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At least 10 health insurers have now sued CMS over their 2027 Medicare Advantage star ratings, claiming the agency used…
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Mike Yetter is joining WellSense Health Plan, under Boston Medical Center Health System, as CIO, according to a Nov. 9 LinkedIn post. Mr. Yetter most recently worked at Jefferson Health Plans, part of Philadelphia-based Jefferson Health. Mr. Yetter’s LinkedIn profile…
Oakland, Calif.-based Kaiser Permanente recorded an operating income of $495 million (1.4% operating margin) in the third quarter of 2026, up from $218 million (0.7% margin) during the same period last year, according to its Nov. 6 financial report. Seven…
Surgical access often looks like a scheduling challenge — but at scale, it’s a strategic growth lever. Take Lee Health, where fragmented systems, rigid block schedules and manual coordination created the illusion of constrained capacity, even when usable OR time…
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CMS is ending its Medicare Part D Premium Stabilization Demonstration at the end of 2026, bringing standalone drug coverage back to “traditional market conditions,” per the agency. After the Inflation Reduction Act redesigned Part D to lower drug cost-sharing, Part…
Health systems across the country are making very different bets on whether to be in the insurance business. Carle Health, Michigan Medicine, Memorial Hermann, Providence, and UMass Memorial have all shuttered or sold their insurance arms within the last two…
The attorneys general of Oregon, Minnesota, New Mexico and Washington are suing HHS and CMS, arguing the federal government cannot pull existing Medicaid funding from states that don’t adopt the Medicaid work requirement in HR 1. The lawsuit, filed Nov.…
Patient access is often the first place health systems apply artificial intelligence. Scheduling, confirmations, cancellations and reschedules are high-volume, rules-heavy and chronically understaffed which is why voice agents and other automation tend to land here first. But the gap between…
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Tacoma, Wash.-based MultiCare Health System has entered the Medicare Advantage market with its new health plan, a move more than a decade in the making that runs against a tide of health system-owned plan closures across the country. MultiCare Health…
Aetna left the ACA market at the beginning of 2026, citing underperformance. Other insurers have also been navigating a rocky ACA landscape, marked by the expiration of enhanced premium subsidies and shifting risk-pool dynamics. CVS Health previously recorded a $448…
A federal judge in Pennsylvania denied Aetna’s request for arbitration Nov. 4 in a lawsuit from Philadelphia-based Jefferson Health and Lehigh Valley Physician Hospital Organization regarding the insurer’s “level of severity inpatient payment policy” for Medicare Advantage beneficiaries. The lawsuit…
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