The Latest

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    Primary care physicians’ EHR work persists after reducing patient visits: study

    Visit volume for physicians who scaled back on appointments declined nearly 33%, but their EHR time only fell 21%, according to a study published in Health Affairs.

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    Sponsored by Amazon Business

    How healthcare organizations can streamline procure-to-pay processes

    A roadmap for reducing friction, improving visibility and optimizing healthcare buying.

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    Trump signs funding bill with PBM reforms, hospital-at-home and telehealth extensions

    The funding package ends a partial government shutdown and enacts several healthcare policies, including preserving telehealth flexibilities in Medicare through 2027.

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    CMS presses ahead on accelerated Medicare Advantage audits

    The agency quietly released a memo updating MA plans on how it’s approaching risk adjustment data validation audits after a Texas judge’s ruling last year threw the expanded reviews into doubt.

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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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    One-quarter of Medicaid doctors don’t actually treat Medicaid patients: study

    The new research published in Health Affairs adds to concerns about low physician participation in the safety-net insurance program, especially among mental health practitioners.

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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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    Prices rise at surgery centers acquired by Optum: study

    The full financial impact of the price hikes could exceed $67 million each year in two dozen markets, according to the new study published in Health Affairs.

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    Genetic testing takes greater share of Medicare Part B test spending: OIG

    Spending on the tests, which analyze genetic material from both people and pathogens, rose 20% year over year in 2024, the analysis found.

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    Humana deploys 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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    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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    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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    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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    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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    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.

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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.

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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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    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.