughly 1.2 million cases were filed in that period, mostly by the same private equity-backed providers.

  • A brick wall with a red CVS Pharmacy sign.
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    CVS accused of shutting out rival pharmacy hubs in House Judiciary investigation

    The company’s massive pharmacy benefit manager changed its rules and weaponized audits to ensure independent pharmacies couldn’t work with competing pharmacy service companies, House Republicans said.

  • A beige office building with large rectangular windows and vertical blinds, featuring a “Kaiser Permanente” sign near the rooftop.
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    Alamy
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    31,000 Kaiser Permanente workers strike in California, Hawaii

    Kaiser workers are calling for increased staffing and wages, which the union argues haven’t kept pace with rising costs. The health system said a generous offer is already on the table.

  • Six people in business clothes sit behind a dias in a congressional room.
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    Rebecca Pifer Parduhn/Healthcare Dive
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    Insurance CEOs’ no good, very bad day on the Hill

    The chief executives of UnitedHealth, CVS, Cigna and Elevance were pilloried for care denials, vertical consolidation and sky-high executive compensation during two House hearings Thursday.