Geisinger is eliminating nearly 100 Geisinger Health Plan positions as part of a restructuring that comes as the system's health insurance operation faces financial headwinds, officials said. 'There are no staff reductions elsewhere at Geisinger,' system President and CEO Dr. Terry Gilliland said in the message sent to all Geisinger employees and reviewed by The Times-Tribune. 'In fact, we're currently recruiting for approximately 2,500 open positions systemwide, and expect many impacted GHP employees to transition into new roles within Geisinger.' But Gilliland's message also notes financial challenges that Geisinger Health Plan has grappled with in recent years, including a $231 million operating loss last year. It's still operating at a loss despite performing 'much better' this year, per the internal correspondence.
Eden Prairie-based UnitedHealth Group has engaged in a widespread campaign to quash criticism, according to a The New York Times investigation. The findings suggest that the company used legal threats to impede news sources and activists from publishing negative information about the company. The Times investigation began with a tip that a docuseries critical of the healthcare industry was taken off of Amazon and Vimeo after a law firm working with UnitedHealth Group sent a letter claiming defamation. The filmmaker, Mary Strause, had helped manage pharmacies and was hoping to shed light on drug industry middlemen, including UnitedHealth subsidiary Optum Rx.
Medicare is proposing across-the-board cuts to what Trump administration officials believe are overpriced medical procedures, scans, and tests — a consequential decision designed to even the score between highly paid specialists and primary care doctors.
Hospitals lost big in President Donald Trump's megabill, but they still have plenty of time to fight back. The One Big Beautiful Bill Act that Trump signed on the 4th of July will take a $340 billion bite out of hospital budgets over a decade to pay for tax cuts and other Trump priorities. Then again, maybe it won't. Congress delayed implementation of the most devastating of those cuts till 2028, and hospitals, their armies of lobbyists and many allies on Capitol Hill are already gearing up to use the next two and a half years to persuade lawmakers to rescind them. And 2028 is not only an election year, but a presidential one.
A federal judge has ruled that medical debt can remain on Americans' credit reports, cancelling a policy set in place by the Biden administration to help relieve the burden of healthcare expenses weighing on nearly a third of the population. The ruling — handed down by U.S. District Court of Texas' Eastern District Judge Sean Jordan on Friday — was a major blow to the Consumer Financial Protection Bureau, which has fought against medical debt as a metric of credit worthiness.
Beginning in CY 2026, CMS proposes to implement two separate conversion factors: one for qualifying alternative payment model participants and one for physicians and practitioners who are not qualified participants. The rule would increase the APM conversion factor by 3.83% in CY 2026 as compared to CY 2025. It would increase the non-conversion factor by 3.62% in CY 2026 as compared to CY 2025. These updates include statutory updates of 0.75% and 0.25% for the APM and non-factors, respectively, another update of 2.5% as required under the One Big Beautiful Bill Act, and 0.55% that CMS states is necessary to account for proposed changes in work relative value units.
CMS also proposes that, for CY 2026, it would make an efficiency adjustment to certain work RVUs of -2.5%. In addition, the agency is proposing significant updates to its practice expense methodology that it says will recognize greater indirect costs for practitioners in office-based settings compared to facility settings. It also proposes to utilize data from auditable, routinely updated hospital data to set relative rates and inform cost assumptions for some technical services paid under PFS. Specifically, for CY 2026, it proposes to use this data in setting rates for radiation treatment services, and for some remote monitoring services.