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Health spending tied to rise in premiums, new study finds
The study, published last week in JAMA, counters concerns that insurers are raising premiums to pad profits.
By Eric Wicklund • Sept. 11, 2026 -
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Half of Medicare Advantage stars thresholds harder to reach in 2027
The CMS released draft star ratings, including the thresholds for reaching those ratings, to plans earlier this week. The grading sheet got stricter, which doesn’t bode well for insurers, one MA expert said.
By Rebecca Pifer Parduhn • Sept. 10, 2026 -
Explore the Trendline➔
Yujin Kim/Healthcare Dive
TrendlinePayer/provider relationships
As M&A intensifies and companies embrace more holistic and value-based care models, partnerships have become more closely intertwined.
By Healthcare Dive staff -
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Top Democrat investigates No Surprises arbiters
Rep. Frank Pallone sent oversight letters to six arbiters requesting information on how they decide awards, how they’re paid and more. His office is also in talks with other arbiters, but they’ve been more responsive, a staffer said.
By Rebecca Pifer Parduhn • Sept. 9, 2026 -
Courtesy of UnitedHealth Group
UnitedHealthcare expects to be ‘very competitive’ in Medicare Advantage next year, CFO says
The insurer is still working on strategies to ensure its MA markets remain as profitable as possible, but it’s confident in its posture heading into 2027 open enrollment, Wayne DeVeydt said Wednesday.
By Rebecca Pifer Parduhn • Updated Sept. 10, 2026 -
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Mass General Brigham health plan drops MA coverage for Dana-Farber patients
The contract lapse comes as the health system and cancer institute wind down a decades-old partnership.
By Eric Wicklund • Sept. 8, 2026 -
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Cambia, Arkansas Blue Cross affiliation moves ahead
No assets are changing hands as a result of the deal, which is expected to close this October with Cambia assuming control of the Arkansas Blue plan’s operations.
By Rebecca Pifer Parduhn • Sept. 8, 2026 -
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Q&AFinance is ‘leaning in’ to manage healthcare costs, WTW exec says
CFOs are increasingly partnering with human resource executives to help trim rising healthcare costs, WTW’s Tim Stawicki says.
By Maura Webber Sadovi • Sept. 2, 2026 -
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HaloMD says No Surprises is lowering spending on emergency care. Researchers aren’t convinced.
The NSA has saved at least $1 billion on out-of-network emergency medical spending, according to the billings firm’s new study. But HaloMD’s methodology leaves something to be desired, independent experts said.
By Rebecca Pifer Parduhn • Sept. 2, 2026 -
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Medicare spent hundreds of millions of dollars on ineligible drugs, audit finds
Shoddy CMS oversight is to blame, and the agency needs to do better, the HHS Office of the Inspector General said. The CMS concurred.
By Rebecca Pifer Parduhn • Sept. 2, 2026 -
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Johns Hopkins Health Plans taps interim CEO as it searches for successor
Daniel Chojnowski, JHHP’s current CFO, will provide stability so that the Baltimore-area insurer can recruit full-time for its next chief executive, the company said.
By Sydney Halleman • Sept. 2, 2026 -
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UnitedHealthcare cuts prior authorization from 1,700 codes
The list tells providers what treatments will no longer need preapproval this October, part of UnitedHealthcare’s pledge to cull 30% of its much-maligned utilization management controls. The codes span a broad range of services.
By Rebecca Pifer Parduhn • Sept. 2, 2026 -
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Medicaid losses leave more patients paying cash, Epic finds
An analysis of more than 550 million healthcare encounters from the EHR giant’s research division illuminates how restricting Medicaid coverage leaves low-income patients more directly on the hook for medical bills.
By Rebecca Pifer Parduhn • Sept. 1, 2026 -
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Florida attorney general sues PBMs Express Scripts, Prime over alleged price fixing
A deal between rival drug middlemen Prime Therapeutics and Express Scripts depressed reimbursement rates for pharmacies, according to the new complaint. It’s the latest legal challenge against the partnership.
By Jill Hughes • Aug. 31, 2026 -
Samantha Liss/Healthcare Dive
Centene taps Fannie Mae executive as CIO
Bradley Bolivar is taking the reins of Centene’s IT strategy as artificial intelligence drives a sea change for how insurers do business.
By Rebecca Pifer Parduhn • Aug. 31, 2026 -
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Specialty providers refute hefty Georgetown estimates of No Surprises costs
Researchers estimate that independent dispute resolution has created $22 billion in unnecessary spending. But that estimate is flawed, argue associations representing anesthesiologists, radiologists and ER doctors.
By Rebecca Pifer Parduhn • Aug. 28, 2026 -
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Humana-owned Villages Health agrees to $542M settlement for overbilling Medicare
The Central Florida provider manufactured fake diagnosis codes for its Medicare Advantage patients from 2020 to 2024, the DOJ said. Humana bought The Villages Health last year.
By Rebecca Pifer Parduhn • Aug. 27, 2026 -
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Employers face ‘existential reckoning’ as health costs surge
Employers are expecting a median 9.2% increase in medical spending next year, according to a new survey. But they’ve underestimated actual cost growth for the past three years, so even that figure may be too optimistic.
By Rebecca Pifer Parduhn • Aug. 26, 2026 -
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No Surprises dispute resolution has generated $22B in extra costs, research finds
Accelerating dispute volumes and sky-high award amounts are inflating how much independent dispute resolution is costing the U.S., according to new Georgetown research. Patients could pay the price with higher premiums.
By Rebecca Pifer Parduhn • Aug. 26, 2026 -
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Monogram Health to pay $2.4M to settle Medicare Advantage upcoding allegations
Monogram, a home health company, overcharged Medicare through contracts with Cigna and Humana by inflating diagnostic codes, according to the Justice Department.
By Sy Mukherjee • Aug. 26, 2026 -
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Healthcare costs could rise by nearly 10% in 2027
Employers plan to cover more than 80% of the burden, but employees will also be hit by rising costs, an Aon report found.
By Lara Ewen • Aug. 25, 2026 -
Permission granted by Elevance Health
Elevance’s behavioral health division nabs new president
Dr. Patrick Fox, a forensic psychiatrist and health plan leader, will take the reins at Carelon Behavioral Services effective immediately. His experience will be “invaluable” for the unit, a top Elevance executive said.
By Rebecca Pifer Parduhn • Aug. 25, 2026 -
Permission granted by CVS Caremark
Sponsored by CVS CaremarkTransparency was never a pivot. It’s always been how we work.
We’ve been building the PBM of the future. Let me share what that means.
By Ed DeVaney, EVP & President, CVS Caremark • Aug. 24, 2026 -
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R1 drills down on AI prior authorizations with Humata buy
The revenue cycle company wants to automate claims processing, and R1 is banking that Humata’s track record of streamlining medical preapprovals should help further that goal.
By Jill Hughes • Aug. 20, 2026 -
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Humana taps physician executive as new chief medical officer
Dr. Shantanu Nundy is joining the Kentucky-based insurer from health navigation firm Accolade. He’s had a varied career — advising the FDA on AI, teaching, working for the World Bank, practicing medicine and more.
By Rebecca Pifer Parduhn • Aug. 20, 2026 -
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Providence Health Plan to close completely after Medicare Advantage deal falls through
The regional health plan was in talks with an unnamed national insurer to keep its MA plans afloat. But the agreement sputtered “despite significant effort on all sides,” a Providence spokesperson said.
By Rebecca Pifer Parduhn • Aug. 19, 2026
