Healthcare Dive

The managed care giant raised its 2026 earnings outlook for the second time this year following the results, which its CFO called “fantastic.”

The update is the latest in a COVID-19 vaccine mandate case brought by a former consultant against the Permanente Medical Group.

The regional nonprofit and surgical facility operator have co-owned the facilities since 2023. But Surgery Partners, which expects to net almost $800 million from the deal, is looking to reorient its portfolio to a more outpatient-heavy model.

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People formerly covered by the ACA exchanges are remaining uninsured almost on a one for one basis. “For us, obviously, it’s not a good thing,” CEO Sam Hazen said.

The hospital operator recorded a $65 million hit from turbulence on the Affordable Care Act exchanges in the second quarter, but avoided the worse repercussions slamming some of its peers.

Healthcare AI has poured into the exam room, but choosing the right provider remains untouched.

CHS’ financial results fell below internal expectations as the hospital operator served more uninsured patients and surgery volumes declined, executives said.

The Trump administration is fighting to restore controversial provisions that a judge threw out last month, including shorter sign-up windows and heightened eligibility verification.

Selected devices will be exempt from certain pre-market requirements while manufacturers collect real-world data through Medicare.

Regulators recalculated plans’ quality scores last month after losing a lawsuit to Clover Health. But they used a different methodology for Clover than its peers, causing Elevance to lose out on $115 million, the insurer told a court.

Fewer companies may be impeding the flow of digital health information, but some could be doing so frequently, the ONC said. 

The deal brings Highmark Health-owned AHN’s hospital count to 16. The combined system will invest about $285 million over the next decade to bolster Heritage Valley’s facilities.

The rule, released Thursday, builds on Trump administration’s priorities, including cutting Medicare reimbursement for drugs in the controversial 340B program and equalizing payment between sites of care.

Medicare is spending more on quality bonuses despite fewer enrollees in eligible plans, the health policy research group said — a concerning trend putting more stress on Medicare’s coffers that could amplify calls for reform.

Millions of people could meet criteria to receive GLP-1s, which could cost Medicare billions of dollars, according to a report by KFF.

Steve Walsh, the CEO of a Massachusetts hospital group, will assume the top role in the early fall, after the AHA’s longtime leader Rick Pollack retires.

Express Scripts, Caremark and Optum Rx sued the FTC after the agency accused them of driving up the cost of insulin. But the countersuit is being put to bed now that the PBMs are settling with regulators.

Following Vijay Kumar’s exit, acting CBER Director Karim Mikhail will also oversee a review office that has become a battleground for debates on FDA flexibility.

Twenty-six states are seeking to overturn some of the regulation released by the CMS this month that outlined Medicaid work requirements — and asking the court to pause implementation for the time being.