Healthcare Dive reports that Centene is forecasting its Medicare business will break even a year ahead of schedule, following a strong third quarter. The company has reduced its workforce by 6,000, which led to immediate severance expenses but is expected to improve margins by 2027.
This development signals ongoing cost control efforts among major US insurers. For healthcare executives, the early break-even and job cuts indicate continued pressure to balance profitability with operational efficiency. Further restructuring or shifts in workforce strategy could affect industry benchmarks.
Epic’s Vice President of Value-Based Care, Ryan Bohochik, told Healthcare Dive that payers are working to implement new prior authorisation technology before the January 1 regulatory deadline. Bohochik described the industry’s progress to date but did not provide specific figures or outcomes.
The adoption of this technology will affect how quickly approvals are processed between providers and insurers. For senior leaders, the focus is on ensuring compliance and operational readiness as the deadline approaches. Monitoring progress and addressing gaps will be key in the coming months.
Healthcare Dive reports that the US Centres for Medicare & Medicaid Services (CMS) plans to require stricter checks on income and residency before granting subsidies for Affordable Care Act (ACA) health plans. The agency expects the change could see over 300,000 people leave ACA plans each year.
This move could mean lower enrolment and more administrative work for insurers and health plan administrators. Companies may need to adjust forecasts and prepare for more churn as some members lose eligibility. The change may also affect risk pools and pricing strategies for health insurers.
Healthcare Dive reports that US provider groups are pressing the Food and Drug Administration to make technology companies, rather than doctors, accountable for the safety and performance of generative AI-powered medical devices. They argue that developers are best placed to assess these tools.
This move could change how risk and responsibility are assigned in the use of AI in healthcare. It matters for healthcare and pharma leaders, as new liability rules could affect procurement, compliance, and partnerships with technology vendors.
