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CMS Takes Aim at Nurse Churn

CMS Takes Aim at Nurse Churn

CMS Rules
Hospitals Face New Scrutiny Over Price Transparency

Hospitals Face New Scrutiny Over Price Transparency

CMS Rules
AHCCCS Revises Predictions for Members Impacted by Work Requirements

AHCCCS Revises Predictions for Members Impacted by Work Requirements

Arizona News
Medicare Advantage Roundup: Falling Satisfaction, Commission Cuts and a Costco Partnership

Medicare Advantage Roundup: Falling Satisfaction, Commission Cuts and a Costco Partnership

Available To All
Arizona News

Healthcare Powers Arizona Job Growth

Healthcare accounted for more than half of Arizona's job growth over the past year, helping offset losses in sectors ranging from hospitality to finance. But industry leaders warn that persistent workforce shortages could limit the industry's...
MA Pullback Leaves More Seniors Shopping for Coverage National News

MA Pullback Leaves More Seniors Shopping for Coverage

Millions of Medicare Advantage (MA) beneficiaries will face plan changes, benefit reductions or coverage disruptions in 2027 as insurers continue a multiyear effort to restore profitability amid rising medical costs and regulatory pressures. Major insurers including UnitedHealthcare, Humana and Aetna are shrinking their MA...
Arizona News

Kidney Care Overhaul Targets Status Quo

The Department of Health and Human Services (HHS) unveiled a sweeping national strategy to overhaul kidney care, aiming to boost early detection, increase competition in the dialysis market and accelerate innovation in treatment and transplantation. The plan was announced Tuesday by Health Secretary Robert F. Kennedy Jr. who...
Arizona News

CMS Moves to Tighten ACA Subsidies

The Centers for Medicare & Medicaid Services (CMS) is proposing stricter verification requirements for consumers seeking financial assistance through Affordable Care Act marketplaces, a move the Trump administration says will reduce fraud and ensure taxpayer-funded subsidies go only to eligible enrollees.  Under the proposed...
Aetna, Centene Sue CMS Over Star Ratings National News

Aetna, Centene Sue CMS Over Star Ratings

A growing legal battle over Medicare Advantage quality scores is pitting major insurers against federal regulators, with Aetna and Centene joining a wave of lawsuits that could reshape how the Centers for Medicare & Medicaid Services calculates its influential Star Ratings. The disputes come as both companies report improving...
Arizona News

Mayo Clinic Arizona Study Finds Measurable Brain Response Within Minutes of Deep Brain Stimulation

The senior author of the study, Jonathon Parker, M.D., Ph.D., a Mayo Clinic neurosurgeon in Arizona, reported demonstrated measurable changes in the brain within 18 minutes of deep brain stimulation (DBS) in people with drug-resistant epilepsy, a finding that could eventually help clinicians personalize treatment without waiting months...
White Papers, E books, Reports and more

State to Federal Roadmap Series - Working Strategies to Address Healthcare Consolidation & Costs

A three-part Georgetown University Center on Health Insurance Reforms series released this month uses states’ experiences with transparency, pricing reforms, and market oversight to propose federal strategies addressing healthcare ownership transparency, hospital fair-pricing reforms, and oversight of hospital and provider...
National News

AMA & Other Physician Groups Back New Challenge to Medicaid Work Rule

The American Medical Association, Maryland State Medical Society and several national physician groups filed an amicus brief supporting a new lawsuit challenging CMS regulations governing exemptions from Medicaid work requirements. In Taylor v. Kennedy, the groups argue that CMS exceeded its authority by requiring people with serious...
National News

$25M Fraud Whistleblower Program Launched - Targeting Hospice & Home Health

The Trump administration unveiled a new $25 million whistleblower initiative designed to encourage the public to report fraud involving federal programs, offering cash rewards for tips that lead to criminal charges or significant enforcement actions. The announcement given on Tuesday by President Donald Trump and Vice...
Arizona Prison Healthcare Takeover Delayed Arizona News

Arizona Prison Healthcare Takeover Delayed

A federal appeals court has temporarily paused a court-ordered takeover of Arizona’s prison healthcare system, delaying what would be one of the most significant interventions in the state prison system's history while a broader legal battle plays out. The 9th U.S. Circuit Court of Appeals ruled Oct. 16 that Arizona may retain...
New Executive Order Creates Women's Health Office Then Faces Funding Questions National News

New Executive Order Creates Women's Health Office Then Faces Funding Questions

The Trump administration is launching a new federal women's health initiative that will create a Women's Health Division within the National Institutes of Health (NIH) and establish a White House task force aimed at accelerating research, improving diagnosis and treatment, and translating scientific discoveries into clinical care. The...
National Reports & Surveys

Report Finds Insurers Blocking Women's Birth Control Access

More than a decade after the Affordable Care Act (ACA) guaranteed most privately insured Americans access to birth control without out-of-pocket costs, many women continue to face coverage denials, unexpected bills and administrative hurdles that can delay or prevent care.  In 2021, an estimated 61.4 million women ages 18 to 64 had...
National News

CMS Marketplace Broker Freeze Draws Lawsuit

The National Association of Benefits and Insurance Professionals (NABIP) is suing the Centers for Medicare & Medicaid Services (CMS) over a new moratorium that blocks thousands of agents and brokers from registering to sell Affordable Care Act marketplace coverage for the 2027 plan year, intensifying a dispute over how the...
Available To All

CMS Pushes MA Directory Overhaul, Protections for Members & Increased Scrutiny of PBMs

The Centers for Medicare & Medicaid Services (CMS) proposed new rules designed to improve the accuracy of Medicare Advantage provider directories, strengthen oversight of pharmacy benefit managers and expand financial protections for beneficiaries. The proposed rule would require Medicare Advantage (MA) plans to: ...
Arizona Comings & Goings

Phoenix Children's Adds HR & Marketing Leaders

Wanda Shoer will join Phoenix Children’s as SVP and chief people officer effective Nov. 2. She will oversee talent acquisition, human resources, employee development and organizational effectiveness, with responsibility for strengthening career pathways, leadership development and employee engagement. Phoenix Children’s also named...
AHA Report: America’s Rural Hospitals at a Crossroads National News

AHA Report: America’s Rural Hospitals at a Crossroads

A new American Hospital Association report warns that longstanding pressures on rural hospitals, including low patient volumes, workforce shortages, geographic isolation and inadequate reimbursement, are intensifying as policy and payer changes increase the risk of service reductions and hospital closures. Medicaid financing...
National Reports & Surveys

Research: Healthcare Leaders Are Shifting Tech Strategy to Adjust to CMS’ ACCESS Model

NAACOS and Innovaccer partnered on a survey to better understand how provider organizations and value-based care leaders are evolving their technology strategies and responding to the CMS ACCESS model. Rather than evaluating the model in isolation, the report examines it within the broader context of the technology investments, data...
Arizona News

Arizona Included in KFFs Analysis of Nursing-Home Payments Under Pending OBBA SDP Changes

State-directed payments (SDPs) allow states like Arizona to increase payments to specified providers. For the 2025-26 contract year, AHCCCS plans distributed up to $95.4 million in supplemental payments to eligible nursing facilities. Those payments are expected to change as provisions regarding SDPs in the One Big Beautiful Bill are...
Arizona News

Value-Based Care Pushes Deeper Into Orthopedic and Spine Care

Value-based care is becoming less optional for orthopedic and spine specialists as Medicare and commercial insurers push financial accountability further into musculoskeletal (MSK) care. Specialists face an increasingly urgent choice: Help design the models now or work within systems shaped largely by others. The stakes are...

AZRx Prescription Discount Program Reports $1M in Savings

Arizona’s AZRx prescription discount program has saved residents more than $1 million, or an average of $249 per prescription, according to a Wednesday press release from Gov. Katie Hobbs’ office. The free card is available to all Arizona residents, regardless of age, income or insurance status, and is accepted at 98% of...
Medicare Advantage 2027 Star Ratings - UHC I-SNP Plan Only MAPD in Arizona to Earn 5 Stars Arizona News

Medicare Advantage 2027 Star Ratings - UHC I-SNP Plan Only MAPD in Arizona to Earn 5 Stars

The Centers for Medicare and Medicaid Services (CMS) released star ratings for Medicare Advantage plans ahead of the 2027 annual enrollment period that begins today, October 15, 2026 and runs through December 7, 2026. CMS publishes the MA (Medicare Part C) and Part D Star Ratings each year to measure the quality of health and...
National News

Congress Weighs Medicare Physician Pay Overhaul

Congress is considering a bipartisan overhaul of Medicare physician payments that would establish annual inflation-based updates, reduce quality-reporting burdens and provide new payment options for independent primary care practices. The American Medical Association notes that the proposal comes as Medicare physician payments have...
Arizona Gets Less Rural Health Funding Than Expected Arizona News

Arizona Gets Less Rural Health Funding Than Expected

Arizona will receive $166.99 million in the first year of a federal rural healthcare initiative (more than $30 million less than state officials requested) as rural providers prepare for Medicaid eligibility changes that could increase demand for uncompensated care. The funding gap comes as Arizona's rural healthcare safety net...

Hospital Groups Sue to Block 340B Rebate Pilot - Again

The American Hospital Association and five co-plaintiffs have once again sued the federal government to block a second version of a 340B Drug Pricing Program rebate pilot, arguing that the policy could impose more than $1 billion in costs on hospitals and strain providers’ cash flow. The lawsuit marks the second challenge to the rebate...

Humana Taps BlackRock in $2.8B CenterWell Deal

Humana is bringing in a new private equity partner to fuel the growth of its senior-focused primary care business, announcing a $2.8 billion transaction that will give BlackRock a majority stake in nearly 150 CenterWell Senior Primary Care clinics, 12 of those are in the Phoenix metropolitan area. Humana announced the deal on Oct. 13...
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