Latest news with #HealthcareDive
Yahoo
6 days ago
- Business
- Yahoo
Sutter Health names new chief operating officer
This story was originally published on Healthcare Dive. To receive daily news and insights, subscribe to our free daily Healthcare Dive newsletter. Name: Kevin Manemann Previous title: Executive vice president and chief integration officer, City of Hope New title: Chief operating officer, Sutter Health Manemann, an executive with more than two decades of leadership experience in large health systems, will be Sutter Health's next chief operating officer, the Sacramento, California-based system announced Tuesday. He'll be filling a role that's sat vacant since March, when previous COO Mark Sevco left Sutter to become the CEO of Pittsburgh-based Alleghany Health Network. Manemann, who assumes his new role on Sept. 15, was formerly an executive at Southern California-based City of Hope, a $6 billion cancer care system. Prior to that, Manemann held several leadership roles at Providence St. Joseph Health, the third-largest nonprofit health system in the U.S. — including leading a $10 billion division overseeing Northern and Southern California. Manemann was at Providence for more than 16 years, according to his LinkedIn. Manemann's selection as COO is the latest in a string of executive appointments for Sutter. The system named a new chief financial officer in May, a new chief scientific officer and chief nurse officer in January, and a new senior vice president of population health in December. At Sutter, Manemann will work closely with the system's chief physician executive to co-lead clinical and nonclinical operations, according to the release. Manemann's specific purview includes Sutter's operating structure, service lines, ambulatory surgery centers, nursing and home care. One of his priorities will be to support Sutter's ambulatory growth plans, the release said. The system, already a powerhouse in Northern California with more than two dozen hospitals, has been steadily snapping up more of the region's care delivery market, adding roughly 1,000 doctors and advanced practice clinicians in 2024. Sutter also opened or expanded a number of care centers last year, while announcing other capital projects, including an advanced neurological and neurosurgical care complex and a comprehensive cancer center. The system is also pursuing growth through a joint venture with SCAN Health Plan to offer new Medicare Advantage products next year, and a deal with GE Healthcare to integrate artificial intelligence into its operations. Amid these initiatives, Sutter's finances have remained relatively stable compared to some of its nonprofit peers, according to ratings agencies. Still, the system hasn't been immune to pressures hitting hospitals, including rising costs of labor and medical supplies. Sutter reported $142 million in operating income in 2024, down from $320 million the year prior. Though, hefty investment income in both years hiked Sutter's profits to $1 billion and $1.2 billion in 2024 and 2023, respectively. Sutter is also dealing with other operational challenges facing providers, including contract spats with major insurers. Sutter also been hit with multimillion-dollar settlements this year to settle legal actions over alleged anticompetitive behavior, retirement plan mismanagement and fraudulent billing for anesthesia services. Recommended Reading Sutter Health taps new CFO
Yahoo
7 days ago
- Business
- Yahoo
ACA health plan premiums could spike in 2026: report
This story was originally published on Healthcare Dive. To receive daily news and insights, subscribe to our free daily Healthcare Dive newsletter. Dive Brief: Insurers offering Affordable Care Act marketplace plans are proposing the largest premium increases since 2018 amid significant policy uncertainty, according to a preliminary analysis by KFF and the Peterson Center on Healthcare. Across more than 100 marketplace insurers in 20 markets, payers are requesting a median premium increase of 15% for 2026, according to the report published Friday. In comparison, average premiums for marketplace plans have held relatively steady or risen slightly since 2018. Insurers say potential policy changes — like expiring financial assistance for people buying coverage on the exchanges and cost hikes linked to tariffs — are contributing to premium hikes. Dive Insight: Insurers submit rate filings to state regulators each spring and summer to justify their premium changes for the following plan year. Typically, medical costs are the biggest factor behind premium changes — but planning for 2026 also reflects significant policy changes on the horizon, according to KFF and Peterson. The latest analysis, which includes 105 insurers in 19 states and Washington, D.C., found that most payers are requesting premium increases of 10% to 20% for 2026. Additionally, more than one-quarter are proposing premium hikes of 20% or more. That's a divergence from recent years. In 2025, the average benchmark premium was $497, increasing about 4% from $477 the previous year, according to KFF. And so far, no insurers have proposed decreasing their premiums for 2026, while at least some have dropped rates in recent years. Policy uncertainty is changing insurers' premium calculus, according to the report. For example, enhanced premium tax credits — first enacted in 2021 to increase subsidies and eligibility for financial assistance — are set to lapse at the end of 2025, absent intervention from Congress. And if lawmakers don't extend the tax credits, premiums would spike for many ACA enrollees, pushing some to leave the exchanges entirely. Insurers expect those beneficiaries would likely be healthier on average, leaving behind sicker and more expensive enrollees, according to the report. Tariffs could also drive up the cost of drugs, medical equipment and other supplies, increasing costs for insurers. Some payers report the uncertainty surrounding tariff policy is driving rate increases about 3% higher than they would otherwise, according to the report. Some insurers also submitted proposed premiums before President Donald Trump signed a massive tax law with significant healthcare implications in early July. The law is expected to result in nearly 12 million more uninsured people by 2034, due to policies like Medicaid work requirements and other eligibility checks. Additionally, the CMS recently finalized a regulation that would shrink sign-up windows for ACA plans and increase eligibility verification. It's unclear how insurers will respond to these policies, according to the analysis. Finalized rate changes for 2026 are expected to be published in late summer. Recommended Reading Tariffs send healthcare industry into 'unchartered waters'
Yahoo
16-07-2025
- Business
- Yahoo
Judge nixes Biden-era rule removing medical debt from credit reports
This story was originally published on Healthcare Dive. To receive daily news and insights, subscribe to our free daily Healthcare Dive newsletter. Dive Brief: A federal judge has vacated a rule from the Biden administration that would have removed medical debt from credit reports, in a win for the credit reporting industry. Judge Sean Jordan, a Trump appointee, said that the rule exceeded the authority of the Consumer Financial Protection Bureau, an independent agency that's been carved out by cuts under the Trump administration. The CFPB had finalized the rule in January, weeks before former President Joe Biden left office. The Biden administration estimated the regulation, which never went into effect due to legal challenges, would have removed almost $50 billion of medical debt from the credit reports of some 15 million Americans. Dive Insight: Two credit reporting trade associations, the Cornerstone Credit Union and the Consumer Data Industry Association, sued to overturn the CFPB's rule earlier this year. The rule would cut into revenue such groups earn from training providers on how to submit medical debt data to credit reporting agencies. Credit reporting agencies also argued that the rule would make it hard for lenders to get an accurate picture of a consumer's financial status in making loan determinations. The hollowed-out CFPB under Trump declined to defend its regulation in court. Though a group of clinics and individuals with medical debt stepped up as intervening defendants in the litigation, their arguments were unsuccessful in swaying Jordan that the rule should go into effect. According to the judge, the Fair Credit Reporting Act of 1970 allows reporting agencies to include information about consumers' medical debt and lenders to consider such information when making credit decisions. The CFPB overstepped in seeking to prevent that, Jordan wrote in his Friday opinion. The judge's decision to vacate the rule is a stumbling block for those advocating to reduce the burden of medical debt. More than 100 million Americans struggle with medical debt, which is the largest source of debt in collection across the country, the Biden administration said in January. Roughly 1 in 12 adults have unpaid medical bills of $250 or above, according to an analysis from the Peterson Center on Healthcare and KFF last year. The bills can weigh on patients' credit scores, suppressing financial opportunities, patient advocates say. That's despite such bills being prone to errors and often the result of one-time medical emergencies, instead of evidence of long-term financial mismanagement. The rule was part of a larger effort from the Biden administration to crack down on medical debt. A handful of states have also tried to ease the burden of medical debt in recent years, including North Carolina and New Jersey. 'The facts are clear: Medical debt is not predictive of creditworthiness,' said Allison Sesso, the president and CEO of nonprofit Undue Medical Debt, in a statement Monday. 'This decision will hurt people's financial futures, including their ability to buy a home, care for their families, or even get a job — all because they got sick, injured or were born with a chronic condition through no fault of their own. It will also further decrease their willingness to get the care they need,' Sesso added. The pullback of the rule comes amid a larger Trump administration push to roll back the U.S. safety net, including steep Medicaid cuts in the 'One Big Beautiful Bill Act' passed earlier this month. An estimated 12 million people are expected to lose health insurance as a result of the bill. Recommended Reading New rule wipes medical debt from consumer credit reports
Yahoo
16-07-2025
- Health
- Yahoo
Teladoc to launch employee assistance program
This story was originally published on Healthcare Dive. To receive daily news and insights, subscribe to our free daily Healthcare Dive newsletter. Dive Brief: Teladoc Health is launching an employee assistance program as the virtual care giant looks to boost its mental healthcare offerings. The program, called Wellbound, includes online therapy through its direct-to-consumer mental healthcare unit BetterHelp, as well as additional psychiatry and medication management services provided through Teladoc, the telehealth vendor said Tuesday. The EAP will also be able to connect users to Teladoc's other services, like primary care and chronic condition management programs. Dive Insight: EAPs, which provide short-term counseling and services for workers managing mental health or personal problems, are a common benefit offered by mid-sized and large employers. However, EAPs often go underutilized, even though employees say they want a range of mental healthcare benefits. More than 80% of workers who know they have an EAP available to them have never used it, according to a survey published last year by Gallup. Stigma surrounding mental health conditions may prevent some from accessing care, while others may be stymied by a busy schedule or other commitments, experts say. Additionally, many workers aren't aware of their options. One poll published early this year found only about half of employees knew how to access mental health benefits, and more than one-quarter didn't know if their employer offered mental health benefits, an EAP, flexible work arrangements or sick days for mental health concerns. Wellbound, Teladoc's first EAP, wants to help address challenges with the programs that employers and health plans have reported to the telehealth vendor, Matthew Sopcich, SVP of mental health solutions at Teladoc, said in a statement to Healthcare Dive. Employees sometimes face a fragmented benefits experience, and they aren't sure where to go when they run of out allotted therapy sessions or when they have different needs, Teladoc said. To that end, the company's offering include navigation support, as well as access to other resources like legal consultation, financial planning services and referrals for elder or child care. Wellbound is available to health plan sponsors today, and the EAP will be accessible to users in January, according to a press release. Teladoc has embarked on a business strategy to increase its offerings and advance its position in virtual mental healthcare under the leadership of CEO Chuck Divita, who took the helm at the company last summer. The telehealth vendor has inked two acquisitions this year: virtual mental health company UpLift and preventive care firm Catapult Health. Last month, executives said M&A would play a key role in Teladoc's strategy as it expands its services. Additionally, Teladoc launched a cardiometabolic health program in April and added partnerships with other digital health companies like Carrot Fertility and digestive health firm Oshi Health. Recommended Reading M&A to play 'important role' at Teladoc: CEO Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
Yahoo
11-07-2025
- Business
- Yahoo
UnitedHealth names new chief of government programs, Medicaid unit
This story was originally published on Healthcare Dive. To receive daily news and insights, subscribe to our free daily Healthcare Dive newsletter. UnitedHealth has tapped longtime insurance executive Mike Cotton to lead its Medicaid business, filling a role that has stood empty since the company reshuffled its executive team earlier this year, the company confirmed to Healthcare Dive. Meanwhile, Bobby Hunter, who leads the healthcare juggernaut's Medicare division, is stepping up as CEO of government programs, with oversight of both Medicare and Medicaid. The changes follow board chair Stephen Hemsley returning as the company's CEO this spring after UnitedHealth pulled its financial outlook, citing an unexpected step-up in medical spending. The move sent UnitedHealth's shares plummeting. The executive appointments are the latest leadership changes at the beleaguered healthcare behemoth, which operates the largest private insurer in the U.S., a major pharmacy benefits manager, an extensive physician network and other businesses. But UnitedHealth's value has plummeted this year as the company struggles to adjust to an unforeseen increase in medical spending. Higher utilization in Medicare Advantage plans has been spreading to more complex patients, like people dually eligible for Medicare and Medicaid, and popping up in traditionally healthier populations as well, like people enrolled in Affordable Care Act plans. Pressure in government programs is also hitting Centene and Molina, two payers with a heavy presence in Medicaid and the ACA that pulled and cut their 2025 guidances, respectively, this month. But UnitedHealth is also facing intense regulatory scrutiny. According to reports, the Minnesota-based payer faces a criminal investigation by the Department of Justice, with the Wall Street Journal reporting on Wednesday that prosecutors are questioning former UnitedHealth employees over the company's billing practices. The pressures have led multiple investment banks to downgrade UnitedHealth's stock, which has lost more than 40% of its value year-to-date. UnitedHealth plans to report second quarter earnings on July 29. Recommended Reading UnitedHealth downgraded by investment banks Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
