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Main Line Health threatens to go out of network with Cigna over contract dispute
Main Line Health says Cigna hasn't updated its reimbursement rate since 2016. Cigna says it is negotiating in good faith to find a solution that keeps healthcare affordable for patients.
By Susanna Vogel • Jan. 29, 2025 -
Kayla Bartkowski/Getty Images via Getty Images
Lawmakers report states shut out of Medicaid payment portals following Trump funding freeze
Other payment systems also appear to be offline, suggesting a broader shutdown of federal portals related to grants and funding.
By Rebecca Pifer Parduhn • Updated Jan. 28, 2025 -
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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 -
Courtesy of UnitedHealth Group
UnitedHealth names Tim Noel to replace slain insurance CEO
UnitedHealthcare has a new chief executive seven weeks after former CEO Brian Thompson was shot and killed in New York City.
By Rebecca Pifer Parduhn • Jan. 24, 2025 -
Permission granted by Elevance Health
Elevance’s fourth-quarter profit slashed in half amid higher Medicaid costs
In a call with investors, CEO Gail Boudreaux didn’t directly address the killing of UnitedHealthcare’s top executive but spent more time than usual arguing Elevance is working to improve healthcare.
By Rebecca Pifer Parduhn • Jan. 23, 2025 -
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Americans mixed on potential Trump healthcare priorities: KFF poll
About half of respondents said the nation should spend more on Medicaid and Medicare — a potential challenge for the Trump administration looking to cut costs.
By Emily Olsen • Jan. 22, 2025 -
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ACA enrollment breaks records again in 2025
About 24.2 million people signed up for Affordable Care Act plans during the open enrollment period for 2025, with huge increases in major Republican-led states.
By Rebecca Pifer Parduhn • Jan. 21, 2025 -
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Ozempic among drugs picked by Medicare for price talks
Announcing the 15 medicines chosen for the second round of negotiations is one of the Biden administration’s final health policy acts.
By Ned Pagliarulo • Updated Jan. 17, 2025 -
Courtesy of UnitedHealth Group
UnitedHealth reaches record revenue in 2024, though profit falls
UnitedHealth’s net income plummeted to its lowest level since 2019 amid hefty costs, including some from the Change cyberattack. CEO Andrew Witty also remembered slain executive Brian Thompson on a Thursday morning call.
By Rebecca Pifer Parduhn • Jan. 16, 2025 -
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Alignment Healthcare names new president as insurer eyes growth
Medicare Advantage payer Alignment has named longtime insurance executive Dawn Maroney president.
By Rebecca Pifer Parduhn • Jan. 15, 2025 -
Joe Raedle via Getty Images
CMS expands enforcement power over shady ACA brokers
A rule finalized Monday makes it easier for regulators to suspend agents and brokers from selling Affordable Care Act plans if they pose a risk to the exchanges.
By Rebecca Pifer Parduhn • Jan. 14, 2025 -
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FTC releases second report slamming pharmacy benefit managers
Agency commissioners voted unanimously on Tuesday to publish the report, which makes similar allegations against the controversial drug middlemen as the agency’s first report released last summer — but relies on more data.
By Rebecca Pifer Parduhn • Updated Jan. 15, 2025 -
Courtesy of UnitedHealth Group
Investors ask UnitedHealth for answers about delayed, denied care
A faith-based group of investors has requested UnitedHealth prepare a report looking into how its practices could be leading to “delay or abandonment of medical treatment and serious adverse events for patients.”
By Rebecca Pifer Parduhn • Jan. 13, 2025 -
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CMS proposes Medicare Advantage payment hike in 2026
The Biden administration’s last MA rule is a boon for insurers, though it remains to be seen how the incoming Trump administration might put its stamp on the regulation before it’s finalized this spring.
By Rebecca Pifer Parduhn • Jan. 13, 2025 -
Samantha Liss/Healthcare Dive
Centene appoints first head of ICHRA products
Longtime WTW executive Alan Silver was named the inaugural president of Ambetter Health Solutions. Silver’s mandate is to accelerate growth in Centene’s ICHRA plans.
By Rebecca Pifer Parduhn • Jan. 9, 2025 -
Eric Risberg/AP
Blue Shield of California restructures, launches health services business and names first female CEO
The bevy of changes for the massive California nonprofit is meant to improve operations, and should also give Blue Shield a financial leg-up as it competes with well-funded for-profit peers.
By Rebecca Pifer Parduhn • Jan. 9, 2025 -
Joe Raedle via Getty Images
ACA signups set to smash record at 24M with enrollment continuing
The Biden administration attributed the growth to generous subsidies that are scheduled to expire at the end of this year.
By Rebecca Pifer Parduhn • Jan. 8, 2025 -
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Transcarent to acquire fellow health benefits navigator Accolade for $621M
If closed, the deal will take Accolade private and create a single firm with more than 1,400 employer and payer clients.
By Emily Olsen • Jan. 8, 2025 -
Mario Tama via Getty Images
CVS successfully converts commercial pharmacy contracts to “cost plus” model
CVS’ efforts to reform how its pharmacies are paid have reached a significant milestone that should stabilize flagging margins.
By Rebecca Pifer Parduhn • Jan. 8, 2025 -
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Deep DiveHealth insurers will step off the roller coaster in 2025
After a turbulent year, things should calm for payers with the advent of a business-friendly Trump administration — though challenges will persist. Here are experts’ biggest predictions for 2025.
By Rebecca Pifer Parduhn • Jan. 8, 2025 -
Courtesy of UnitedHealth Group
UnitedHealth, Amedisys delay close date of $3.3B merger
The massive healthcare company and the home health provider have agreed to push back the timeline of their deal after the Department of Justice sued to block it.
By Rebecca Pifer Parduhn • Jan. 7, 2025 -
Aetna sues drugmakers over alleged price-fixing scheme
The complaint alleges nearly two dozen pharmaceutical companies colluded to limit competition, causing costs for certain generic medications to skyrocket.
By Emily Olsen • Jan. 7, 2025 -
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Independent Health settles with Justice Department over alleged Medicare Advantage upcoding
The $100 million settlement is one of the larger recent sums agreed to by an MA payer accused of inflating its members’ sicknesses to get higher reimbursement from the government.
By Rebecca Pifer Parduhn • Jan. 3, 2025 -
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Biden signs funding bill extending telehealth flexibilities, but no relief for doctors — or PBM reform
Physician groups slammed Congress for allowing a 2.8% cut to their Medicare pay to go into effect.
By Rebecca Pifer Parduhn • Dec. 23, 2024 -
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Stopgap funding bill includes sweeping PBM reform, preserves telehealth flexibilities
The bipartisan agreement will fund the government through March. It could also reshape the pharmacy supply chain by reforming how controversial drug middlemen do business.
By Rebecca Pifer Parduhn • Dec. 18, 2024 -
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GoodRx appoints former PBM exec as permanent CEO
Wendy Barnes will take up the role more than a year after the drug discount and digital health company’s founders stepped down as co-chief executives.
By Emily Olsen • Updated Dec. 19, 2024
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