Molina controls costs in Q1 but future Medicaid spending in doubt

The Latest

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  Amazon One Medical launches weight management program including GLP-1 drugs

  The company argues the offering is a more comprehensive approach to weight management, allowing patients to receive ongoing support care and transparent pricing on prescriptions.

  Health IT

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  Sponsored by Counsel Health

  3 questions every payer should ask about medical AI

  As medical AI scales, how are payers ensuring safe and compliant care?

  Payer

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  Moderna, after losing US funding, rebounds to start mRNA bird flu vaccine trial

  A program that got caught up in HHS’ decision to abandon mRNA research was revived by a public-private coalition and is now beginning a large, late-stage test that could support a future approval.

  Government

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  UnitedHealth hikes profit outlook after better-than-expected first quarter

  Premium hikes, plan redesigns and other efforts from the Minnesota-based company to wrangle medical spending bore fruit in the first quarter. UnitedHealth’s stock jumped accordingly.

  Payer

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  Providers push back on 340B rebate model

  Hospitals and clinics told regulators that switching to rebates in the 340B drug discount program would impose costs that would outweigh the program’s benefits.

  Hospitals

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  Blue Shield of California taps chief pharmacy officer

  Hayley Park will oversee BSCA’s prescription drug programs. The insurer has worked to overhaul its pharmacy management model in a bid to lower drug costs.

  Payer

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  QuikTrip to sell urgent care clinics after 6 years in business

  The retailer, which at one point had 14 MedWise sites, is divesting its nine-location network to Saint Francis Health System.

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  RFK Jr. defends HHS tenure, 12% proposed budget cut

  Republicans largely praised the HHS secretary’s track record during a marathon of House hearings last week, but some GOP lawmakers raised concerns about proposed budget cuts to the National Institutes of Health.

  Government

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  Physician burnout is improving but some specialties lag, the AMA finds

  The influential physician association surveyed thousands of doctors and found that burnout last year was lower than in 2024 or 2023. Still, certain specialties, especially those on the front lines of care, face an elevated risk of burning out.

  Hospitals

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  Judge dismisses Aetna’s No Surprises fraud suit against Radiology Partners

  The insurer accused the radiology group of gaming the No Surprises Act to reap higher reimbursement. A judge tossed the case last week, saying Aetna needed to raise its complaints during the dispute resolution process.

  Payer

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  Stakeholders urge Labor Department to finalize PBM transparency rule

  Employers, lawmakers and more said regulators should hustle to get disclosure mandates for the controversial drug middlemen across the finish line, while PBMs slammed the rule as illegal, unnecessary and anticompetitive.

  Payer

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  GE HealthCare, RadNet expand AI mammography collaboration

  The partnership adds access to a workflow for second reads of complex cases and other software features made by RadNet subsidiary DeepHealth.

  Health IT

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  CMS proposes repeal of add-on payment path for breakthrough devices

  The agency said it developed concerns about the limited evaluation process for the devices after gaining experience with the alternative pathway.

  Government

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  ACA exchanges will continue to shrink as fewer enrollees pay premiums, analysis suggests

  About 14% of ACA enrollees didn’t pay premiums in January, a higher rate than usual and one that suggests ACA enrollment will continue to decline, according to Wakely.

  Payer

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  Erica Schwartz, ex-deputy surgeon general, picked to be next CDC director

  If confirmed by the Senate, Schwartz could finally fill a void for an agency that’s cycled through multiple leaders over the last year.

  Government

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  Abridge partners with medical journals to expand AI clinical decision support

  The AI scribe company said information from the New England Journal of Medicine and the JAMA Network will allow providers to more easily access the latest medical research.

  Health IT

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  More employers considering medical, pharmacy vendor switch amid rising healthcare costs, survey finds

  Healthcare affordability continues to keep employers up at night. More businesses are shopping for new healthcare vendors as a result, according to the Purchaser Business Group on Health.

  Payer

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  Walmart expands digital health platform’s weight loss offerings, including GLP-1 prescribing

  Customers can now connect to third-party providers for weight management services through Walmart’s digital health platform, then turn around and fill GLP-1 prescriptions at its retail pharmacy.

  Updated April 17, 2026

  Telehealth

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  FDA moves toward easing restrictions on certain peptides

  The agency’s decision to hold an advisory committee meeting on the topic comes after HHS Secretary Robert F. Kennedy Jr. told podcaster Joe Rogan he’s a “big fan” of peptides.

  Government

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  Surprise Billing

  California judge tosses Elevance’s surprise billing suit in win for providers

  It’s a major victory for controversial billing intermediary HaloMD, which cheered the court’s decision. Elevance said it plans to appeal.

  Payer

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  ChristianaCare names successor after CEO retires

  Dr. Janice Nevin will step down in September after more than 12 years in the health system’s top role. ChristianaCare’s former chief legal counsel will take her place.

  Hospitals

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  More insurance claims denials are being overturned upon appeal, study finds

  Study authors, who reviewed data from New York, said rising rates of overturned claims suggest that insurers’ claims review processes might not be working as intended, and policymakers should consider getting involved.

  Payer

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  VA deploys Oracle EHR at four Michigan medical centers

  The rollout marks the first deployment of the records system at a VA medical center in years after technical problems plagued the project. In total, 13 medical centers are scheduled to receive the Oracle EHR in 2026.

  Health IT

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  With health costs ballooning, workers turn to wellness and the internet, ADP finds

  When workers delay care because of cost, it could hurt employers more in the long run, other research suggests.

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  CMS accepts more than 150 providers, digital health firms for ACCESS model

  Participants will receive set reimbursement for managing Medicare beneficiaries’ chronic conditions, like diabetes, chronic kidney disease and hypertension.

  Payer

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  Tenet CIO to retire at year end

  Paola Arbour will stay at Tenet on a part-time basis to provide transition and support services through early 2028.

  Hospitals

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