Aetna expands program curbing hospital readmissions for Medicare Advantage members

One hospital has piloted the program for a few months and seen some early successes that have made other operators interested, an Aetna spokesperson said.

States are ramping up AI regulation. How should healthcare respond?

Industry leaders should engage with state lawmakers on AI bills, given many legislators have limited experience with the technology or in healthcare more broadly, experts said during a HIMSS summit.

Premier to go private in $2.6B deal with California investment firm

The take-private deal should give Premier more capital to bolster its operations and invest in technology.

Optum Insight names new CEO

UnitedHealth’s data and analytics arm has tapped its second chief executive officer since May as the company continues to reshuffle its executive bench.

CVS’ Omnicare division files for bankruptcy

CVS’ pharmacy services subsidiary was hit with a $949 million judgment in July. The Chapter 11 process could delay the government from recouping the funds.

States should be full steam ahead on Medicaid work requirements, experts say

There’s a lot that states want the CMS to weigh in on. But given the tight rollout timeline for the controversial mandates, they shouldn’t delay implementation, experts said during a MACPAC meeting.

How to ensure healthcare workers benefit from AI

Trust is key to getting providers on board when health systems look to roll out artificial intelligence, experts said at the HIMSS AI Leadership Strategy Summit in Chicago.

Medicare Advantage plans to share provider directories under CMS final rule

The policy was originally proposed by the Biden administration in November, but comes amid a larger push for more transparency around payers’ provider networks from health officials in the Trump regime.

Kansas, Hawaii Blues invest in Blue Shield of CA’s health tech sister company

Stellarus was launched as part of Blue Shield of California’s restructuring to sell services to nonprofit plans that they don’t have the resources to build themselves. That pitch has now worked on at least two Blues plans.

CDC advisers postpone vote to delay some newborns’ hepatitis B shot

Members of ACIP postponed a planned vote on withholding some infants’ first hepatitis B vaccine dose, adding more confusion to an already muddied meeting.

Ascension returned to profitability in 2025

It’s a victory for the system, which reported a $1 billion loss last year as it struggled to recover from a cyberattack.

Top healthcare legislation to watch so far this year

Federal lawmakers have proposed dozens of bills targeting core healthcare issues, including 340B, Medicaid, AI and site-neutral payments.

More hospitals using predictive AI, but disparities persist: ASTP

More than 70% of hospitals reported using predictive tools last year. But small, rural, independent and critical-access hospitals are lagging behind, according to the analysis.

Johns Hopkins, UnitedHealthcare end contract negotiations after failing to reach agreement

The Baltimore-based system and the major insurer called off contract negotiations, keeping some 60,000 patients out of network.

Updated Sept. 18, 2025

GOP bill extends telehealth flexibilities, sidesteps ACA subsidies

The continuing resolution would preserve virtual care flexibilities through Nov. 21. But it makes no mention of extending more generous financial assistance for people who buy plans on the ACA exchanges.

Optum Rx hikes payment floor on brand name drugs for independent pharmacies

The move builds on the major PBM’s pivot to cost-based pricing for pharmacies announced earlier this year.

Fired CDC director says RFK Jr. aims to change childhood vaccine schedule

Susan Monarez told senators at a hearing Wednesday that Robert F. Kennedy Jr. pushed her out for refusing to rubber-stamp changes.

House lawmakers scrutinize nonprofit hospitals’ tax-exempt status

Republicans pushed for more oversight, or complete removal, of nonprofits’ tax-exempt status. Democrats warned restrictions could cause hospital closures.

How to reform Medicare’s physician fee schedule to reprioritize primary care

America’s primary care chassis is crumbling, and how Medicare pays physicians is partially to blame. Expanding value-based payment arrangements could be the answer, experts say.

Memorial Sloan Kettering to cut staff

The New York-based provider said it’s cutting less than 2% of staff as it contends with rising expenses.

Foundation models are medtech’s newest trend. But what are they?

The AI models, which are built on massive datasets and can be adapted to multiple tasks, have become a part of medtech companies’ lexicon in the past few years.

Medicare prior authorization pilot raises concerns among providers

The additional red tape could save money, but may harm patient access and quality of care. Stakeholders are urging the CMS to increase transparency and hold participants accountable.

Doctors slam specialty cuts in 2026 Medicare pay proposal

Major physician groups and specialists commented in droves that regulators missed the mark on the Medicare physician fee schedule for next year.

CMS opens applications for Rural Health Transformation Fund

States have been anticipating more details about the program since July. Now, they will have until Nov. 5 to submit applications for a piece of the $50 billion pie.

Democrat governors urge Congress to extend ACA subsidies

Eighteen blue state governors are warning of a looming affordability cliff for millions of Americans if lawmakers allow generous financial assistance to lapse at the end of this year.