Coalition Urges Policymakers to Reject No Surprises Act Enforcement Bill
The Coalition Against Surprise Medical Billing launched a campaign opposing the No Surprises Act Enforcement Act, arguing it would worsen IDR process abuse.
Nearly 200 Organizations Back Bill to Expand Access to Clinical Trials
Nearly 200 healthcare and patient advocacy organizations endorsed the bipartisan Clinical Trial Modernization Act, which seeks to reduce financial barriers and expand access to clinical trials for underrepresented patients.
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Top 7 Modern AI-Powered EAP Providers for Global Workforces in 2026
Discover the top AI-powered EAP providers for 2026. Compare platforms like Kyan Health and Spring Health on triage speed, global reach, and clinical quality to transform workforce wellbeing.
Does CMS Know What It Is Doing With Its GLP-1 Obesity Coverage Pilot?
CMS’s new GLP-1 Bridge program expands Medicare access to obesity drugs but raises concerns about cost, supply and implementation challenges.
ACA Marketplace Insurers Propose 14% Median Premium Increase in 2027
KFF found that ACA Marketplace insurers are proposing a median 14% premium increase for 2027, driven by rising healthcare costs and the expiration of enhanced premium tax credits.
Elevance Sues CMS Over Star Ratings, Seeks Same Recalculation Applied to Clover
Elevance filed a lawsuit last week against the Department of Health and Human Services and the Centers for Medicare & Medicaid Services, alleging that CMS unlawfully refused to recalculate Elevance's 2026 Medicare Advantage Star Ratings on the same basis that it recently recalculated Clover Health's ratings after a court ruling.
Report Highlights Private Equity’s Lesser-Known Strategy: Nonprofit Joint Ventures
A new report finds private equity firms are increasingly using joint ventures with nonprofit health systems to expand in healthcare, prompting calls for greater oversight.
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Closing the Quality-Affordability Gap in Workplace Mental Health
In an interview, Kyan Health Co-Founder and Chief Commercial Officer Konstantin Struck discussed how Kyan gives mid-market and enterprise employers access to premium workforce mental healthcare, at a price point that is affordable.
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Closing the Quality-Affordability Gap in Workplace Mental Health
In an interview, Kyan Health Co-Founder and Chief Commercial Officer Konstantin Struck discussed how Kyan gives mid-market and enterprise employers access to premium workforce mental healthcare, at a price point that is affordable.
Medicare to Spend $13B on MA Quality Bonus Program in 2026
KFF estimates Medicare will spend $13.4 billion on the Medicare Advantage Quality Bonus Program in 2026 amid continued scrutiny of the program.
MedCity Pivot Podcast: The Evolution of Palliative Care at Home
In this month's pivot podcast, I speak to the chief medical officer of San Francisco-based Vynca, an innovative company in the world of palliative care that is providing serious disease management at home.
Healthcare Moves: A Monthly Summary of Hires, Exits and Layoffs
June has seen a slew of executive hires, exits and layoffs across the healthcare industry. For instance, the American Medical Association, CMS and R1 RCM named new executives. There were also layoffs at organizations including ADC Therapeutics, Equip and UPMC.
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New Webinar: The Payer AI Readiness Gap: Why Better Data Will Define the Next Era of Health Plan Performance
We'll explore why the next era of payer performance will depend on building a trusted data foundation that connects people, providers, and relationships across the enterprise.
CMS Recalculates Star Ratings — Again
CMS is recalculating some 2026 Medicare Advantage Star Ratings after a court ruled it improperly calculated Clover Health's rating, a decision that could boost payments for a small number of insurers.
New Bill Led by Democrats Aims to Cap Medicare Out-of-Pocket Costs
The Medicare Cost Cap Act seeks to create a $5,000 cap on out-of-pocket costs for traditional Medicare beneficiaries.
UnitedHealthcare Threw Open Its HQ to Journalists and Influencers. Why?
UnitedHealthcare CEO Tim Noel, Optum CEO Dr. Patrick Conway, and other top executives and employees gave unprecedented access to journalists and others in order to show how the company is trying to reduce friction in healthcare. The goal was to change hearts and minds. Did the insurance behemoth succeed?
New Partnership Aims to Lower Out-of-Pocket Costs, Even Eliminate Them In Some Cases
Priority Health is partnering with Garner Health to steer members to high-quality physicians and reduce healthcare costs for employers.
Abarca Health and LucyRx to Combine to Scale Independent PBM Model
Abarca Health and LucyRx plan to combine to build a larger independent PBM serving more than 9 million members.