Finances
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Ballad Health sues UnitedHealth for Medicare Advantage ‘manipulation’
The Appalachian system said it is turning to the courts as a last resort after failing to resolve years of payment and patient care issues.
By Rebecca Pifer • Oct. 24, 2025 -
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Molina slashes 2025 profit guidance again on ACA woes
Molina’s profit in the third quarter plummeted as the insurer was hit with an increase in marketplace medical costs that one analyst called “staggering.”
By Rebecca Pifer • Oct. 23, 2025 -
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‘A quiet alarm bell going off’: Job-based family coverage hits $27K annually
Premium increases are outpacing wage growth and general inflation at a time of intense focus on healthcare affordability, according to new research from KFF.
By Rebecca Pifer • Oct. 22, 2025 -
Emily Olsen/Healthcare Dive
HLTH25Digital health IPO window opens, but uncertainty clouds outlook
Health technology firms are interested in going public next year, but policy and economic uncertainty is creating a difficult environment for IPOs, experts said at HLTH.
By Emily Olsen • Oct. 22, 2025 -
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Elevance outperforms in third quarter but warns of Medicaid challenges
The Indianapolis-based company is the first major insurer to release earnings this cycle. Elevance did well in the quarter, but hinted that profits could be constrained in 2026.
By Rebecca Pifer • Oct. 21, 2025 -
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Humana loses Medicare Advantage stars lawsuit for a second time
A federal judge ruled in favor of the CMS on Tuesday, one day before the start of Medicare open enrollment. A spokesperson for Humana said the insurer is considering “all available legal options.”
By Rebecca Pifer • Oct. 14, 2025 -
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Sponsored by West MonroeNavigating the perfect storm: Cost pressures and regulatory challenges
Healthcare’s perfect storm: soaring costs, shifting regs and AI’s role in survival.
By Esteban López, MD, MBA Partner, Healthcare • Oct. 13, 2025 -
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Digital health funding outpacing last year as huge rounds increase: report
Investment in 2025 has reached $9.9 billion, exceeding the $8.4 billion that was raised through the third quarter last year, according to Rock Health.
By Emily Olsen • Updated Oct. 16, 2025 -
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Sponsored by ECHOPayment fraud in healthcare is getting harder to detect. Here’s how to fight back.
Fraudsters are raising the stakes. Explore why they’re harder to catch and how to strengthen your defenses across every claim payment.
By Brian Young • Oct. 6, 2025 -
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Humana’s Medicare Advantage star ratings slip for 2026
Humana is giving investors an early look at stars data after a CMS slip-up led some information to be inadvertantly shared online. The results are in line with expectations but still unsatisfactory, Humana said.
By Rebecca Pifer • Oct. 2, 2025 -
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CommonSpirit announces initiative to address mounting headwinds, lagging finances
"We’ve worked hard, but have not made as much progress as is needed," CFO Daniel Morissette said about the company’s 2025 financial results.
By Susanna Vogel • Oct. 2, 2025 -
Courtesy of Summa Health
General Catalyst’s HATCo finalizes Summa Health acquisition
The $515 million deal has closed after roughly two years, creating the first hospital system owned by a venture capital company.
By Rebecca Pifer • Oct. 1, 2025 -
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Hospitals, doctors could lose $32B in revenue next year if ACA subsidies expire: report
It’s the latest warning about the impact to the healthcare system if the subsidies are allowed to lapse.
By Rebecca Pifer • Sept. 26, 2025 -
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Privia acquires Evolent’s value-based primary care unit for $100M
It’s an opportunity for Privia to further increase its shared savings in Medicare’s largest value-based program, while enticing Evolent Care Partners’ affiliated physicians onto its technology and services platform.
By Rebecca Pifer • Sept. 24, 2025 -
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Premier to go private in $2.6B deal with California investment firm
The take-private deal should give Premier more capital to bolster its operations and invest in technology.
By Rebecca Pifer • Sept. 23, 2025 -
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CVS’ Omnicare division files for bankruptcy
CVS’ pharmacy services subsidiary was hit with a $949 million judgment in July. The Chapter 11 process could delay the government from recouping the funds.
By Rebecca Pifer • Sept. 22, 2025 -
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States should be full steam ahead on Medicaid work requirements, experts say
There’s a lot that states want the CMS to weigh in on. But given the tight rollout timeline for the controversial mandates, they shouldn’t delay implementation, experts said during a MACPAC meeting.
By Rebecca Pifer • Sept. 22, 2025 -
Illustration: Xavier Lalanne-Tauzia for Industry Dive
Ascension returned to profitability in 2025
It’s a victory for the system, which reported a $1 billion loss last year as it struggled to recover from a cyberattack.
By Susanna Vogel • Sept. 19, 2025 -
Courtesy of Blue Shield of California
Kansas, Hawaii Blues invest in Blue Shield of CA’s health tech sister company
Stellarus was launched as part of Blue Shield of California’s restructuring to sell services to nonprofit plans that they don’t have the resources to build themselves. That pitch has now worked on at least two Blues plans.
By Rebecca Pifer • Sept. 18, 2025 -
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Doctors slam specialty cuts in 2026 Medicare pay proposal
Major physician groups and specialists commented in droves that regulators missed the mark on the Medicare physician fee schedule for next year.
By Rebecca Pifer • Sept. 16, 2025 -
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340B incentivizes hospital-clinic M&A, drives higher health spending: CBO
The nonpartisan scorekeeper’s new report reinforces longstanding concerns about the 340B drug discount program, including that it incentivizes behaviors that increase health costs for federal and private payers.
By Rebecca Pifer • Sept. 10, 2025 -
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Hospital financial performance holds steady, but headwinds loom: report
Hospital finances have been generally strong this year, but the future is precarious as expenses rise, according to an analysis by Kaufman Hall.
By Emily Olsen • Sept. 10, 2025 -
Courtesy of UnitedHealth Group
Early Medicare Advantage stars data bodes well for UnitedHealth
The healthcare behemoth expects to have roughly 78% of its MA enrollees in plans rated four stars or higher, a key cutoff for valuable bonuses in the privatized Medicare program.
By Rebecca Pifer • Sept. 9, 2025 -
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Surprise BillingNo Surprises dispute resolution is creating billions of dollars in extra costs, could raise premiums: analysis
Providers are turning to the law’s arbitration process in droves to settle out-of-network claims, one factor fueling spending that could cost consumers down the line.
By Rebecca Pifer • Aug. 27, 2025 -
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ModivCare files for bankruptcy with over $1.4B in debt
The medical transportation firm blamed mounting headwinds for its financial challenges, including labor cost inflation and declining reimbursements from public payers.
By Susanna Vogel • Aug. 26, 2025
