Elevance curbs elevated medical costs, raises 2023 forecast

Although it’s still early in the redeterminations process, Elevance is seeing “encouraging” signs that many Medicaid members who lose coverage are transitioning onto ACA plans, according to its CFO.

By Rebecca Pifer • July 19, 2023

Colorado to shut down failing Friday Health Plans

State regulators had initially hoped the insurtech could operate for the rest of the year, but Colorado’s insurance division became concerned about Friday’s longevity after placing the insurer into rehabilitation.

By Emily Olsen • July 18, 2023

UnitedHealth beats Q2 expectations, despite medical cost growth fears

Rising outpatient utilization among seniors that spooked investors earlier in the quarter left the payer’s bottom line largely unscathed.

By Rebecca Pifer • July 14, 2023

M&A transactions heat up to pre-pandemic levels, Kaufman Hall finds

Transactions in Q2 were the most in a single quarter since the COVID-19 pandemic began — a sign the M&A market is “regaining momentum.”

By Susanna Vogel • July 14, 2023

CFPB urged to abolish deferred interest amid medical debt concerns

Panelists who spoke during a recent hearing on medical billing and collections identified deferred interest credit cards as a prime culprit saddling patients with medical debt.

By Caitlin Mullen • July 13, 2023

Humana, Elevance, Centene downgraded days before second-quarter earnings kickoff

J.P. Morgan and Wolfe Research analysts cited uncertainty and pricing concerns in Medicare Advantage in addition to cost pressures in the commercial market when downgrading major U.S. payers.

By Rebecca Pifer • July 13, 2023

New normal: Less money, fewer investors for digital health

Rock Health’s latest report found U.S. startups raised $6.1 billion across 244 deals in the first half of 2023. If investment stays at the same pace, the sector is facing its lowest funding year since 2019.

By Emily Olsen • July 11, 2023

Feds drill down on medical cards

With consumers increasingly tapping medical credit cards to pay for healthcare costs, the Biden administration is zeroing in on regulations to police such financial services.

By Lynne Marek • July 10, 2023

Home health industry group sues CMS, HHS over payment cuts

The National Association for Home Care and Hospice said regulators used “an illogical and invalid methodology” in a new payment model.

By Emily Olsen • July 7, 2023

Healthcare costs will grow 7% next year, PwC finds

Providers are expected to seek rate increases from payers as they struggle with labor costs, while health plans will face pressure from increased pharmaceutical expenses.

By Emily Olsen • June 29, 2023

Primary care compensation growth outpacing other specialties

Primary care doctors have particularly benefited from CMS coding tweaks in 2021, according to a new survey. The gains could help narrow the compensation gap between primary care physicians and other specialties.

By Rebecca Pifer • June 29, 2023

MA beneficiaries with chronic conditions have lower utilization, spending, industry-backed report finds

The Better Medicare Alliance-funded analysis compared beneficiaries with hypertension, hyperlipidemia and diabetes across MA and traditional Medicare and found that spending was “consistently higher” among FFS beneficiaries.

By Emily Olsen • June 28, 2023

Hospital operating margins positive for third consecutive month: Kaufman Hall

Hospitals’ financial health has yet to return to pre-pandemic levels, but it appears to be stabilizing as Congress debates changing federal payments to providers.

By Susanna Vogel • June 28, 2023

FTC proposes updates to merger review that could slow healthcare dealmaking

A new rule proposed by antitrust regulators would ask companies to provide additional information about planned mergers to help the Federal Trade Commission keep pace with increased deal volume and complexity.

By Emily Olsen • June 28, 2023

Walgreens stock plummets after pharmacy chain cuts 2023 outlook

“Our performance in the third quarter did not meet our overall expectations,” Walgreens CEO Roz Brewer told investors Tuesday morning.

By Rebecca Pifer • June 27, 2023

Babylon to go private, merge with MindMaze

The take-private proposal from AlbaCore Capital comes after the digital health firm has fared poorly on the stock market.

By Emily Olsen • June 26, 2023

UnitedHealth to acquire Amedisys for $3.3B after home health provider reneges on Option deal

The deal would be UnitedHealth’s second purchase of a home health and hospice company, as the integrated healthcare giant looks to capture revenue from medical care increasingly delivered outside of hospitals.

By Rebecca Pifer • June 26, 2023

Health services M&A holding steady despite economic headwinds

Deal volumes declined 4% in the year ended May 15 compared to 2022, according to a PwC report. But the consulting firm is “optimistic” about the sector’s M&A outlook for the rest of the year.

By Emily Olsen • June 23, 2023

State Medicaid spending fell below pre-pandemic levels during continuous enrollment

An analysis by KFF found state spending on Medicaid fell during the COVID-19 pandemic even as enrollment soared. But spending will likely increase as the federal government begins to pare back its increased contribution.

By Emily Olsen • June 21, 2023

SEIU accuses HCA of inappropriate patient transfers to hospice to boost profits, executive pay

HCA called the allegations “not serious” and “propaganda filled with misleading and absurd accusations that are not supported by facts” in a statement following the union report’s release.

By Rebecca Pifer • Updated June 22, 2023

Oracle reportedly lays off hundreds of Cerner employees amid VA contract troubles

The layoffs, reported by Insider, come after the VA renegotiated its contract with Cerner over patient safety issues and follow massive job cuts from other tech giants this year.

By Rebecca Pifer • June 20, 2023

Cano CEO steps down after push from former board members

Prior to the leadership change, three former board members, who jointly own the largest stake in the company, accused the Florida-based chain of poor corporate governance and urged Cano to oust CEO Marlow Hernandez.

By Emily Olsen • June 20, 2023

Humana becomes second major payer to flag higher outpatient volumes in Q2

Pent-up demand for healthcare delayed during COVID-19 is making a reappearance, pressuring medical costs for health insurers that had a financial windfall during the pandemic.

By Rebecca Pifer • June 16, 2023

US health spending to surpass $7T by 2031, CMS actuaries say

The unwinding of the COVID-19 public health emergency and recent legislation are expected to influence health spending across the country’s major payers over the next decade.

By Rebecca Pifer • June 15, 2023

Large, geographically diverse insurers see ‘very stable’ operating performance

Payers including UnitedHealth, Elevance Health, Cigna and Humana are benefiting from strong market share that aids them in negotiations with providers, Fitch Ratings found.

By Emily Olsen • June 14, 2023