Payer
-
Getty Images
Humana soars, Alignment plummets in 2027 Medicare Advantage star ratings
A Healthcare Dive analysis of highly anticipated stars data shows a mixed bag of winners and losers, though — as expected — the quality scores slipped overall. See how major carriers fared for 2027.
By Rebecca Pifer Parduhn • Oct. 9, 2026 -
Kayla Bartkowski via Getty Images
Medicare penalizes more hospitals for readmissions
About 80% of hospitals are having their Medicare payments shaved down over high readmission rates this fiscal year, compared with 78% the year prior, according to new CMS data. It continues a worrying trend.
By Rebecca Pifer Parduhn • Oct. 8, 2026 -
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 -
Brandon Bell/Getty Images via Getty Images
Texas attorney general investigates UnitedHealth over care denials
Ken Paxton is on the hunt for evidence that UnitedHealth is breaking the Deceptive Trade Practices Act and other Texas laws, citing “alarming reports” of denied care.
By Rebecca Pifer Parduhn • Oct. 7, 2026 -
Getty Images
A health insurance agency’s journey from pilot to full-time voice AI agent
After struggling with high call volume — especially during Medicare open enrollment — eHealth turned to voice AI agents for help.
By Matt Vartabedian • Oct. 7, 2026 -
Getty Images
Top healthcare conferences to attend in 2027
These are the best industry events for digital health, provider and payer leaders to attend next year.
By Healthcare Dive staff • Oct. 6, 2026 -
Kayla Bartkowski via Getty Images
Trump administration revamps insurer price transparency reporting
On Monday, the HHS and Labor and Treasury Departments finalized a rule meant to strip out junk cluttering cost disclosures, among other reforms. Employers cheered the changes, which are a mixed bag for insurers.
By Rebecca Pifer Parduhn • Oct. 5, 2026 -
Andrew Harnik via Getty Images
Trump pledges to send $90 Medicare Part B rebates to seniors
About 20.8 million beneficiaries will receive a direct deposit or check this month, the latest in a growing list of cash payments promised by the White House in advance of the November midterm elections.
By Rebecca Pifer Parduhn • Oct. 5, 2026 -
Getty Images
Independence Blue Cross to pay $22.5M to resolve MA fraud allegations
Independence Blue Cross will pay to settle allegations it defrauded Medicare by inflating diagnosis codes for MA beneficiaries. The payer cited “industry-wide challenges” in applying MA risk adjustment standards.
By Jill Hughes • Oct. 2, 2026 -
Getty Images
Governors ask HHS for more time to implement Medicaid work requirements
The governors of Oregon, California, Maine, New York and Virginia don’t think it’s possible for states to meet the Jan. 1 deadline to stand up work requirements while protecting beneficiaries.
By Rebecca Pifer Parduhn • Oct. 2, 2026 -
Spencer Platt via Getty Images
Insurers say their 2027 Medicare Advantage offerings preserve benefits. The data tells a different story
A Leerink Partners analysis of Medicare Plan Finder shows how the largest MA carriers are cutting dental allowances and premium givebacks next year as they continue to prioritize margin recovery.
By Rebecca Pifer Parduhn • Oct. 1, 2026 -
Alamy
Elevance cracks down on hospital billing for off-campus care
The insurer said it’s trying to restrict hospitals from charging higher rates for services at off-campus outpatient departments. Hospital groups say the reimbursement cuts could threaten access to care.
By Jill Hughes • Updated Sept. 30, 2026 -
Alamy
Cigna unveils $3B productivity initiative, including use of AI
The company will focus on automating and modernizing processes, better managing suppliers, partners and vendors and making employees more efficient, executives said during a Wednesday investor day.
By Rebecca Pifer Parduhn • Sept. 30, 2026 -
Getty Images
Here’s how much insurers are cutting Medicare Advantage plans for 2027
Newly released CMS data shows that insurers continue to adapt to pressure in the privatized Medicare program by culling plans. A press release stressing “stability” didn’t soften the blow.
By Rebecca Pifer Parduhn • Sept. 29, 2026 -
Alamy
UnitedHealthcare names new president in latest leadership shuffle
Robert Hunter will focus on UnitedHealthcare’s “modernization agenda” in the new role. It’s the latest in a slew of leadership changes at UnitedHealth as the company works to restore its image.
By Jill Hughes • Sept. 29, 2026 -
DNY59 via Getty Images
Insurers say AI could add billions in health costs. Billing companies disagree
Studies from insurers say AI-backed billing tools used by providers raise health costs. But the companies making those tools say the problem isn’t with AI — it’s with the healthcare billing system.
By Jacqueline LaPointe • Updated Sept. 29, 2026 -
Anna Moneymaker/Getty Images via Getty Images
AI will inflate healthcare costs before lowering them, Oz says
AI will “turbocharge” medical billing and drive up costs in the short term, CMS Administrator Dr. Mehmet Oz warned. But he said the pain is worth it for long-term savings.
By Jill Hughes • Sept. 24, 2026 -
Courtesy of UnitedHealth Group
UnitedHealth names first chief administrative officer
Jodee Kozlak, a veteran of major multinational corporations, joins UnitedHealth to modernize and align the healthcare behemoth’s operations across its various businesses.
By Rebecca Pifer Parduhn • Sept. 24, 2026 -
Rebecca Pifer Parduhn/Healthcare Dive
Oz: Medicare Advantage a garden ‘vulnerable to weeds and overgrowth’
The CMS administrator’s comments Tuesday at an MA industry event suggest that the Trump regime remains interested in tougher oversight of the program, despite watering down or scrapping some of its biggest proposed reforms.
By Rebecca Pifer Parduhn • Sept. 23, 2026 -
Joe Raedle via Getty Images
CMS freezes new ACA broker registrations for 2027, culls ‘unauthorized’ enrollees
The agency said the pause would help crack down on fraud among new brokers on the exchanges. It also announced on Tuesday it would cancel the enrollments of more than 760,000 people.
By Jill Hughes • Sept. 23, 2026 -
Rebecca Pifer Parduhn/Healthcare Dive
MedPAC chair defends Medicare Advantage overpayment analysis at insurer lobby event
Amid growing public debate over how best to analyze spending in MA versus traditional Medicare, Dr. Amol Navathe, the leader of the group behind the most-cited estimate, stepped into the lion’s den to support its work.
By Rebecca Pifer Parduhn • Sept. 23, 2026 -
DNY59 via Getty Images
Texas hospitals sue Independence Blue Cross over denied claims
Despite a $2.8 billion settlement over BlueCard program disputes, five HCA-affiliated hospitals say the program still traps them in red tape.
By Jacqueline LaPointe • Sept. 22, 2026 -
Getty Images
New lawsuit targets Medicaid work requirements’ medical frailty rules
The new lawsuit, filed on behalf of five Medicaid enrollees and a swath of provider groups, says the CMS narrowed exemptions for those too sick to fulfill upcoming work requirements in the safety-net insurance program.
By Sara Heath • Sept. 22, 2026 -
Bruce Bennett via Getty Images
Judge approves CVS unit Omnicare’s bankruptcy plan
The plan should make all Omnicare creditors, including the Department of Justice, whole.
By Rebecca Pifer Parduhn • Sept. 21, 2026 -
LaylaBird via Getty Images
Sponsored by Elevance HealthThe hidden cost of disconnected care
Disconnected care can be a major – and often overlooked – driver of unnecessary healthcare costs.
By Mark Kaye, Chief Financial Officer and Executive Vice President, Elevance Health • Sept. 21, 2026 -
Sponsored by ECHO
Uncovering the hidden costs of healthcare payments
The true cost of payment operations sits in four budgets. What happens when you add them up?
By Tom Davis, EVP Business Development & Strategy • Sept. 21, 2026
