Category: Healthcare Finance News

Centene sues CMS over Medicare Advantage star ratings

Centene has joined the list of insurers that are suing the Centers for Medicare and Medicaid Services over the 2025 Medicare Advantage Star Ratings.
Centene of Missouri and 10 affiliated plans such as Meridian Health Plan of Michigan and several Wellca…

389 healthcare companies hit by ransomware this year, Microsoft finds

This year, 389 healthcare institutions in the U.S. were attacked with ransomware, which caused network shutdowns, offline systems, rescheduled appointments and delays in critical procedures, finds a new report from Microsoft.

Oscar Health expands ACA presence with chronic condition plans

Healthcare insurtech Oscar Health will be expanding its presence on the Affordable Care Act marketplace in 2025 and is introducing new plans for people with multiple chronic conditions.
The company will expand into 405 markets across 18 states next yea…

Providence Health & Services in Oregon optimizes value-based care

Value-based care has long been the goal, but becomes more than aspirational when the majority of patients are paying through Medicare and Medicaid.
Providence Health & Services in Medford, Oregon has a payer mix of 60% Medicare and 20% Medicaid, accord…

Elevance laying off 123 California employees

Elevance Health is laying off a combined 123 employees across two southern California locations, according to regulatory documents filed this month.

Waltz Health tackling GLP-1 management with Noom

Waltz Health, a digital health company focusing on the pricing and distribution of prescription medications, is collaborating with digital chronic disease prevention company Noom on a new weight loss program the two describe as comprehensive and more a…

Cleveland Clinic and Amazon One Medical collaborate on primary care clinics

The Cleveland Clinic and Amazon One Medical are collaborating on primary care clinics in Northeast Ohio. 
Amazon One Medical said it would open its first primary care office in affiliation with the Cleveland Clinic next year, offering same and next-day…

Evernorth taps Transcarent for digital cancer program

Evernorth Health Services has selected Transcarent to power its new Oncology Benefit Services program.
The digital platform included in the offering is geared to bring together cancer services across pharmacy and medical benefits and provide more perso…

Most independent pharmacies may not carry negotiated Medicare Part D drugs

A new national survey shows more than 90% of independent pharmacists may not sell drugs for which the Medicare Part D program is trying to negotiate lower prices. If they don’t, the administration’s effort to reduce prescription drug prices is bound to…

Humana sues over 2025 Medicare Advantage Star Ratings

Humana has sued the Centers for Medicare and Medicaid Services over the results of the 2025 Medicare Advantage and Part D Star Ratings.