Trump signs funding bill with PBM reforms, hospital-at-home and telehealth extensions

The Latest

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  Tenet regains full ownership in RCM subsidiary Conifer as CommonSpirit exits

  CommonSpirit, angling to insource its revenue cycle management functions, is offloading its minority share in Conifer back to Tenet. Tenet said the deal will create almost $2.7 billion in value.

  Hospitals

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  Sponsored by Elavon

  As self-pay increases, healthcare leaders look to retail for inspiration

  In a world where rising costs, flat or declining reimbursement and staffing shortages threaten the viability of small and independent medical practices.

  Payer

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  Telehealth flexibilities, hospital-at-home waivers lapse amid partial government shutdown

  The Senate passed a spending package Friday, but the measure is still awaiting House approval. House Speaker Mike Johnson said the partial shutdown should be brief.

  Hospitals

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  Healthcare bankruptcies fall in 2025, but providers still face headwinds: report

  Bankruptcy filings dropped 21% compared to 2024, according to Gibbins Advisors. Still, the sector’s financial outlook is unsteady due to pressures from Medicaid cuts and other policy changes.

  Hospitals

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  Labor Department wants to strong-arm PBMs into being more transparent with employers

  The DOL proposed a rule that would force pharmacy benefit managers to share a broad range of pricing and compensation information with their employer clients, calling it the most significant proposed PBM reform in decades.

  Payer

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  Healthcare industry outlook for 2026: Providers, insurers, IT companies look to stability

  Companies are hoping to reshore finances and double down on efficiency initiatives this year as several policy sea changes threaten to upend the industry.

  Hospitals

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  Top healthcare conferences to attend in 2026

  These are the events healthcare leaders should plan for this year, covering topics like digital health, rural care and financial management.

  Updated Jan. 30, 2026

  Hospitals

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  CMS finalizes rule cracking down on Medicaid provider taxes

  The rule puts limits on states levying higher taxes on Medicaid businesses. The CMS argues the tax arrangements allow states to shift costs onto the federal government, but providers say they’re integral for covering the cost of care.

  Payer

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  Deep Dive

  Health insurers brace for impact in 2026

  Profits will start to tick up after reaching trough levels. Washington will play nice. M&A and AI adoption will accelerate. We asked experts to look into their crystal balls on what the coming year means for a beleaguered industry.

  Payer

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  Medicaid contractors strike deals with CMS to help states execute work requirements

  Ten Medicaid systems vendors have agreed to provide low- or no-cost services to states over the next two years. The Trump administration said the agreements would save $600 million.

  Payer

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  ACA enrollment backslides to 23M in 2026

  That’s down 5% from last year. But it’s not the nosedive some market watchers predicted, and a handful of states — notably, Texas — saw robust growth.

  Payer

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  Opinion

  The healthcare claims system is ready for transformation. Here are 5 ways to prepare in 2026.

  Artificial intelligence could rework the claims and reimbursement process, allowing faster decision-making, reduced errors and billions in savings, according to an Optum executive.

  Payer

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  HCA could lose $1B from ACA subsidy lapse, Medicaid state payment decline

  The for-profit hospital operator said it’s implementing a resilience plan to offset losses. Still, HCA anticipates its earnings this year will skew closely to or exceed 2025 figures.

  Hospitals

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  Q&A

  Chuck Divita on why 2026 is Teladoc’s ‘execution year’

  The CEO sat down with Healthcare Dive to discuss the company’s move to accept insurance at BetterHelp, its M&A strategy and how Teladoc is using artificial intelligence.

  Health IT

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  Drugs for cancer, arthritis and HIV on Medicare’s list for 2028 price cuts

  Still, the medications in the latest round of negotiations — which now includes Part B drugs given in doctor’s offices — draw very limited revenue from Medicare, an analyst pointed out.

  Government

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  Elevance expects lower revenue, earnings, membership in 2026

  This year should see improvements in Medicare Advantage and Affordable Care Act plans but continued pressure in Medicaid, Elevance executives warned investors.

  Payer

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  CMS official defends flat Medicare Advantage rate proposal for 2027

  Medicare director Chris Klomp said the Trump administration is “massively” in support of MA as health insurers cry foul over the meager rate update.

  Payer

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  CMS proposes excluding chart reviews from MA risk scoring in 2027 payment rule

  The proposal would eliminate the financial motivation insurers have to mine their members’ charts for additional diagnoses. Regulators also proposed a flat rate update for 2027, prompting anger from insurers.

  Payer

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  Interconnectedness, extortion risk make cybersecurity a healthcare C-suite priority

  A new report from Trellix reviews the biggest breaches, describes the most effective defenses and profiles the most dangerous attackers.

  Health IT

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  UnitedHealth revenue climbs in 2025, though profit continues to fall

  The healthcare behemoth posted its lowest profits since 2018 last year, largely thanks to continued Medicare Advantage challenges. Executives warned how regulators’ “disappointing” rate update might further contract MA.

  Payer

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  Surprise Billing

  No Surprises disputes increasing even as arbiters catch up, CMS says

  The agency released new data on independent dispute resolution in the first half of 2025. Roughly 1.2 million cases were filed in that period, mostly by the same private equity-backed providers.

  Hospitals

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  CVS accused of shutting out rival pharmacy hubs in House Judiciary investigation

  The company’s massive pharmacy benefit manager changed its rules and weaponized audits to ensure independent pharmacies couldn’t work with competing pharmacy service companies, House Republicans said.

  Payer

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  31,000 Kaiser Permanente workers strike in California, Hawaii

  Kaiser workers are calling for increased staffing and wages, which the union argues haven’t kept pace with rising costs. The health system said a generous offer is already on the table.

  Hospitals

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  Insurance CEOs’ no good, very bad day on the Hill

  The chief executives of UnitedHealth, CVS, Cigna and Elevance were pilloried for care denials, vertical consolidation and sky-high executive compensation during two House hearings Thursday.

  Payer

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  Deep Dive

  Top healthcare AI trends in 2026

  While health systems will continue their AI rollout, use of the technology could evolve amid intensifying competition from EHRs, fragmented regulations and growing M&A opportunities.

  Health IT

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  Why cover GLP-1s? They’ll lower employer healthcare costs, study says

  While the medications may be pricey, a multi-year study by Aon found consistent use correlates with lower medical cost growth and fewer hospitalizations for cardiovascular events.

  Payer

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