1+ day, 6+ min ago  (593+ words) Hospitals are still on quite fragile financial footing if you look beneath the surface, according to new Kaufman Hall data. Rising costs, uneven patient volumes, and ongoing reimbursement and payer mix pressures continue to limit the sector's financial recovery. Hospitals…...

2+ day, 8+ hour ago  (1678+ words) The Department of Justice has sued both Ohio Health and New York-Presbyterian Hospital this year, alleging that they use contracting tactics that limit competition and keep healthcare prices high. The cases mark a broader push by regulators to scrutinize how…...

4+ day, 3+ hour ago  (300+ words) Chapter, a Medicare navigation platform, announced on Thursday that it raised $100 million in Series E funding. The New York-based company's AI platform compares health plans from every insurance carrier, including Humana, United Healthcare and Cigna. Seniors using the platform can…...

4+ day, 9+ hour ago  (150+ words) The good news: fixing our ancient administrative infrastructure does not require technology that's particularly experimental, nor does it require passing new laws or regulations. It does, however, require coordination. Insurance premiums are now a tough kitchen-table issue as more households…...

5+ day, 1+ hour ago  (382+ words) Cigna Healthcare ranks highest in digital experience among commercial plans, while UPMC Health Plan ranks highest among Medicare Advantage plans, according to a new JD Power report. Cigna Healthcare leads the way in digital experience among commercial health plans, while…...

6+ day, 3+ hour ago  (501+ words) Jefferson Health in Philadelphia is suing Aetna over a new Medicare Advantage payment policy that hospitals say unfairly reduces reimbursements for legitimate inpatient stays. The case highlights a broader clash between providers and Medicare Advantage plans over "downcoding" short hospital…...

6+ day, 20+ hour ago  (657+ words) Healthcare leaders can't tell whether value-based care and Medicare Advantage are truly lowering costs. Some see promise in these models and ongoing innovations, while others say the programs haven't delivered measurable savings and point to direct contracting as a more…...

1+ week, 4+ day ago  (365+ words) Generic medicines face no tariffs, though the Trump administration reserves the right to revisit that in the future. Some branded drugmakers face a reduced tariff rate, but that could change if they don't reach a so-called most-favored nation drug price…...

1+ week, 4+ day ago  (411+ words) A group of 131 hospitals has sued HHS over a CMS policy they say improperly reduces Medicare disproportionate share hospital (DSH) payments. The lawsuit is the latest in a decade-long legal battle over how the agency counts patient days and calculates…...

1+ week, 6+ day ago  (440+ words) When the CEOs of United Health, CVS, Cigna, and Elevance appeared before Congress, they weren't just summoned to account for high premiums, hidden prices, and claim denials. They were expected to account for the entire system that perpetuates them." The…...