Medicare drug price rule may target under-the-skin cancer immunotherapies
For 2029, a federal rule proposes closing a “loophole” that protects medicines transitioning from intravenous administration from price protection.
Data analytics for payers: Improving maternal health outcomes while reducing total cost of care
How health plans can use analytics to improve maternal care and reduce avoidable utilization
How healthcare AI is closing the revenue gap
Discover how healthcare organizations are moving from early experimentation to broader AI adoption, connecting clinical improvements to financial impact.
UnitedHealth, FTC reach proposed settlement in insulin case
The tentative deal comes months after CVS Health reached a proposed settlement in the lawsuit alleging major pharmacy benefit managers are inflating insulin costs.
Abridge partners with Eli Lilly, Nvidia as AI scribe eyes expansion
The company is working with Nvidia to build a foundation model for clinical conversations, and it scored a strategic investment from drugmaker Eli Lilly, Abridge announced during a sweeping keynote Thursday.
Major Medicare Advantage insurers appear to deny care for profit, federal watchdog finds
MA insurers commonly deny requests for post-acute care — but none more frequently than UnitedHealth, Humana and CVS, the HHS OIG said. Insurers were not happy about the findings.
CMS increases oversight of state Medicaid demonstrations
States will have to provide more rigorous financial analyses for their Medicaid demonstrations beginning in 2027, according to new federal guidance.
CMS creates office dedicated to health technology
The Office of Health Technology and Products is the latest technology development from the CMS as it doubles down on digital tools.
Health plans say AI is pushing healthcare costs higher
Nearly 70% of surveyed health plans said providers’ use of AI documentation and coding tools was a top three trend inflating commercial healthcare costs next year, according to a new report from PwC.
UHS deal exposes pitfalls of physician group acquisitions
Despite major financial struggles, some providers at a physician group in Washington, D.C., say the contract terms from its new, and much larger, parent is not the lifeline they want.