- AdventHealth CEO brings a cyclist’s mind to healthcare headwind navigation
- Baptist Health Arkansas hospital to end OB services
- Baptist Health Arkansas hospital to end OB services
- Texas behavioral health provider launches 6th Austin-area clinic
- The readiness gap facing new dental graduates
- Texas AG sues dental providers for Medicaid fraud
- Health systems embrace teledermatology
- New Jersey expands authority for advanced practice nurses
- Boone Health sues Missouri Heart Center for breached contracts, data misuse
- 42 North Dental appoints senior VP of operations
- Advocate Health taps Epic’s AI Agent Factory
- Why HealthPartners won’t get ‘caught up in the race’ on AI
- The groups among whom mammography rates are falling: Study
- Why these 2 roles are key to expanding behavioral access, per SAMHSA
- Why ASCs are watching NewYork-Presbyterian’s anticompetitive lawsuit
- CVS Health to open more stores than it closes in 2026
- CMS signals tougher expectations for hospital nutrition services: 5 notes
- Sun Life appoints dental business president
- Memorial Regional, Joe DiMaggio Children’s name CFO
- Dr. Yun Saksena appointed vice dean for academic, student affairs at University of Washington
- 12 Big Tech health system partnerships
- MB2 Dental’s 3-year growth recap: 17 moves
- Kaiser Permanente’s $9.3B net income draws scrutiny: 6 things to know
- New orthopedic CEO trims $2.5M in costs — 2 targeted areas
- How 2 orthopedic groups formed strong payer partnerships
- ACA enrollment at 23.1 million in 2026
- 6 states with the most DSO activity in Q1
- Illinois hospital to expand cardiovascular care with $29M project
- Intermountain Health outpatient building acquired by real estate firms
- 2026 gastroenterology fellowship match: A breakdown
- Maryland eye practice acquired
- South Carolina system centralizes OB delivery services
- CDRH Guidance: Patient Preference Information (PPI) in Medical Device Decision Making
- CDRH Guidance: Patient Preference Information (PPI) in Medical Device Decision Making
- Unlocking Hidden Margin: How Health Systems Are Thinking About AI, Automation, and Revenue Risk
- BSCI’s LAAC CHAMPION-AF study for WATCHMAN FLX meets primary and secondary safety and efficacy endpoints
- BSCI’s LAAC CHAMPION-AF study for WATCHMAN FLX meets primary and secondary safety and efficacy endpoints
- Apple Store to ID Regulated Medical Device Apps
- Apple Store to ID Regulated Medical Device Apps
- 16 dentists making headlines
- California autism center to close 2 locations, lay off 62
- 70+ DSO affiliations in Q1: State-by-state breakdown
- Oceans Healthcare taps VP of corporate development
- PCDM acquires Ohio periodontics practice
- Pennsylvania expands law enforcement, SUD treatment collab
- Washington physician sentenced for selling recalled medical devices to patients as new
- How Orlando Health is reshaping bariatric care
- CMS: This year's open enrollment brought fewer signups, higher premiums
- White House denies plans for 20% NIH funding cut
- Medical Schools No Longer Required To Teach Health Inequities
- Connecticut behavioral health provider names president
- 10 providers seeking RCM talent
- Lilly presses for UK deal that would see higher drug prices in exchange for resumed investments: FT
- Closed Illinois hospital may receive lifeline
- United plots Tyvaso FDA filing after ph. 3 win elicits talk of 'new IPF standard' and blockbuster sales
- RCM firm names Quorum Health veteran VP of revenue cycle operations
- 7 health systems with boosted outlooks
- Fluoride Quietly Removed From Birmingham Water Years Ago, Officials Face Backlash
- FDA Weighs Expanding What Can Go Into Supplements
- 9 Now Sickened in Outbreak Tied To Raw Milk and Cheese
- BMS, Novartis, Gilead, Iovance dinged over biologics promos in rare spate of CBER untitled letters
- Nearly half of US hospital markets entirely controlled by 1 or 2 health systems: KFF
- Idorsia eyes pediatric insomnia use with midstage trial win for sleep med Quviviq
- Electronic Paperwork Increasing Burnout Risk Among Young Doctors
- Kratom Cases Surging In U.S.
- What Makes Play Fun For Children? Seven Factors Stand Out, Study Says
- Night Shifts Are Tough On People With Type 2 Diabetes, Study Says
- Women's Bone Loss Tied To Heart Health, Study Finds
- Want To Lose Weight? Eat A Boring, Repetitive Diet, Researchers Suggest
- Samsung Biologics union gathers votes to strike as tension over wage, governance mounts
- Takeda begins US layoffs as part of massive $1.3B restructuring
- Biogen looks to shake up SMA status quo with FDA nod for high-dose version of Spinraza
- She Owed Her Insurer a Nickel, So It Canceled Her Coverage
- Inside the High-Stakes Corporate Fight Over Feeding Preterm Babies
- Study Links High Antioxidant Intake To Changes in Offspring Development
- The Healthcare Burnout Backlash (pt 1): Burnout Reaches Well Beyond Clinicians
- The Healthcare Burnout Backlash (pt 1): Burnout Reaches Well Beyond Clinicians
- Even Mild Oxygen Loss in Preemies' First Hours Poses Lifelong Brain Risks: Study
- Oklahoma officials warn of new opioid
- Michigan finalizes Medicaid mental health assessment policy changes
- How the Trump Administration Uses Migrant Kids To Find and Detain Family Members
- Oral GLP-1s, COVID preventatives: 3 more drugs in the pipeline, Optum says payers should watch
- Providence trims 2025 operating loss to $132M, notches second consecutive quarter of gains
- Missouri system debuts mobile behavioral health unit
- $3M Verdict Links Social Media to Anxiety and Depression
- The White House Delays CDC Pick
- New COVID 'Cicada' Variant Is Spreading — What Experts Want You To Know
- Advocate Health to launch ‘nation’s largest’ hospital drone delivery program in Zipline partnership
- Op-ed: Empathy meets efficiency—how the responsible use of AI can transform Medicare
- Family Caregivers Provide $1 Trillion In Annual Labor, AARP Says
- ‘Health Doesn’t Need to Be Ludacris’: Bayer signs rapper-actor to multivitamin campaign
- Rocket plots measured trajectory for new gene therapy Kresladi after clearance to launch from FDA
- Healthy Lab Results May Mask Future Risks for Kids with Obesity
- At-Home Chemotherapy Is Safe, Feasible, Pilot Study Indicates
- What You Do While Sitting Could Predict Dementia Risk
- New Cholesterol Guidelines: What Patients and Caregivers Need to Know
- Want A Bootlicking Yes Man? Ask An AI Chatbot For Advice, Study Warns
- Specially Coated Implants Better For Breast Cancer Patients, Study Finds
- Give and Take: Federal Rural Health Funding Could Trigger Service Cuts
- Trump Team Claims Successes Against ACA Fraud While Pushing for More Controls
- Fierce Pharma Asia—Takeda’s $1.3B reorg; India’s GLP-1 floodgates; Gilead’s $2.2B buy of a China NewCo
- Where are you with EUDAMED?
- Where are you with EUDAMED?
- HL7 Launches Real‑Time Medical Device Interoperability Accelerator
- HL7 Launches Real‑Time Medical Device Interoperability Accelerator
- Two GA Tech ATDC Startups — Nephrodite and OrthoPreserve — Secure FDA Breakthrough Device Designation
- Two GA Tech ATDC Startups — Nephrodite and OrthoPreserve — Secure FDA Breakthrough Device Designation
- Artificial Intelligence: ROI, not Clinical Autonomy, Leads Operational Workflows
- Artificial Intelligence: ROI, not Clinical Autonomy, Leads Operational Workflows
- Medtronic and Merit Medical Systems distribution agreement for new, ViaVerte basivertebral nerve ablation system
- Medtronic and Merit Medical Systems distribution agreement for new, ViaVerte basivertebral nerve ablation system
- Breakthrough Device Designation for Noah Labs Vox Heart Failure Detection Device
- Breakthrough Device Designation for Noah Labs Vox Heart Failure Detection Device
- What the Health? From KFF Health News: A Headless CDC
- Recordati confirms it's weighing CVC Capital buyout offer of $12.6B
- Nonprofit celebrates rescue, recapitalization of Prospect Medical Holdings' Rhode Island hospitals
- UnitedHealth shareholder sues over proposal to include details on integration in annual proxy
- SCAN taps biopharma, CMS vet Aman Bhandari as its first chief AI officer
- Infosys to acquire Optimum Healthcare IT in $465M deal
- Healthcare systems can create AI care pathways with new Viz.ai tool
- DOJ alleges NewYork-Presbyterian forces payers into anticompetitive 'all-or-nothing' contracts
- FDA Warns Biotech Firm Over Cancer Drug Anktiva Claims
- Bees and Hummingbirds May Be Consuming Small Amounts of Alcohol
- Two States Sue Cord Blood Company Over Misleading Claims
- New WHO Guidance Aims To Speed Tuberculosis Testing
- As questions swirl around ATTR competition, Alnylam plots path to market leadership for Amvuttra
- Trump admin delays nomination for new CDC director past deadline
- Outspoken ACIP member steps down amid vaccine panel uncertainty: reports
- Egg-based drugmaker Neion Bio emerges from stealth to cook up multi-product biosimilar collab
- Genentech walks the walk in lupus as sponsor of annual awareness and fundraising event
- Study Reveals How Many Americans Consider Using a Gun
- Massive Study Finds Stress and Grief Don’t Cause Cancer
- Ultra-Processed Foods Harm Fertility In Both Men And Women, Studies Reveal
- Small Daily Habits Can Add Up To Better Heart Health
- Ritalin Might Protect ADHD Kids' Long-Term Mental Health, Study Finds
- Can You Drink Enough Fluids To Prevent Kidney Stones? Maybe Not, New Study Says
- Clasp, loan-linked hiring tool for employers, clinches $20M to expand amid federal loan caps
- Taking a GLP-1? Doctors Say Not To Forget About Movement and Mental Health
- OpenEvidence rolls out AI medical coding feature
- CDC’s Acting Chief Promises a Return to Stability in a Tumultuous Moment
- Remarks at the Financial Stability Oversight Council Meeting
- RWJF: Between 5M and 10M people could lose Medicaid coverage in 2028 under work requirements
- New therapy animal program aims to support 100K patients, providers
- Pulse check on Lilly's GLP-1 fortunes
- Gen Z nurses prioritize schedule flexibility, need more manager interactions to avoid turnover
- How pharma marketers can capitalize on HCPs’ AI, social media and streaming habits
- Federal Officials Investigate States That Require Abortion Coverage
- Corcept's lead drug bounces back from FDA snub with different approval as Lifyorli in ovarian cancer
- Ionis slashes Tryngolza's price tag by 93% ahead of anticipated label expansion
- FDA approves Denali's Hunter syndrome drug, handing rare disease community a win
It would appear that the "Hands Off My Medicare" crowd attacking RFK, Jr. and the Trump Administration have been waxing delusional:
https://www.fiercehealthcare.com/payers/cms-finalizes-506-medicare-advantage-benchmark-increase
CMS finalizes 5.06% Medicare Advantage benchmark increase
By Noah Tong - April 7, 2025The Centers for Medicare and Medicaid Services (CMS) finalized an increase of the average benchmark payments to Medicare Advantage (MA) plans by 5.06% on Monday.
It is nearly a three percentage-point increase over the advance notice proposed in the waning days of the Biden administration and will be seen as favorable to payers. CMS said this is due to the effective growth rate increase from 5.93% to 9.04% in the rate announcement.
“This change is primarily due to the inclusion of additional data on fee-for-service (FFS) expenditures, including payment data through the fourth quarter of 2024, which was not included on account of the early Advance Notice publication,” the agency said in a news release.
Rebasing and re-pricing ultimately brought the payments to plans down by approximately a quarter of a percent.
UnitedHealth Group stock increased by 6% in after-hours trading over its day-end closing price, following brutal days for the stock market because of tariff-induced challenges. CVS Health jumped by 9%, Elevance Health by 8% and Humana by 16%. Insurtechs Clover Health Alignment Healthcare increased by 6% and 9% respectively.
CMS will also finish phase-in of the MA risk adjustment model, and continue the phased-in approach for removing medical education costs from expenditures in growth rate calculations. Most insurers asked for the risk adjustment model to be paused.
The rate increase was supported by Medicare Advantage advocate Better Medicare Alliance and the Alliance for Community Health Plans (ACHP). The ACHP was one of the few insurer groups to support the new risk adjustment model and did not want it delayed.
"ACHP commends the Trump administration for finalizing policies in the [rate notice] that reflect higher care delivery costs and for taking another step toward reining in aggressive risk adjustment to boost competition," said President and CEO Ceci Connolly in a statement. "ACHP has long supported the new MA risk adjustment model and is pleased that CMS will finally complete the transition."
In January, CMS released the proposed rate, which would have increased payments by 2.23% and continued implementation of the risk adjustment model. Payments from the federal government would have increased by $21 billion, or 4.33%, the CMS said.
Doctors criticized the proposed rate, arguing insurers were once again receiving preferential treatment from the federal government. Providers and physicians said Congress still hasn't reversed painful doc pay cuts implemented by CMS as required by prior statute—and yet insurers were in line to get a boost.
The physician pay reversal was included in an end-of-the-year healthcare package before the bill failed at the eleventh hour due to other political considerations. It was again rejected in an effectively symbolic introduction by Senators Ron Wyden, D-Oregon and Bernie Sanders, I-Vermont before the Senate agreed to a government funding bill.
The insurance lobby criticized Biden’s health officials during his tenure for enacting tougher rates on plans, so the 2.23% rate was more favorable to payers than initially expected. In 2024, the government finalized a cut of 0.16% to MA plans.
Starting Jan. 1, annual out-of-pocket prescription drug costs were capped at $2,000 for enrollees.
CMS recently released its Contract Year 2026 MA and Part D final rule, choosing to punt on implementing agent and broker marketing requirements, most star ratings changes and imposing new guardrails on AI. The rule also declined to adopt a Biden-supported policy to have Medicare and Medicaid cover anti-obesity drugs, but did include new requirements on prior authorization and Special Supplemental Benefits for the Chronically Ill.
Left of center Morning Brew brings some additional macro market perspective.
https://www.healthcare-brew.com/stories/2025/04/09/cms-hikes-medicare-advantage-payments
CMS hikes Medicare Advantage payments up 5%, over $25b
Government payments to MA plans are set to rise over $25b in 2026—and Wall Street noticed.
By Caroline Catherman | April 9, 2025The federal government is going to pay Medicare Advantage (MA) plans a lot more in 2026.
In payment policy updates released on Monday evening, the Centers for Medicare and Medicaid Services (CMS) said MA plans will receive average payment increases of 5.06%—or more than $25 billion—from 2025 to 2026. This is 2.83 percentage points higher than CMS had predicted in its January advance notice of these changes, and more than double the 2.33% increase it had estimated from 2024 to 2025.
“This was the administration’s first chance to pump the brakes on MA, and there was some uncertainty going into the release. The rate notice indicates a desire to drive on—and maybe accelerate,” Luke Hansen, chief medical officer at Arcadia, a healthcare data platform for payers and providers, told Healthcare Brew.
For 2025, the Medicare Payment and Advisory Commission predicted the federal government will pay MA plans $538 billion. (In 2024, it paid $494 billion, per the commission.)
Though the stock market is largely a burning dumpster fire right now, MA providers’ shares are soaring after the news.
The largest MA provider, UnitedHealthcare, saw its stock jump from $524.70 at market close on Monday to $582.17 at market open on Tuesday, though the stock came down to around $553.08 by the day’s end.
Why so high? CMS said on April 7 that the rate increase is “largely attributable” to an increase in the effective growth rate. This rate represents the average expected change in MA benchmarks, which is the maximum amount the government will pay each Medicare Advantage plan, according to independent research nonprofit the Commonwealth Fund.
Benchmarks are calculated using the average spending in traditional fee-for-service Medicare in each county. That data wasn’t complete for 2024 when CMS estimated a 5.93% effective growth rate in its 2026 advance notice. Now, with the data complete, the effective growth rate is 9.04%, CMS said.
Zooming out. The rate updates and 2026 guidance were released just days after Congress approved Mehmet Oz as the new CMS director on April 3.
The New York Times reported in February that Oz has financial ties to Medicare Advantage companies, like TZ Insurance, sparking concerns about potential conflicts of interest. But during congressional confirmation hearings, Oz addressed bipartisan concerns about prior authorization and overpayment.
CMS will also in 2026 complete reforms to the MA risk adjustment model, which is intended to reduce overpayments, and finalize guidance on the Inflation Reduction Act’s Part D changes, including the Medicare Drug Price Negotiation Program.
Get MHF Insights
News and tips for your healthcare freedom.
We never spam you. One-step unsubscribe.















