Medicare unveils successor to ACO REACH

The value-based care pilot will be replaced by ACO LEAD, a new model that providers and analysts say seems to address many of the problems posed by its predecessor.

By Rebecca Pifer • Dec. 19, 2025

Trump administration moves to bar hospitals from providing youth gender-affirming care

Under new proposed rules, hospitals would lose federal funding if they offer treatments including puberty blockers, hormone therapy or surgical procedures to minors. 

By Sydney Halleman • Dec. 18, 2025

Explore the Trendline➔

Payer/provider relationships

As M&A intensifies and companies embrace more holistic and value-based care models, partnerships have become more closely intertwined.

By Healthcare Dive staff

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 Rebecca Pifer • Dec. 16, 2025

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 Rebecca Pifer • Dec. 16, 2025

Hospitals look to manage expenses as uncertainty looms: report

Only 30% of hospital leaders expect balance sheets to improve next year as health systems grapple with costs and changes to federal healthcare policy, according to Kaufman Hall.

By Sydney Halleman • Dec. 12, 2025

Provider groups urge Trump administration to drop proposed HIPAA update

The proposed cybersecurity rule, released during the waning days of the Biden administration, would add “substantial new financial burdens” on providers, the groups wrote to the HHS.

By Emily Olsen • Dec. 11, 2025

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 Rebecca Pifer • Dec. 10, 2025

CVS agrees to pay $38M to settle insulin fraud claims

For a decade, CVS knew it was skirting rules meant to limit overprescribing but did nothing to stop, according to the Department of Justice.

By Rebecca Pifer • Dec. 3, 2025

[Podcast] Beyond Documentation: Transforming Healthcare Workflows With AI

This podcast explores how AI is transforming clinical care and reshaping how healthcare teams work.

By Healthcare Dive's studioID • Updated Dec. 2, 2025

Family physicians are departing rural areas: report

Between 2017 and 2023, the share of family physicians working in rural areas dropped 11%, according to a study published in the Annals of Family Medicine.

By Susanna Vogel • Dec. 2, 2025

Why Medicare Advantage contract negotiations are getting heated

“There’s simply more at stake in these negotiations for payers and providers than there used to be,” one expert said.

By Michael Brady • Nov. 26, 2025

CMS finalizes 2.6% outpatient pay bump, site-neutral policies

Hospitals lambasted the final rule as inadequate, arguing the sector is facing significant financial pressures.

By Emily Olsen • Nov. 24, 2025

Optum Health names new CEO

Krista Nelson replaces Dr. Patrick Conway, who was appointed as CEO of UnitedHealth’s healthcare delivery unit in June. Conway will stay on as CEO of the company’s broader health services division.

By Susanna Vogel • Nov. 17, 2025

More rural hospitals shutter labor and delivery units in 2025: report

Only 41% of rural hospitals in the U.S. deliver babies, according to a report by the Center for Healthcare Quality and Payment Reform. In some states, fewer than one-third of these facilities offer labor and delivery services.

By Emily Olsen • Nov. 13, 2025

4 tips on protecting health systems from cyberattacks

Healthcare organizations should invest in post-attack recovery and carefully evaluate risks from vendors, according to industry experts who spoke at a Healthcare Dive virtual event.

By Sydney Halleman • Nov. 7, 2025

UnitedHealthcare pays Optum doctors more than other doctors: study

Researchers said the results suggest UnitedHealth may be sidestepping government rules meant to keep a lid on exorbitant payer profits. UnitedHealth said the study was “flat-out wrong.”

By Rebecca Pifer • Nov. 4, 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

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

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 • Oct. 27, 2025

Cigna’s Express Scripts to transition away from rebate drug model

The massive PBM also said it will move to a cost-plus reimbursement model for in-network pharmacies. The moves come as the controversial drug middlemen attempt to lessen regulatory scrutiny.

By Rebecca Pifer • Oct. 27, 2025

Optum taps its second CFO in 6 months

It’s the latest management shakeup at UnitedHealth as the company attempts to shore up investor confidence.

By Rebecca Pifer • Oct. 24, 2025

Optum launches AI system to speed medical claims

Optum Real allows providers to receive information about patients’ health benefits in real time, the company said.

By Emily Olsen • Oct. 22, 2025

ANA President Jennifer Mensik Kennedy talks nursing shortage, vaccine misinformation

Federal divestment in nursing education and stress due to medical misinformation could add to the the nation's nursing shortage, according to the American Nurses Association leader.

By Susanna Vogel • Oct. 22, 2025

Healthcare AI investment focused on profit margins, ROI: report

As providers and payers navigate an increasingly challenging financial environment, executives are targeting AI tools that show a clear return on investment, according to a report by Klas Research and Bain & Company.

By Emily Olsen • Oct. 15, 2025

CVS closes deal for 63 Rite Aid stores

The drugstore retailer will also bring on more than 3,500 employees from the rival chain and make “targeted investments” in its own stores.

By Cara Salpini • Oct. 15, 2025