Finances: Page 2
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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 Rebecca Pifer Parduhn • Dec. 4, 2025 -
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 Rebecca Pifer Parduhn • Dec. 1, 2025 -
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 -
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 Emily Olsen • Nov. 26, 2025 -
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 Susanna Vogel • Nov. 25, 2025 -
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 -
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 Emily Olsen • Nov. 20, 2025 -
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 -
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 Emily Olsen • Nov. 19, 2025 -
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 Susanna Vogel • Nov. 19, 2025 -
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 Susanna Vogel • Nov. 18, 2025 -
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 Rebecca Pifer Parduhn • Nov. 17, 2025 -
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 Susanna Vogel • Nov. 14, 2025 -
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 Rebecca Pifer Parduhn • Nov. 5, 2025 -
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 Rebecca Pifer Parduhn • Updated Nov. 4, 2025 -
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 Emily Olsen • Oct. 30, 2025 -
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 Rebecca Pifer Parduhn • Oct. 30, 2025 -
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 Susanna Vogel • Oct. 29, 2025 -
CVS hikes 2025 guidance despite goodwill impairment charge on healthcare delivery
The healthcare giant beat Wall Street expectations in the third quarter, but reported a net loss after recording a $5.7 billion charge linked primarily to decelerating clinic growth at Oak Street Health.
By Emily Olsen • Oct. 29, 2025 -
Tenet pledges more money for high-acuity growth in 2025
The hospital operator will invest more in organic hospital growth and high-acuity service lines as it sees strong demand for services.
By Susanna Vogel • Oct. 29, 2025 -
Centene posts $6.6B loss on massive value writedown
The goodwill impairment charge is meant to realign Centene’s value on its own books with its value in the market, which has plummeted this year. Still, Centene upped its earnings outlook for 2025.
By Rebecca Pifer Parduhn • Oct. 29, 2025 -
UnitedHealth maps path back to Wall Street’s good graces
The healthcare giant beat Wall Street expectations in the third quarter and raised its 2025 earnings guidance, albeit modestly.
By Rebecca Pifer Parduhn • Oct. 28, 2025 -
Deep Dive // HLTH25
Health systems are racing to adopt AI. But can they prove its value?
Measuring financial returns from AI can be challenging, experts said at the HLTH conference. But other metrics, like provider and patient satisfaction, are important too — and also impact providers’ bottom lines.
By Emily Olsen • Oct. 27, 2025 -
Surprise Billing
High volume of surprise billing disputes are ineligible for arbitration, insurers allege
Plans found 39% of claims submitted to independent dispute resolution last year were actually ineligible for the process, but arbiters themselves caught only 17% of improper cases, according to AHIP and the BCBSA.
By Rebecca Pifer Parduhn • Oct. 27, 2025 -
HCA raises 2025 guidance, but eyes looming headwinds
The for-profit operator's guidance raise is "cautious," one analyst said. Still, HCA is staring down challenges like the potential expiration of more generous Affordable Care Act subsidies.
By Susanna Vogel • Oct. 27, 2025