High Stakes in CMS’s 2026 Medicare Advantage Star Ratings
The CMS released 2026 Medicare Advantage star ratings showing mixed results for major insurers. Star ratings affect bonus payments and rebates, impacting insurer revenues and market strategy.
Expiration of Enhanced ACA Premium Tax Credits Could Double Premium Costs in 2026
The expiration of enhanced ACA premium tax credits in 2026 could more than double premium costs for millions of Marketplace enrollees, driven by rising healthcare costs and regulatory changes impacting affordability in the U.S. insurance market.
ACA Subsidy Expiration to Cost Georgia $3.7B Health Sector Revenue in 2025
Expiration of ACA subsidies threatens $3.7B loss in Georgia's health sector revenue with widespread impacts on Medicaid, premiums, and healthcare employment nationwide.
Comprehensive Guide to FSA-Eligible Medications and Reimbursement
Explore detailed insights on Flexible Spending Accounts (FSAs), covering eligible medications, reimbursement processes, and regulatory requirements under U.S. healthcare plans.
Specialty Drugs and Upcoding Drive Rising Medical Costs, Pressure U.S. Health Insurers
Major U.S. health insurers face rising medical costs driven by specialty drug spending and upcoding, impacting earnings and Medicaid, ACA market dynamics in 2025.
Rising Payer Denials and Delays Challenge ASC Revenue Cycles
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.
Moody's Report: Medicaid Cuts, Insurer Challenges, and Emerging Healthcare Trends
Moody's report highlights impending Medicaid cuts, insurer financial pressures, evolving Medicare Advantage rates, and trends in U.S. healthcare leadership and technology.
Hospitals Expand Facility Fees on Outpatient Visits, Raising Patient Costs
Hospitals nationwide, including the Cleveland Clinic in Florida, increasingly charge outpatient facility fees, impacting patient costs amid insurance challenges and regulatory scrutiny.
Quantum Health Strengthens Executive Team to Drive Healthcare Innovation
Quantum Health appoints new CFO, Chief Transformation Officer, and Chief Marketing Officer to accelerate growth and innovation in healthcare navigation amid rising industry challenges.
Elevance Health Q1 2025: Revenue Growth, Medicare Advantage Expansion, and Carelon Rx Gains
Elevance Health reports 15% revenue growth in Q1 2025 driven by Medicare Advantage expansion, premium increases, and CarelonRx portfolio growth, highlighting ongoing healthcare market evolution.