CMS releases 2026 Medicare payment reforms focusing on site-neutral payments, alongside Medicaid financing reforms in the One Big Beautiful Bill and updates on Part D bids influenced by the Inflation Reduction Act.
Centene Corporation posts Q2 2025 earnings showing revenue growth but adjusted losses; strategic repricing planned for 2026 amid regulatory and market challenges in healthcare insurance.
Explore the implications of the 2025 One Big Beautiful Bill Act on Medicare and Medicaid programs, focusing on coverage changes, eligibility hurdles, and the impact on rural hospitals and long-term care.
Truist lowers Centene price target to $35 from $42 following Q2 results, citing ongoing cost trend challenges but strong Prescription Drug Plan and Medicare Advantage performance. Buy rating maintained.
Explore expert insights on retirement planning with crypto allocations, target date fund strategies, and managing rising Medicare Part B premiums for optimal retirement outcomes.
Medicare is reforming post-surgical payments to hold hospitals accountable for 30-day post-discharge costs. The sustainability of this model depends on permanent Medicare coverage for telehealth physical therapy, a cost-effective and patient-preferred rehabilitation method. Congressional action is critical to extend tele-PT benefits.
UnitedHealth Group is cooperating with DOJ investigations into its Medicare Advantage practices, emphasizing compliance and initiating third-party reviews. Independent CMS audits and court rulings support UnitedHealth's adherence to Medicare regulations.
ASCs face increasing delays and denials from payers impacting revenue cycles. Increased scrutiny on device/pharma claims and contract carve-outs prompt ASC contract renegotiations amid Medicare Advantage changes.
CMS introduces the WISeR Model pilot program leveraging AI-driven prior authorization to reduce Medicare overuse and fraud in six states from 2026-2031.
Starting in 2025, Medicare prescription drug plans will have a new $2,000 out-of-pocket cap under the Inflation Reduction Act, eliminating the donut hole and lowering costs for beneficiaries. This applies to both Part D and Medicare Advantage plans with drug coverage.
