All stories
Jump to date
Wednesday, September 2 · 4 stories
- Industry
Referral Partners Balance Home Health and SNF Placements to Reduce Readmissions
Post-acute care referral partners are refining site-of-care decision-making to route patients appropriately between home health, skilled nursing facilities, and other settings. The focus is on matching patient needs with the right post-acute setting to prevent costly hospital readmissions. Effective placements require thorough documentation and communication across hospitals, SNFs, and home health agencies. The approach affects discharge planning workflows and care coordination for Medicare and Medicaid beneficiaries moving from acute to post-acute care.
Tuesday, September 1 · 3 stories
- Industry
Novartis, Bristol Myers Pause Cell Therapy Trials After Three Patient Deaths
Novartis and Bristol Myers Squibb have halted multiple autoimmune cell therapy trials after inflammatory side effects emerged, including three patient deaths from immune reactions in Novartis trials of CAR-T candidate rap-cel. Bristol Myers voluntarily paused enrollment in autoimmune trials for its CAR-T treatment zola-cel. Both therapies use accelerated production technology compared to earlier CAR-T products. The pauses affect investigational treatments not yet approved for any indication, with unclear timelines for resumption.
- Industry
Centene Names Bradley Bolivar Chief Information Officer
Centene Corporation has appointed Bradley Bolivar as Chief Information Officer. Bolivar joins from Fannie Mae and will lead the company's information technology strategy. The appointment comes as insurers, including Medicaid managed care organizations, increasingly integrate artificial intelligence into operations. No effective date was specified in the announcement.
- Industry · NY
Troy Hospital Keeps Birthing Center Open After Community Opposition
A hospital in Troy, New York, reversed plans to close its birthing center following bipartisan community opposition to the closure. The facility is the county's last birthing center. Local Democrats and Republicans joined forces to challenge the closure decision by the national Catholic health system that operates the hospital. The reversal preserves maternity services in a county that would otherwise have lost all local birthing options.
Monday, August 31 · 9 stories
- Industry
Employers Reassess Health Benefits as GLP-1 Drug Costs Strain Budgets
Employers are fundamentally reconsidering health benefit design as spending on GLP-1 medications (Ozempic, Wegovy, Mounjaro) drives unprecedented cost increases. Self-insured employers and commercial health plans are implementing new coverage restrictions, prior authorization requirements, and cost-sharing structures to manage expenses that some benefit managers describe as unsustainable under current benefit designs. The shift is occurring across 2026 plan years as employers finalize benefits for 2027. This development matters primarily for commercial payers but has spillover implications for Medicaid programs in states that cover GLP-1s for weight loss, as commercial market strategies often preview Medicaid managed care utilization management approaches.
- Industry
FDA Expands Mounjaro Approval to Reduce Cardiovascular Risk in Type 2 Diabetes
The FDA approved Mounjaro (tirzepatide) to reduce major adverse cardiovascular events — cardiovascular death, nonfatal heart attack, and nonfatal stroke — in adults with type 2 diabetes at high cardiovascular risk. The approval follows the Surpass-CVOT trial involving over 13,000 participants across 30 countries. The expanded indication is effective immediately. This matters for Medicaid managed care organizations because cardiovascular disease is a leading driver of costs in diabetic populations, and the new indication may affect prior authorization policies, formulary placement, and utilization management for tirzepatide in high-risk beneficiaries.
- Industry · ID
Idaho Public Housing Authorities Largely Decline HUD Work Requirement Proposal
One Idaho public housing authority has joined a HUD coalition exploring work requirements for subsidized housing, while other authority leaders remain skeptical. HUD is encouraging housing authorities to impose work rules and time limits for residents. The proposal affects public housing residents but does not directly involve Medicaid programs. While some housing authority residents may also be Medicaid beneficiaries, this development concerns housing policy under HUD jurisdiction, not Medicaid eligibility, covered services, or managed care operations.
- Industry · MD
ACLU Report Documents 143 Deaths in Maryland Police Encounters, Half Involving Medical or Behavioral Health Crises
An ACLU of Maryland report documents 143 deaths in police encounters from 2015 to 2023, finding nearly half involved individuals showing signs of medical or behavioral health crises. Black Marylanders were killed at three times the rate of white residents, and among unarmed victims, close to 80% were Black. The report calls for redirecting crisis response away from armed officers toward trained crisis teams and notes no on-duty officer was convicted of any crime related to these deaths during the study period. The findings highlight systemic failures across policing, medical examiner practices, and legal accountability.
- Industry
Hospital Consolidation Drives Wide Price Variation for Knee Replacements Across Markets
A KFF Health News analysis using newly available hospital price transparency data shows knee replacement costs under the same commercial health plans vary by more than double across markets with differing levels of hospital competition. Mission Hospital in Asheville, NC charged Blue Cross Blue Shield approximately $40,000 for the procedure compared to $16,000 at Catawba Valley Medical Center 60 miles away. Similar price disparities appear in Florida and Colorado markets where dominant hospital systems face limited competition. The analysis illustrates how hospital consolidation enables price increases that insurers pass through as higher premiums for all enrollees, including Medicaid managed care plans operating in dual or integrated markets.
- Industry · ME
Portland Nonprofit Expands Direct Cash Assistance Program for Single Mothers
Project Home Trust, a Portland nonprofit providing direct cash assistance to low-income single mothers, received a $1.47 million anonymous donation to expand its program. The expansion will serve 100 mothers and their children with $500 monthly payments for three years and extend services to a fourth county in Maine. The program targets families earning no more than 60% of area median income and helps participants navigate benefits cliffs when income increases threaten public program eligibility. Current participants in Cumberland, York, and Androscoggin counties are receiving assistance as SNAP and Medicaid eligibility changes affect vulnerable families statewide.
- Industry
Private Equity Healthcare Deal Volume Drops 50% in Physician Practice Management Amid State Oversight Laws
Private equity healthcare deals declined in both volume and value in the first half of 2026 compared to 2025, driven by new state oversight laws in at least 25 states. California, Oregon, and Rhode Island implemented transaction reporting requirements this year, while seven states enacted private equity guardrails in 2025. Physician practice management deals — the sector with the largest private equity presence — are on track to decline by half in 2026. The new state laws increase transaction costs, extend timelines, and restrict physician practice corporate ownership models that private equity has historically relied on for roll-up strategies.
- Industry · MN
Minnesota AG Clears Sanford Health Acquisition of North Memorial Under 10-Year Service Commitments
South Dakota-based Sanford Health received approval from the Minnesota Attorney General to acquire North Memorial Health after signing a 10-year oversight agreement requiring maintenance of hospital and emergency services at North Memorial's Robbinsdale safety net hospital. The agreement extends far beyond Sanford's initial two-year service commitment and requires preservation of the Level 1 trauma center, emergency department, labor and delivery, mental health services, and other core services for a decade. The acquisition moves forward in September 2026, with North Memorial citing financial distress and risk of closure without the transaction. The agreement addresses concerns from healthcare advocates and labor leaders about consolidation's impact on care access and costs.
- Industry · CA
UCSF Transfers Pediatric Subspecialty Services from Oakland Hospital to San Francisco
UCSF has moved bone marrow transplant, interventional radiology, and specialty testing services from UCSF Benioff Children's Hospital in Oakland to its San Francisco facilities a year after taking over Children's Hospital Oakland. Affected families — many covered by Medi-Cal, undocumented, or low-income — must now travel across the Bay for care previously available locally. The hospital serves as one of five Level 1 pediatric trauma centers in California and historically served as a safety-net institution for East Bay children. Clinical staff and community members have protested the service transfers, citing increased transportation barriers and racial equity concerns, particularly for Black children with sickle cell disease.
Saturday, August 29 · 1 story
- Industry
Hospital CEOs Navigate Site-Neutral Payment Pressures Amid Medicaid Changes
Health system CEOs are confronting multiple financial pressures, including Medicaid coverage and reimbursement changes under HR 1, ongoing 340B drug discount program policy challenges, and site-neutral payment considerations. These policy shifts are influencing where health systems invest and deliver care. The article features perspectives from executives at Valley Health and other systems on how they are adapting their care delivery and investment strategies in response to these combined pressures.
Friday, August 28 · 1 story
- Industry
Trump-Kennedy Health Industry Agreements Lack Enforcement Mechanisms, Face Implementation Uncertainty
Voluntary agreements between the Trump administration and health industry stakeholders on drug pricing, synthetic food dyes, and prior authorization have not been enforced since their announcement. The agreements were publicly touted as policy victories but contain no binding compliance mechanisms or regulatory authority. Implementation timelines remain unclear, and the voluntary nature of the commitments raises questions about whether the agreements will produce measurable changes to industry practices. The lack of enforcement structure leaves managed care organizations and other affected entities without clear compliance obligations or operational guidance.
Thursday, August 27 · 3 stories
- Industry
No Surprises Act Dispute Resolution Costs Reach $22B, Georgetown Finds
New Georgetown University research found that independent dispute resolution under the No Surprises Act has generated $22 billion in additional healthcare costs, driven by accelerating dispute volumes and high arbitration award amounts. The researchers warn that these costs could translate into higher health insurance premiums for consumers. The No Surprises Act, which took effect in 2022, established a federal arbitration process for out-of-network billing disputes but does not apply to Medicaid managed care plans, which operate under different surprise billing protections.
- Industry
Sword Health Acquires Headspace in All-Cash Deal Expected to Close Next Month
Sword Health is acquiring Headspace in an all-cash transaction expected to close in September 2026, according to a filing with Massachusetts regulators. The deal will combine Headspace's wellness services with Sword's virtual care platform under one entity. The acquisition represents consolidation in the digital health space, bringing together musculoskeletal care and mental health/wellness capabilities. Financial terms were not disclosed in the regulatory filing.
- Industry
Becker's Compiles Trump Administration Health Technology Policy Actions
Becker's Hospital Review has compiled a tracker of recent Trump administration actions affecting health technology policy, including moves related to AI adoption, digital infrastructure, data sharing rules, cybersecurity requirements, and federal oversight mechanisms. The compilation covers regulatory changes and policy shifts reported by Becker's across multiple areas of healthcare technology. The tracker appears to be an ongoing compilation rather than reporting a single discrete policy event, aggregating developments that may affect hospitals, health systems, and other healthcare entities operating digital health programs.
Wednesday, August 26 · 3 stories
- Industry
Mark Cuban Discusses Pricing Transparency and Cost Plus Drug Company Model
Mark Cuban, founder of Cost Plus Drug Company, discussed healthcare pricing transparency and his approach to generic drug pricing in an interview with KFF Health News. Cuban's online pharmacy model focuses on transparent pricing for generic drugs. The discussion covers his views on broader healthcare system reform and price disclosure. The interview addresses how his direct-to-consumer pharmacy model differs from traditional pharmacy benefit manager arrangements.
- Industry
Home Health M&A Activity Increases After Four-Year Decline
Home health and hospice merger and acquisition activity is increasing after four consecutive years of decline. Industry analysts expect the proposed CY2027 home health rule and Medicare enrollment moratoria to drive further dealmaking through 2027. Transaction volume and valuations are both projected to rise. The trend affects home health agencies operating in Medicaid programs, particularly those serving dual-eligible beneficiaries or those considering consolidation strategies.
