Medical Groups
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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 -
Sponsored by Microsoft
[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 -
Explore the Trendline➔
Yujin Kim/Healthcare Dive
TrendlinePayer/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 -
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 -
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 last week. 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 • 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 -
HLTH25
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 -
Q&A // HLTH25
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 -
Sponsored by Express Healthcare Staffing
Beyond the resume: Why cultural fit matters in healthcare organizations
Why cultural fit matters as much as credentials in healthcare staffing.
By Express Healthcare Staffing, Julie Neal • Oct. 13, 2025 -
Amazon Pharmacy to launch prescription kiosks at One Medical clinics
The kiosks will dispense common medications like blood pressure drugs or inhalers at five Los Angeles area clinics starting in December. Amazon will begin expanding them to other locations next year.
By Emily Olsen • Oct. 9, 2025 -
Unnecessary back surgeries cost Medicare $1.9B: Lown
More than 200,000 “low-value” back surgeries for older adults were billed to Medicare from 2020 to 2023 — totaling one unnecessary procedure every eight minutes, according to a new analysis from the Lown Institute.
By Sydney Halleman • Oct. 9, 2025 -
No Surprises dispute resolution remains operational despite shutdown
However, a prolonged lapse in funding could affect other activities underpinning implementation of the law that holds consumers blameless for unexpected out-of-network bills.
By Rebecca Pifer • Oct. 6, 2025 -
Deep Dive
AI could transform healthcare. Can safety-net providers keep up?
Implementing artificial intelligence requires significant human labor and technical expertise, threatening to create a digital divide between highly resourced health systems and safety-net providers.
By Emily Olsen • Oct. 2, 2025 -
Top healthcare conferences to attend in 2026
These are the events healthcare leaders should plan for next year, covering topics like digital health, rural care and financial management.
By Healthcare Dive staff • Oct. 1, 2025 -
Hospitals, doctors could lose $32B in revenue next year if ACA subsidies expire: report
It’s the latest warning about the impact to the healthcare system if the subsidies are allowed to lapse.
By Rebecca Pifer • Sept. 26, 2025