Medicare Advantage Signal Feed
Latest scored signals across all monitored sources.
722 signals
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16 payers cutting jobs | 2026
Payers are continuing to trim their workforces amid financial pressures, growing medical and pharmacy utilization, Medicaid funding cuts and strategic restructuring. Below are workforce reduction efforts or job eliminations that were announced or take effect in 2026. Insurance industry layoffs in 2025 are here. Editor’s Note: This is not an exhaustive list. This webpage was […] The post 16 payers cutting jobs | 2026 appeared first on Becker's Payer Issues | Payer News .
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CMS issues hospital inpatient payment final rule for FY 2027
The Centers for Medicare & Medicaid Services today issued a final rule that would increase Medicare rates by a net 2.3% in fiscal year 2027, compared with FY 2026, for hospitals that are meaningful users of electronic health records and submit quality measure data. This payment update reflects a 3.2% hospital market basket increase, as well as a 0.9% productivity cut. Overall, it will increase hospital payments by $2.9 billion in FY 2027 compared to FY 2026. This includes an increase in dispr...
Policy / Regulatory Changes · 67 signals · last 30 days -
Kaiser Permanente invests $10M to expand youth mental health peer support
The initiative recruits and trains peers to support teens within schools, health clinics and community organizations. The goal is to help youth navigate stress, isolation and early signs of mental health concerns before a crisis occurs.
KaiserKaiser Permanente · 5 signals · last 30 days -
WellSpan Health, Hippocratic AI ink ‘multi-year’ partnership with plans to co-develop clinical AI agents
The partnership was first announced in September 2024, with WellSpan Health being one of the first organizations to launch Hippocratic AI’s generative AI agent.
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Op-ed: Hospitals on the edge, a time for CMS to do no harm
The Centers for Medicare & Medicaid Services' job is to implement last year's $911 billion Medicaid spending reduction, not cut even deeper than Congress intended, New Jersey Hospital Association President and CEO Cathy Bennett writes.
Policy / Regulatory Changes · 67 signals · last 30 days -
Alignment records 32% increase in membership
Alignment Healthcare grew its membership 31.5% year over year to just over 294,000, the Medicare Advantage insurer said in its second quarter earnings posted July 30. Total revenue was $1.3 billion, a 31.6% increase year over year. Net income was nearly $37 million, more than double the $15.7 million the company recorded in the second […] The post Alignment records 32% increase in membership appeared first on Becker's Payer Issues | Payer News .
Alignment HealthcareAlignment Healthcare · 2 signals · last 30 days -
Prescription drugs drove more than 40% of fully insured cost growth last year: UnitedHealth
Total medical costs for fully insured individuals rose 9% per person in 2025, an average increase of $722, according to a July analysis from UnitedHealth Group’s Center for Health Care Research. The estimates are based on 2024 and 2025 UnitedHealthcare claims for individuals enrolled in fully insured employer coverage, paid through February 2026 and adjusted […] The post Prescription drugs drove more than 40% of fully insured cost growth last year: UnitedHealth appeared first on Becker's Paye...
UnitedHealthcareUnitedHealthUnitedHealthcare · 34 signals · last 30 days -
Why specialists see risk in Medicare’s doctor pay overhaul plan
“Primary care is very important. They need more money. Everybody needs more money,” said Dr. Murad Alam, a dermatologist.
Competitive / Operational Strategy · 38 signals · last 30 days -
Agency Information Collection Activities: Submission for OMB Review; Comment Request
The Centers for Medicare & Medicaid Services (CMS) is announcing an opportunity for the public to comment on CMS' intention to collect information from the public. Under the Paperwork Reduction Act of 1995 (PRA), federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information, including each proposed extension or reinstatement of an existing collection of information, and to allow a second opportunity for public comment on the notice....
Policy / Regulatory Changes · 67 signals · last 30 days -
ELLSWORTH ASSOCIATES, LLP v. CVS HEALTH CORPORATION
Case 2:19-cv-02553-JMY Document 282 Filed 07/31/26 Page 1 of 39 IN THE UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF PENNSYLVANIA UNITED STATES OF AMERICA, ex rel. : ELLSWORTH ASSOCIATES, LLP, : : Plaintiff-Relator, : Civil Action : Original document
CVS Health PennsylvaniaCVS Health / Aetna · 10 signals · last 30 days -
Waystar boosts 2026 outlook as AI-powered RCM solutions gain traction with providers
The healthcare payment software maker brought in $319.7 million in second-quarter revenue, up 18% YOY.
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Fiscal Year 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements Final Rule (CMS-1851-F)
Fiscal Year 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements Final Rule (CMS-1851-F) On July 30, 2026, the Centers for Medicare & Medicaid Services (CMS) issued a final rule (CMS-1851-F) that would update Medicare hospice payments and the aggregate cap amount for fiscal year (FY) 2027 under existing statutory and regulatory requirements.
Policy / Regulatory Changes · 67 signals · last 30 days -
FY 2027 Inpatient Rehabilitation Facilities (IRF) Prospective Payment System (PPS) Final Rule (CMS-1845-F)
FY 2027 Inpatient Rehabilitation Facilities (IRF) Prospective Payment System (PPS) Final Rule (CMS-1845-F) On July 30, 2026, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates Medicare payment policies and rates for inpatient rehabilitation facilities under the Inpatient Rehabilitation Facilities (IRF) Prospective Payment System (PPS) and the IRF Quality Reporting Program (QRP) for fiscal year (FY) 2027. CMS is publishing this final rule consistent with the le...
Policy / Regulatory Changes · 67 signals · last 30 days -
Cigna sees ‘slight downtick’ in Evernorth clients covering GLP-1s
Cigna pulled back GLP-1 weight-loss coverage for its own employees July 1. Now it says its clients have been doing the same. On a July 30 earnings call, Cigna President and CEO Brian Evanko said Evernorth Health Services has seen “a slight downtick” in the percentage of employers that cover GLP-1s for weight management. “That […] The post Cigna sees ‘slight downtick’ in Evernorth clients covering GLP-1s appeared first on Becker's Payer Issues | Payer News .
CignaCigna · 10 signals · last 30 days -
Medicare finalizes hospice, rehab and psych pay hikes
One final rule strengthens a tool meant to detect hospice fraud.
Policy / Regulatory Changes · 67 signals · last 30 days -
UnitedHealth Group becomes 4th largest company in the world
UnitedHealth Group is now the fourth-largest company in the world by revenue, according to the 2026 Fortune Global 500. The list ranks the world’s largest public and private companies by revenue for the 2025 fiscal year. UnitedHealth posted more than $447 billion in revenue last year, up 11.8% year over year, and climbed three spots […] The post UnitedHealth Group becomes 4th largest company in the world appeared first on Becker's Payer Issues | Payer News .
UnitedHealthUnitedHealthcare · 34 signals · last 30 days -
Rural radiology technician shortage motivates new technical college program in northeastern SD
A shortage of rural radiology technicians prompted the South Dakota Board of Technical Education to approve a new program Thursday for a technical college in the northeastern part of the state. Radiology technicians conduct imaging exams such as X-rays, CT scans and MRIs. Two South Dakota technical schools already have radiology technician programs: Mitchell Technical […]
SCAN South DakotaSCAN Health Plan · 11 signals · last 30 days -
Teladoc Health trims 2026 revenue forecast amid challenges with BetterHelp insurance shift
Teladoc Health trimmed its 2026 revenue outlook as its virtual behavioral health unit, BetterHelp, faces revenue pressure with consumer demand for insurance-covered services outpacing clinical capacity.
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Employers are trimming obesity benefits for workers, Cigna says
The weight-loss drug boom is beginning to show signs of a slowdown as employers and insurers pull back on coverage.
CignaCigna · 10 signals · last 30 days -
CCF Comments on Medicaid Work Reporting Requirements Interim Final Rule
The Georgetown University Center for Children and Families submitted the following comments to the Center for Medicare and Medicaid (CMS) and the U.S. Department of Health and Human Services (DHHS) regarding CMS’s Interim Final Rule (IFR) implementing H.R. 1-mandated Medicaid Work Reporting Requirements (WRRs). Read the Comments.
Policy / Regulatory Changes · 67 signals · last 30 days -
The No Surprise’s Act IDR Process Needs a New Operating Model
The No Surprises Act, passed in 2020 and implemented in 2022, was designed to protect patients from unexpected out-of-network medical bills. It also established the federal independent dispute resolution (IDR) process, allowing out-of-network providers and health plans to resolve payment disputes when good-faith negotiations fail. IDR was intended to function as a last-resort “safety valve”, […] The post The No Surprise’s Act IDR Process Needs a New Operating Model appeared first on Becker's...
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Indiana plans to cover GLP-1s for some Medicaid members under BALANCE model
Indiana Gov. Mike Braun directed the state to partake in CMS’ “Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth” model for GLP-1 access in Medicaid. According to a July 30 Indiana news release, under the pilot, GLP-1s will cost the state $85.16 per member per month. Through BALANCE’s negotiations with Eli Lilly and Novo […] The post Indiana plans to cover GLP-1s for some Medicaid members under BALANCE model appeared first on Becker's Payer Issues | Payer News .
Policy / Regulatory Changes · 67 signals · last 30 days -
Blue Shield of California sister company debuts AI copilot for health plan customer service reps
Stellarus, a healthcare technology company born out of a Blue Shield of California restructuring, is rolling out its AI-powered Customer Service Representative Chat for health plan customer service representatives. According to a July 30 news release, CSR Chat is Stellarus’ first commercially available product within its Compass suite, an AI-driven engagement platform for health plans. […] The post Blue Shield of California sister company debuts AI copilot for health plan customer service rep...
Blue Shield CaliforniaBlue Cross Blue Shield plans · 20 signals · last 30 days -
CMS finalizes payment updates and coverage changes for IRFs
The Centers for Medicare & Medicaid Services July 30 released the fiscal year 2027 final rule for inpatient rehabilitation facilities. The rule will increase payments by 2.3% overall, which includes a 3.2% market basket update reduced by a 0.9 percentage point productivity adjustment. In addition, CMS updated the outlier threshold, which it says will increase overall payments by 0.4% in FY 2027.CMS also finalized two changes to the IRF coverage requirements. This includes a requirement that t...
Policy / Regulatory Changes · 67 signals · last 30 days -
Cigna profit jumps but Express Scripts stumbles
Express Scripts is adapting to significant changes in its pharmacy benefit manager model.
CignaCigna · 10 signals · last 30 days