Healthcare has been the costliest industry for data breaches for 13 consecutive years, at an average of $6.64 million per incident. The problem is that much of what attackers steal is still used to verify patient identity. Generative AI is…
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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…
As the payer industry moves through the fourth quarter of 2026, leadership continues to evolve. Some insurers, including Humana and Centene, are reconfiguring their workforces more broadly. Here are eight of the latest executive moves to know:
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.…
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…
Many health systems have brought agency spend down, but contingent labor hasn’t disappeared. Internal float pools, internal travel programs, per diem shift pickup and retiree re-engagement are filling more of the gap. Those programs carry their own risks. Pay can…
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Health systems often treat transportation as a line-item expense. Its impact reaches much further. Transportation gaps can contribute to delayed discharges, missed appointments, staff time spent coordinating rides and lost revenue. Because those effects show up across different parts of…
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Denials have climbed for four straight years. In 2022, 31 percent of providers said at least 10 percent of their claims were denied. In 2026, that figure is 40 percent. The reasons behind those denials are shifting, too. For the…
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