The DOL proposed a rule that would force pharmacy benefit managers to share a broad range of pricing and compensation information with their employer clients, calling it the most significant proposed PBM reform in decades.
The rule puts limits on states levying higher taxes on Medicaid businesses. The CMS argues the tax arrangements allow states to shift costs onto the federal government, but providers say they’re integral for covering the cost of care.
Companies are hoping to reshore finances and double down on efficiency initiatives this year as several policy sea changes threaten to upend the industry.
Ten Medicaid systems vendors have agreed to provide low or no cost services to states over the next two years. The Trump administration said the agreements would save $600 million.
Artificial intelligence could rework the claims and reimbursement process, allowing faster decision-making, reduced errors and billions in savings, according to an Optum executive.
The for-profit hospital operator said it’s implementing a multi-year resilience plan to offset losses. Still, HCA anticipates its full-year earnings this year will skew closely to or exceed 2025 figures.
That’s down 5% from last year. But it’s not the nosedive some market watchers predicted, and a handful of states — notably, Texas — saw robust growth.
The CEO sat down with Healthcare Dive to discuss the company’s move to accept insurance at BetterHelp, its M&A strategy and how Teladoc is using artificial intelligence.
This year should see improvements in Medicare Advantage and Affordable Care Act plans but continued pressure in Medicaid, Elevance executives warned investors.
Still, the medications in the latest round of negotiations — which now includes Part B drugs given in doctor’s offices — draw very limited revenue from Medicare, an analyst pointed out.