ASC Reimbursements and Strategic Pressures Shape 2026 Outlook
In 2026, Ambulatory Surgery Centers face reimbursement challenges amid inflation and rising procedure complexity. Strategic cost management and payer negotiations are key focus areas.
AM Best to Host Briefing on Medicare Advantage Challenges and Market Outlook
AM Best schedules a briefing on January 15, 2026, addressing pressure points and market outlooks in Medicare Advantage and Medicaid Managed Care sectors amid rising costs and utilization trends.
UnitedHealthcare Limits RPM Coverage While Medicare RPM Expands in 2026
UnitedHealthcare limits RPM coverage to select conditions in 2026 amid growing Medicare RPM use, signaling shifts toward value-based care and enhanced oversight.
Humana Announces Leadership Changes in Medicare Advantage and Insurance Segments
Humana appoints Aaron Martin as President of Medicare Advantage, reshaping its insurance segment leadership ahead of George Renaudin's retirement in 2026. This transition aims to strengthen operational excellence and market position in Medicare and Medicaid.
U.S. Initiatives to Reduce Costs of GLP-1 Obesity Drugs Affect Medicare and Medicaid Coverage in 2026
In 2026, U.S. agreements lower costs of GLP-1 drugs for obesity and diabetes, impacting Medicare and Medicaid coverage with a focus on starter dose affordability and access limitations.
CMS Payment Methodology Inflates Medicare Part B Costs for Stelara Biosimilars
CMS's current inclusion of noncovered self-administered drug prices in Medicare Part B payment calculations inflates costs for Stelara biosimilars. OIG recommends revising pricing methodology to achieve savings.
Federal Rescheduling of Cannabis and Medicare Pilot Coverage Poised to Transform U.S. Healthcare and Investment
Federal rescheduling of cannabis to Schedule III and a Medicare pilot program are set to advance U.S. healthcare integration, research, and institutional investment in cannabis-derived products.
Key Financial Risks in Retirement and How to Mitigate Them
Explore common financial shocks retirees face, including Medicare gaps and housing expenses, with expert insights on building adaptable retirement plans and liquidity reserves.
AMA 2024 Study Highlights High Concentration in U.S. Health Insurance Markets
The AMA's 2024 report reveals significant concentration in U.S. commercial and Medicare Advantage health insurance markets, raising concerns over competition and consumer choice.
Medicare Advantage Contract Dispute in Washington Highlights Vertical Integration Risks
A contract dispute between Optum and Humana in Washington state spotlights risks of vertical integration in Medicare Advantage, impacting senior beneficiaries and market competition.