Older, self-employed enrollees more likely to lose ACA subsidies if enhanced tax credits lapse: KFF

Beneficiaries who earn more than four times the federal poverty level wouldn’t be eligible for any subsidies on marketplace plans if the enhanced premium tax credits expire at the end of the year.

By Emily Olsen • March 5, 2025

CVS sells Medicare Shared Savings business to Wellvana

The all-stock deal gives CVS a strategic minority investment in value-based care services firm Wellvana.

By Emily Olsen • March 5, 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

Loss of enhanced ACA subsidies could batter state economies: report

Overall employment could fall by 286,000 jobs next year if the enhanced premium tax credits lapse, including 130,000 lost roles in the healthcare sector.

By Emily Olsen • March 4, 2025

Trump administration policies could create headwinds across healthcare: Fitch

The credit ratings agency is most concerned about Medicaid cuts and how government layoffs will affect device approvals.

By Susanna Vogel • March 3, 2025

[Podcast] The Payer Pod: Empowering Health Plans for Success in 2025

This podcast series explores the market forces impacting payers right now, how to reduce friction for providers, and ways to elevate member engagement.

Feb. 28, 2025

Federal Medicaid cuts could shift $44.3B in costs to expansion states

The 41 states that expanded Medicaid could be asked to spend 25% more to cover care costs if potential cuts are approved by Congress. Some states may cut the expansion program instead.

By Susanna Vogel • Feb. 27, 2025

Medicare Advantage growth slows as UnitedHealthcare nabs members, Humana sheds lives

The CMS released highly anticipated MA enrollment data on Tuesday that showed UnitedHealth further tightening its grip on the privatized Medicare market.

By Rebecca Pifer Parduhn • Feb. 26, 2025

Centene expands board with former Prudential finance chief

The appointment of Kenneth Tanji brings the number of directors on Centene’s board to 12.

By Emily Olsen • Feb. 26, 2025

House Republicans pass budget blueprint that could spell Medicaid cuts

Although the budget resolution does not mention Medicaid specifically, lawmakers would be hard pressed to find enough cuts to meet an $880 billion target without touching federal healthcare programs.

By Sydney Halleman • Feb. 26, 2025

Insurers closed out 2024 on shaky footing

Operating income fell for all but two major payers’ insurance divisions in the fourth quarter. And 2025 may be no better, after many insurers released outlooks suggesting medical costs will continue to rise.

By Rebecca Pifer Parduhn • Feb. 25, 2025

Physicians say prior authorization stands in the way of medically necessary care

Physicians surveyed by the American Medical Association say prior authorization can cause care delays or force patients to abandon treatment. Denials could also increase as insurers adopt AI to review claims.

By Susanna Vogel • Feb. 25, 2025

Express Scripts, Caremark, Optum Rx plan to appeal effort to block FTC lawsuit

The “Big Three” PBMs are kicking their suit up to the 8th Circuit and, in the meantime, are once again asking a Missouri district judge to halt the FTC’s administrative case against them.

By Rebecca Pifer Parduhn • Feb. 24, 2025

Medicaid cuts could worsen home care worker shortage: KFF

States have increased provider payment rates to address workforce shortages, but they may have to cut back if spending cuts hit Medicaid, according to the health policy researcher.

By Emily Olsen • Feb. 20, 2025

FTC case against Caremark, Express Scripts, Optum Rx can move forward, judge rules

A Missouri district court judge on Tuesday said stopping the FTC’s suit against the Big Three PBMs would be “against the public’s interest.” 

By Rebecca Pifer Parduhn • Feb. 20, 2025

Humana plans to add up to 30 more primary care centers this year

The new centers are being built or acquired in 11 of the 15 states where Humana’s primary care network already has a presence.

By Rebecca Pifer Parduhn • Updated Feb. 19, 2025

CVS taps Ed DeVaney to head Caremark

DeVaney was named president of the pharmacy benefit manager after serving in the interim role since December. 

By Emily Olsen • Feb. 19, 2025

MultiPlan rebrands as Claritev amid alleged price-fixing lawsuits

The company has faced a spate of lawsuits, including recent litigation by the American Medical Assocation that claimed it colluded with insurers to underpay providers for out-of-network care. 

By Emily Olsen • Feb. 18, 2025

Trump administration slashes funding for ACA navigators

The CMS on Friday announced a record cut to funding for community groups that help consumers learn about and select ACA plans, suggesting President Donald Trump plans to once again chip away at the exchanges.

By Rebecca Pifer Parduhn • Feb. 18, 2025

RFK Jr. confirmed as HHS secretary

Robert F. Kennedy Jr., a prominent vaccine critic, was confirmed Thursday by the U.S. Senate in a 52-48 vote to serve as the nation’s top health official.

By Emily Olsen • Feb. 13, 2025

GOP calls for $1.5T in cuts, much of which could come from healthcare

House Republicans unveiled their budget wish list last week, which directs the Energy and Commerce Committee — which oversees Medicare and Medicaid — to find $880 billion in savings.

By Rebecca Pifer Parduhn • Feb. 13, 2025

CVS slashes profit in 2024 as high medical costs hit Aetna

However, the healthcare giant beat Wall Street expectations for earnings and revenue in the fourth quarter, sending its stock soaring on Wednesday. 

By Emily Olsen • Feb. 12, 2025

Large healthcare companies are redistributing most of their profits to shareholders, study finds

Researchers suggested that policymakers encourage reinvestment of capital into patient care and limit share buybacks based on the findings.

By Rebecca Pifer Parduhn • Feb. 12, 2025

A new, non-opioid pain drug is here. Getting it to patients could be agony.

After decades of research, Vertex Pharmaceuticals now has an approved pain medication. Can one of the world’s most powerful biotechs contend with a healthcare system that’s long favored opioids?

By Jacob Bell • Feb. 11, 2025

Humana’s 2024 profit slashed in half amid higher medical spending

The massive insurer now expects to lose 550,000 Medicare Advantage members — roughly one-tenth of its individual MA footprint — this year as a result of plan cuts.

By Rebecca Pifer Parduhn • Feb. 11, 2025

Nearly two-thirds of Medicaid beneficiaries already work: KFF

Most adults on Medicaid are employed, suggesting few beneficiaries wouldn’t meet a work requirement policy being considered by Republicans in Congress.

By Emily Olsen • Feb. 7, 2025