Humana expects 14% hike in 2023 MA enrollment as it taps new leaders

The payer said it expects to pick up 625,000 individual Medicare Advantage members in 2023.

By Samantha Liss • Feb. 1, 2023

Consolidated systems charge more for ‘marginally’ better care, study finds

Care delivered by physicians in health systems costs between 12% and 26% higher than care delivered by independent physicians, according to a study published in JAMA Network.

By Hailey Mensik • Feb. 1, 2023

Persistent, heightened labor expenses pummeled hospitals last year, Kaufman Hall reports

Negative margins and heightened labor expenses continued for hospitals in 2022, causing them to suffer their worst financial year since the pandemic began, according to the report.

By Hailey Mensik • Jan. 31, 2023

Addressing 3 pandemic-induced payment integrity challenges

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 Subrahmanyam Mantha, VP of Payment Integrity, Sagility • Jan. 30, 2023

HCA shares slide after company forecasts drop in 2023 profit

The operator cited widespread inflation and continued effects from the COVID-19 pandemic as potential drags on its guidance this year.

By Sydney Halleman • Jan. 27, 2023

Upcoming Medicaid redeterminations could hamper hospitals, payers

Medicaid eligibility checks beginning in April will likely curb hospital revenue and enrollment growth for payers, Moody's Investors Service said in a report.

By Hailey Mensik • Jan. 26, 2023

Amazon doubles down on generic drugs with new RxPass subscription

RxPass will cost Prime customers $5 per month to fill prescriptions from a list of about 50 generic medications.

By Rebecca Pifer Parduhn • Jan. 24, 2023

Study throws claims of telehealth savings into doubt

However, Kaiser Family Foundation researchers did stress telehealth’s benefit in expanding access and convenience for consumers.

By Rebecca Pifer Parduhn • Jan. 19, 2023

Cleveland Clinic expects $200M-plus operating loss in 2022

The anticipated loss is a stark contrast to 2021, when Cleveland Clinic reported its strongest financial performance ever with $746 million in operating income.

By Rebecca Pifer Parduhn • Jan. 19, 2023

Tenet shakes up leadership, operations team

The role changes come a year after the system’s previous COO, Suam Sutaria, was promoted to CEO following the retirement of Tenet chief executive Ron Rittenmeyer.

By Sydney Halleman • Jan. 19, 2023

Teladoc slashes 6% of workforce in cost-cutting effort

The job cuts are part of a larger restructuring plan, with the telehealth company saying it’s eliminating redundant roles after prior mergers.

By Rebecca Pifer Parduhn • Jan. 18, 2023

Healthcare company bankruptcies up 84% in 2022

Filings rose significantly throughout last year, with about three times more in the fourth quarter than in the first quarter, according to a report from Gibbins Advisors.

By Hailey Mensik • Jan. 17, 2023

UnitedHealth, flush off 2022 momentum, eyes membership, value-based growth

Looking forward, UnitedHealth expects growth of its membership rolls, an increase in fully capitated lives in Optum Health and an acceleration of Optum Insight’s integration with Change Healthcare.

By Rebecca Pifer Parduhn • Jan. 13, 2023

Hospitals disappointed with court ruling placing HHS in charge of 340B repayment

The court’s ruling on Tuesday is the latest update in a yearslong legal dispute between safety net hospitals and the government over payment rates.

By Rebecca Pifer Parduhn • Jan. 11, 2023

Teladoc expects $2.4B in 2022 revenue, boosted by BetterHelp

BetterHelp’s contribution implies a growth rate of 43% for the business, up from previous management targets, according to an SVB Securities analyst.

By Rebecca Pifer Parduhn • Jan. 10, 2023

CVS reportedly nearing $10.5B buy of Oak Street

A deal could be announced as soon as this week, according to The Wall Street Journal, as CVS looks to create a vertically integrated healthcare business.

By Rebecca Pifer Parduhn • Updated Feb. 7, 2023

Walgreens raises healthcare segment outlook on Summit acquisition

The company now expects the segment to bring in between $14.5 billion and $16 billion in sales in 2025.

By Rebecca Pifer Parduhn • Jan. 5, 2023

Hospital margins improve modestly in November as expenses dip

The monthly upturn in operating margins, identified in a new report from Kaufman Hall, is a bright spot in an otherwise difficult year for the nation’s hospitals.

By Susan Kelly • Jan. 5, 2023

Labor shortage, inflation drove Mass General Brigham to $432M annual operating loss

The system’s results reflect an “unrelenting economic crisis” impacting healthcare, President and CEO Anne Klibanski said.

By Sydney Halleman • Dec. 19, 2022

Healthcare leaders expect turbulent operating environment next year

Staffing challenges and high inflation are expected to continue into 2023, along with affordability issues for patients, shrinking margins and continual supply chain disruptions, according to a survey from Deloitte.

By Hailey Mensik • Dec. 16, 2022

National health spending reached $4.3 trillion in 2021

Increases in healthcare utilization and insurance coverage were offset by lower government spending on COVID-19, according to new CMS data.

By Rebecca Pifer Parduhn • Dec. 14, 2022

Nonprofit hospitals’ staffing challenges easing, Fitch says

Still, the ongoing pandemic, influenza and RSV cases are causing capacity issues that pose a major near-term risk to labor costs.

By Hailey Mensik • Dec. 14, 2022

Bright Health in danger of being booted from NYSE

The insurtech, which went public last year, has struggled with medical costs during the pandemic and has shrunk its business over the past year.

By Rebecca Pifer Parduhn • Dec. 13, 2022

5 hospital shipping oversights that create financial waste

Shipping and receiving may not get much attention in busy healthcare environments, but there are untapped efficiencies that can come from a more robust and centralized strategy. 

Dec. 12, 2022

Centene reaches $17M settlement with Oregon

The payer has reached settlements with 13 states over allegations it overcharged Medicaid programs.

By Samantha Liss • Dec. 9, 2022