Susan Ladika

Hospital prices have risen faster than other healthcare prices, and some say consolidation into large health systems is to blame. Hospitals counter that they are price takers, not setters.

Lack of federal legislation and consolidation of hospitals into large health systems are among the reasons states are getting more involved in healthcare regulation and oversight.

Putting money directly in the hands of individuals to buy health insurance would unleash consumer forces, say supporters. Others see the plan as undercutting insurance markets and a “consumerism fantasy" with crucial details lacking.

Enrollment in Affordable Care Act health plans has soared because of enhanced subsidies enacted during the COVID-19 public health emergency. Democrats (and perhaps some moderate Republicans) want them continued. Republicans say they have better ideas about how to keep Americans in the individual market covered, including health savings accounts and association health plans.

It may take legislation for it to happen, but the Trump administration is reportedly going to test coverage on an experimental basis.

Most of the attention has been on Medicaid cuts, but the reconciliation bill and CMS rule changes will also slash enrollment in the health plans sold on the Affordable Care Act exchanges.

Proponents say direct-to-consumer sales by drugmakers cut out intermediaries that add needlessly to prices. Detractors see ethical issues and prices that are still too high for many patients.

The new administration bumped up 2026 rates for Medicare Advantage plans. an early sign that it may treat the plans favorably.

Republicans are aiming for major reductions in federal spending, and Medicaid seems a likely target. But the politics of Medicaid are tricky as the program has expanded and covered more people.

In the aftermath of the fires in California and the hurricanes in the Southeast, health insurers relaxed some deadlines for members and helped affected employees.

Payers and providers are figuring out ways to overcome the transportation barriers that get in the way of people receiving healthcare.

Neither party wants to be perceived as threatening the overall Medicare program. The Biden administration did take steps to reduce payment to Medicare Advantage plans. Insurance companies objected, but some industry observers said it was an overdue correction.

The retail giant shuttered its primary healthcare clinics, and CVS and Walgreens are cutting back. Is retail healthcare doomed for failure?

Telehealth companies, Costco, other companies — they are all looking to take advantage of the soaring demand for the weight loss drugs.

Enrollment has soared, but a relatively modest 2025 rate increase and changes to the Star rating system may lead plans to cut back on with their benefit offerings.

New federal rules set time requirements for some insurers.

Canadian health officials warn that maintaining a drug supply for Canadians is their priority. The staunch opposition of the U.S. pharmaceutical industry may also be an obstacle to imports from north of the border.

Payers and hospitals are at odds over proposals that would level out payments to hospital outpatient departments and physician offices.

As the Federal Trade Commission weighs a ban, hospitals and some physician organizations are on opposite sides of the issue.

Medicaid managed care plans will be affected as states shed enrollees because of the end of the continuous enrollment provisions of the COVID-19 public health emergency.

The company paved the way for prescription digital therapeutics.

The COVID-19 pandemic normalized telehealth. Now an increasing number of insurers are offering virtual-first plans that make virtual care the default choice.

Aetna, Signify Health and now Oak Street Health. Some see advantages to CVS acquiring a primary care provider — for U.S. healthcare as well as CVS. Others see risks of even more consolidation in the healthcare sector and perhaps a financial hit to CVS because of Oak Street’s net losses.

As ideas about what constitutes healthcare have expanded, so has the involvement of newcomers such as Best Buy.

After some go-go years, Bright Health, Oscar and Clover Health are leaving some markets.

Cuban’s Cost Plus Drugs business has entered into agreements with Capital Blue Cross and Rightway.

‘We’ve been successful, and we’d like to share our success,’ says the chief medical officer of the healthcare system’s employee health plan.

Two reports show that drug-related deaths are skyrocketing among people 65 years and older.

Two reports show that drug-related deaths are skyrocketing among people 65 years and older.