Centene lowers 2024 earnings guidance as Medicaid redeterminations roll out

The payer beat Wall Street expectations in the first quarter on both earnings and revenue, which reached $39 billion.

By Shannon Muchmore • April 25, 2023

Tenet boosts full-year profit forecast after gains in Q1 volume growth

Surgical cases at the operator’s ambulatory unit climbed 8% year over year, leading to a surge in ambulatory operating revenue.

By Sydney Halleman • April 25, 2023

HCA boosts full-year guidance on Q1 increase in net income, revenue

The operator logged an increase in admissions and a decrease in contract labor spending during the first quarter.

By Sydney Halleman • April 24, 2023

Transformative AI to revamp prior authorizations

With the right payment integrity approach and finely tuned focus, payers will find the exceptional service execution required to thrive in today’s environment.

By Abhishek Danturti Sharma,Principal, Business Transformation, Sagility • April 24, 2023

Hospitals look for immediate return on investments in tough operating environment

“We’re not going after anything that’s kind of cool that takes a couple of years to get to the bottom line. This is about immediate returns,” an Advocate Health executive said Wednesday at HIMSS23.

By Rebecca Pifer Parduhn • April 20, 2023

Elevance sees revenue boost as it focuses on Medicaid redeterminations

The payer said it was pleased with the recent CMS decision to phase in risk adjustment changes to the Medicare Advantage program that would allow it to “smooth the impact” to beneficiaries and providers.

By Shannon Muchmore • April 19, 2023

UnitedHealth notches record revenue in first quarter

UnitedHealth’s growth, which resulted in a profit of $5.8 billion in the quarter, was “stronger than normal,” one analyst said.

By Rebecca Pifer Parduhn • April 14, 2023

Advocate Aurora is latest nonprofit in the red, posts $751M net loss in 2022

Climbing expenses and investment losses contributed to the drop, compared with net income of $1.8 billion in 2021.

By Rebecca Pifer Parduhn • April 13, 2023

CMS proposes 2.8% hospital payment bump for 2024; lobbies decry rise as ‘woefully inadequate’

Hospital lobbies slammed the proposed rule as insufficient to help hospitals address inflation and rising labor costs, though research signals hospitals are more financially stable than such groups suggest.

By Rebecca Pifer Parduhn • April 11, 2023

Cano’s former board members allege conflicts of interest, insider loans

A new open letter from investors Barry Sternlicht, Elliot Cooperstone and Lewis Gold calls on Cano to oust its CEO and sell non-core businesses to focus on profitability.

By Rebecca Pifer Parduhn • April 11, 2023

Last year was second-best ever for healthcare private equity deals, Bain finds

PE transactions were buoyed by a strong first half of the year, with deals declining in the second half due to tensions from Russia’s invasion of Ukraine and growing inflationary pressures.

By Sydney Halleman • April 11, 2023

‘Fair share’ deficits at nonprofit hospitals reached $14.2B in 2020

The amount nonprofit hospitals in several states receive in tax breaks over what they spend on charity care could cover all medical debt for residents, according to the Lown Institute.

By Shannon Muchmore • April 11, 2023

‘Turbulent waters’: The rocky digital health funding market post-SVB collapse

If funding in the next three quarters matches the average funding in the prior three, 2023 is on pace to see the lowest level of digital health funding since 2019, a new report from Rock Health found.

By Rebecca Pifer Parduhn • April 6, 2023

Medicare go-broke date pushed back to 2031

The date Medicare’s hospital trust fund is expected to run dry has been extended by three years, but stakeholders continue to urge action from Washington to address Medicare’s long-term solvency.

By Rebecca Pifer Parduhn • April 3, 2023

Walgreens healthcare division boosts retail giant’s second-quarter earnings

Walgreens’ U.S. healthcare division, including VillageMD, recorded $1.6 billion in sales in the quarter, an increase of $1.1 billion from last year.

By Rebecca Pifer Parduhn • March 28, 2023

Healthcare companies may turn to big banks after SVB collapse

The fall of SVB created a chasm in life sciences financing that could be filled by bigger banks, but might hamper access to quick, short-term cash for startups.

By Sydney Halleman • March 15, 2023

FTC says health privacy key priority in 2024 budget request

The agency cited its need to take on bigger and more complex cases in areas like health privacy in its request on Tuesday for a $160 million funding boost.

By Rebecca Pifer Parduhn • March 15, 2023

Fall of SVB hits healthcare sector as federal regulators step in

The closure of the major healthcare and life sciences lender Friday was the culmination of a rapid four-day nosedive that left some healthcare companies temporarily locked out of funds.

By Sydney Halleman • March 13, 2023

Majority of adults with medical debt owe money to hospitals

While medical debt remains a persistent financial burden in the U.S., a new analysis from the Urban Institute highlights how targeting hospital billing could ameliorate the problem.

By Rebecca Pifer Parduhn • March 13, 2023

Labor expenses, inflation drove Providence to $6.1B net loss last year

The Washington-based nonprofit system also posted a $1.7 billion operating loss in the same period.

By Hailey Mensik • March 10, 2023

Transcarent to acquire majority of telehealth platform 98point6 for $100M

Transcarent will get 98point6’s self-insured employer business, affiliated physician group and a software license. 

By Rebecca Pifer Parduhn • March 6, 2023

Cleveland Clinic posts $1.2B loss in 2022 as expenses rose

The system joined other hospital operators who faced a challenging 2022, the worst financial year since the pandemic began, hospital consultancy Kaufman Hall has said.

By Samantha Liss • March 2, 2023

Bright Health chases cash after overdrawing credit facility

Bright is facing a new threat to its solvency after overdrawing on credit amid efforts to discontinue its health insurance exchange business.

By Rebecca Pifer Parduhn • March 1, 2023

Gross margins in MA market returned to pre-pandemic levels by end of 2021, report finds

The analysis of insurer markets in 2021, the latest year of available annual data, sheds light into the varied financial performance of insurers during the COVID-19 pandemic.

By Sydney Halleman • March 1, 2023

Hospitals start year on better financial footing after challenging 2022, Kaufman Hall says

Volumes, emergency department visits, discharges and total revenues fell for hospitals in January while labor expenses rose, according to the report.

By Hailey Mensik • March 1, 2023