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NaviHealth built a billion-dollar business using AI to scrutinize care in Medicare Advantage. Now, one of its first funders is publicly bashing the company it once backed. → Read More
An algorithm, not a doctor, predicted a rapid recovery for Frances Walter, an 85-year-old Wisconsin woman with a shattered left shoulder and an allergy to → Read More
Hospital systems are turning to cross-market mergers to avoid antitrust heat. But they are also still signing other lower-profile deals, which experts believe lead to higher insurance premiums. → Read More
Large hospital systems’ investments rebounded heavily in the final quarter of 2022, according to a new STAT analysis of financial filings. → Read More
The D.C. attorney general is investigating the dialysis provider DaVita and its ties to the nonprofit American Kidney Fund. → Read More
Private Medicare Advantage plans now catch roughly half of the entire Medicare population. → Read More
Ambulances were excluded from the federal law that banned most types of surprise medical bills starting in 2022, even though roughly 85% of all emergency rides are out-of-network. And there's no solution in sight. → Read More
A recent financial filing from a large, tax-exempt Orlando hospital system provides a glimpse of just how concentrated America’s hospital markets are. → Read More
CVS Health’s $10.6 billion acquisition of Oak Street Health plants another flag in the latest era of health insurance industry consolidation. → Read More
Medicare Advantage insurers could face an average 2.3% cut to payments in 2024, or a net cut of more than $3 billion, if the government proposal stands. → Read More
A new rule will give a free pass to Medicare Advantage plans for any erroneous codes they submitted between 2011 and 2017. → Read More
The rule, part of a decade-long feud between the health insurance industry and regulators, will likely invite lawsuits from industry groups. → Read More
A decade-long battle over Medicare Advantage audits is coming to a head as Medicare makes a final determination about industry oversight. → Read More
Usually, the RAC acronym elicits rage in hospital circles. But another kind — regional advisory councils — helped subsidize some hospitals during Covid. → Read More
Hospitals’ message at #JPM23: This year will be about increasing revenue by expanding footprints and hiking prices. → Read More
“Profitability is the number one goal” for this year, Oscar CEO Mario Schlosser told STAT in an interview at #JPM23. → Read More
Startup insurers Oscar Health, Bright Health, and Clover Health have hemorrhaged money since going public. All three said at #JPM23 that the drastic changes they’ve made should bring profitability. → Read More
Rising labor costs have been the main financial concern for hospitals over the past year, but those costs have peaked and are now a lot lower, according to hospital system executives at #JPM23. → Read More
STAT's @bobjherman and @TaraBannow lay out which health care providers and insurance companies they'll be watching at #JPM23. → Read More
STAT’s business reporters will be paying attention to three hospital and insurance trends next year. Read about them here. → Read More