Could There Be a ‘Soft Opening’ of H.R. 1 Medicaid Changes?
Experts are split on whether H.R. 1 Medicaid changes in 2027 will roll out gradually or on schedule.
AHIP CEO: “We Are Laser-Focused on Affordability”
Rising healthcare costs are a key focus for AHIP, whose CEO says the group is pushing reforms to boost competition and reduce administrative burden.
How Artera is Using Agentic AI to Humanize Patient Care
Artera President Tom McIntyre talks about the practical application of AI in healthcare.
12 Senate Democrats Unveil Plan to Cut Costs, Expand Coverage
In a recent letter, Senate Democrats proposed lowering healthcare costs, expanding coverage and cracking down on insurance company practices.
Why Providence Wants to Sell Its Health Plan
Providence announced its intent to sell its health plan, exiting the “payvider” model as rising costs and operational complexity weigh on smaller regional insurers. The move reflects a broader trend of health systems refocusing on core care delivery and exploring partnerships instead of running insurance themselves.
Lantern Secures $30M to Fuel Growth Across Employers and Health Plans
Lantern's $30 million raise was led by Morgan Health, a JPMorganChase business unit focused on employer-sponsored healthcare, as well as Echo Health Ventures, a strategic investment platform that invests on behalf of multiple Blues health plans.
Behavior Changes Happen Outside the Exam Room, But Validation of Lifestyle Medicine Programs Cannot
If CMS and private payers are serious about whole-person health, reimbursement structures must align with the workforce actually delivering that care. Payment pathways should recognize the value of the broader care team and enable the seamless integration of their expertise with the objective data generated through connected devices and programs like RPM.
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Survey on the Healthcare Financial Landscape Offers a Roadmap for Stakeholders
Zelis highlights how employers, payers, and consumers are integrating digital tools to manage healthcare costs.
Maternal Health Startup Raises $5.7M to Expand Doula Network Nationwide
Flourish Care's seed round was led by Zeal Capital Partners, with participation from Create Health Ventures, Collide Capital, Rogue Women’s Fund, Symphonic Capital, Capita3, Slater Technology Fund and Catalytic Impact Foundation.
Turquoise Health Snags $40M to Simplify Healthcare Contracts & Payments
Turquoise Health raised $40 million in a Series C round to expand beyond price transparency into managing healthcare contracts. The startup’s platform aims to simplify payer–provider agreements, reduce administrative waste and enable patients to see guaranteed upfront prices.
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Survey on the Healthcare Financial Landscape Offers a Roadmap for Stakeholders
Zelis highlights, through a recent survey, how employers, payers, and consumers are integrating digital tools to manage healthcare costs. The findings provide a comprehensive view of the healthcare financial landscape, bringing together stakeholder perspectives, priorities and the opportunities to address them.
Employer Groups Applaud Bill that Aims to Spur Competition in Healthcare
Employer groups praised a bill aimed at boosting healthcare competition and lowering costs by banning anticompetitive insurer-provider contracts.
The New Blueprint: How Clever Care Health Plan is Scaling Its Member Experience [Video]
MedCity News was at the Vive conference and spoke with executives who shared their insights for the healthcare industry.
Carrum, Virta Join Forces on Employer Weight Management Solution
Through a new partnership, Carrum Health can refer patients to Virta Health for weight management support, while Virta can refer patients to Carrum for surgical care.
Chronic Overmedication: The Polypharmacy Waste and Safety Problem
Polypharmacy is a cost and safety problem that is solvable. The right technology platform can reduce it by identifying risky regimens, route specific “stop/switch/consolidate” opportunities to clinicians, and track whether changes stick through refill and adherence patterns.
It Took Years for Congress to Enact PBM Transparency, Delinking. What About Vertical Integration?
Experts say the bipartisan Break Up Big Medicine Act — aimed at breaking up vertically integrated healthcare companies — faces slim chances of passing despite recent PBM reforms.
CVS, Humana & More Are Turning to Google’s AI Models
Google Cloud is partnering with healthcare organizations including CVS Health, Humana, Highmark Health, Quest Diagnostics and Waystar to deploy agentic AI tools across patient engagement, clinical workflows and revenue cycle management
Why Quantum Health Acquired Virtual Care Company CirrusMD
Quantum Health acquired CirrusMD to add 24/7 physician chat to its healthcare navigation services and deliver faster clinical support.