Finances

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    Courtesy of UnitedHealth Group
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    UnitedHealth commits to changes after independent review

    On Friday, the healthcare behemoth released results of three highly anticipated external reviews that drilled down on a number of areas for improvement.

    By • Dec. 22, 2025
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    Alamy
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    Optum Rx says 100% of network community pharmacies in cost-based contracts

    PBMs are pivoting reimbursement models to protect pharmacies from what they say is an unsustainable status quo.

    By • Dec. 18, 2025
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    Healthcare services M&A could rise in 2026: PwC

    Dealmaking in the sector is poised to increase next year after a lull in 2025, as companies use technology, like artificial intelligence, to attract buyers, according to the report.

    By • Dec. 18, 2025
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    Cencora takes majority stake in cancer care platform OneOncology for $5B

    The drug distributor has been steadily building up its specialty support assets as it looks to increase access to drugs.

    By • Dec. 16, 2025
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    JHVEPhoto via Getty Images
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    Deep Dive

    Goliath v. Goliath

    A Medicare Advantage network spat between Optum and Humana in Washington state appears to be benefiting UnitedHealthcare at the expense of its biggest rival. Antitrust experts are alarmed.

    By • Dec. 16, 2025
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    iStock.com/MicroStockHub

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    Sponsored by Brault

    Emergency medicine reimbursement in 2026: Navigating a system under pressure

    Is your EM practice ready for 2026? Get the latest on Medicare physician payments, commercial payer trends and how to navigate the reimbursement headwinds.

    Dec. 15, 2025
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    Rebecca Pifer/Healthcare Dive
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    CVS to launch ‘engagement’ platform in gamble on consumer, industry interest

    CVS is bringing together its disparate businesses onto one platform, and giving its rivals the option to add their products and services as well. The goal is to improve consumers’ health engagement while generating more revenue.

    By • Dec. 10, 2025
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    Joe Raedle via Getty Images
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    Covert watchdog testing finds ACA vulnerable to subsidy fraud

    The Government Accountability Office successfully enrolled 18 out of 20 fake applicants in subsidized ACA plans. Republicans jumped on the report as ammunition in the debate over expanded subsidies.

    By • Dec. 4, 2025
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    Humana appeals Medicare Advantage star ratings loss to 5th Circuit

    The insurer continues to try to prove that regulators acted arbitrarily in downgrading its quality scores for 2025, despite numerous setbacks in the courts to date.

    By • Dec. 1, 2025
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    Getty / andresr

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    Sponsored by Zelis

    ​Four ways to improve claims accuracy without losing provider trust

    ​Improve claims accuracy and provider trust with four strategies that reduce friction.

    Dec. 1, 2025
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    Premier closes $2.6B take-private deal

    The healthcare services and group purchasing organization stopped trading on Nasdaq Tuesday after more than a decade on the public markets.

    By • Nov. 26, 2025
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    Mayo Clinic doubled its operating income in Q3

    Strong patient demand helped lift Mayo Clinic’s operating income by more than 250% year over year.

    By • Nov. 25, 2025
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    Permission granted by Claritev
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    Sponsored by Claritev

    Empowered patients, competitive markets: How transparency will transform healthcare

    See how price clarity can unlock value and advance genuine patient empowerment.

    Nov. 24, 2025
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    Health tech venture capital investment rebounds in 2025: report

    Funding through the third quarter surpassed last year’s total, according to PitchBook. Meanwhile, average deal sizes are skyrocketing as high valuations — especially for AI startups — drive larger rounds.

    By • Nov. 20, 2025
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    Eric Thayer / Stringer via Getty Images
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    Employers, workers to face healthcare ‘affordability crunch,’ Mercer warns

    A “sharp growth” in prescription drug spending, including pricey GLP-1 weight-loss medications, helped fuel the increase, the consulting firm said.

    By Ginger Christ • Nov. 19, 2025
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    Urban safety-net hospitals vulnerable to Medicaid cuts: analysis

    Though the impact on rural facilities has received more focus from lawmakers, the majority of hospitals that are most susceptible to the funding cuts operate in urban communities, according to the report.

    By • Nov. 19, 2025
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    Cleveland Clinic sees profits jump in Q3

    The academic medical system cited strong patient volumes and new Medicare Advantage agreements as driving increased revenue.

    By • Nov. 19, 2025
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    CommonSpirit continues to operate at a loss

    The health system blamed its performance for the quarter ended Sept. 30 on continued payer denials and cost challenges.

    By • Nov. 18, 2025
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    Medicare premiums set to rise 10% next year, CMS says

    The Part B premium hike could have been worse, the Trump administration said. Still, it’s likely to pressure the pocketbooks of millions of seniors, and could drive more into Medicare Advantage plans.

    By • Nov. 17, 2025
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    Illustration: Xavier Lalanne-Tauzia for Industry Dive

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    Providence’s financial turnaround plan delivers results in Q3

    The nonprofit health system was in the black during the third quarter, boosted by higher patient volumes and improved labor efficiency.

    By • Nov. 14, 2025
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    Humana confident in Medicare Advantage growth despite plan generosity muddling margin recovery

    The Medicare giant likes what it’s seen in the first two weeks of open enrollment. But there are steps it can take if membership growth starts getting out of hand, executives said.

    By • Nov. 5, 2025
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    Medicare finalizes controversial cut to specialty care next year

    The CMS finalized the Medicare physician fee schedule for 2026 one day before the statutory deadline. It includes an overall payment hike and a few policies that are deeply unpopular with specialists.

    By • Updated Nov. 4, 2025
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    Courtesy of Teladoc
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    Teladoc expands insurance coverage at mental health unit BetterHelp

    Executives expect insurance coverage availability will be “largely national” by the end of 2026. The initiative is important for Teladoc to turn around financial performance for the segment, which has seen earnings and revenue decline.

    By • Oct. 30, 2025
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    Alamy
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    Cigna’s 2026 pharmacy profits could be dampened by transition to rebate-free model

    Overall, Cigna expects earnings to grow next year after posting a solid third quarter. But investments in a new PBM model and discounted contracts for some big clients could lower Express Scripts’ profitability, executives said.

    By • Oct. 30, 2025
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    UHS raises revenue guidance for 2025

    The operator increased its outlook after posting earnings growth in the third quarter, aided by strong demand for services in its acute business and a newly approved Medicaid state supplemental payment program.

    By • Oct. 29, 2025