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News
Pearl Health Lands $110M to Support Value-Based Care for Medicare Patients
2+ mon, 4+ day ago (237+ words) Pearl's $110 million raise includes a $50 million equity investment led by Andreessen Horowitz with participation from Viking Global Investors, AlleyCorp and Ulysses Capital, as well as a $60 million debt facility led by Trinity Capital. Pearl Health, a healthcare technology company helping…...
Debunked Episode 25: Sutter Health’s Allina Health Acquisition Strategy, a Deep Dive on Doctronic
5+ mon, 1+ week ago (216+ words) In the latest episode of the Debunked podcast, MedCity News Editor-in-Chief Arundhati Parmar and Samir Batra, Managing Partner of Health Innovation Pitch, discussed recent M&A deals and how bots can be manipulated. Several March M&A deals caught the…...
What Do Healthcare Leaders Think About CMS’ Proposed Star Ratings Overhaul?
9+ mon, 5+ day ago (431+ words) CMS is proposing major changes to Medicare Advantage Star Ratings, drawing mixed reactions from healthcare leaders. In recent years, there have been numerous lawsuits from Medicare Advantage plans against the Centers for Medicare and Medicaid Services over Star Ratings, including…...
Harbor Health Coverage
11+ mon, 3+ week ago (118+ words) Harbor Health's funding was co-led by General Catalyst, 8VC and Alta Partners. The round also includes participation from Dell Family Office Management, Health 2047 Capital Partners, Lemhi Ventures,... Harbor Health's funding was co-led by General Catalyst, 8VC and Alta Partners. The round also…...
KFF: Insurers Denied 12%-18% of Prior Authorization Requests in 2025
3+ week, 5+ day ago (291+ words) KFF found that insurers denied 12%-18% of standard prior authorization requests in 2025, with significant variation among insurers and gaps in transparency. In 2025, Medicare Advantage insurers denied 12% of standard prior authorization requests, Medicaid managed care insurers denied 14% and ACA Marketplace insurers denied…...
Do Healthcare CEOs Agree on Whether VBC and MA Actually Save Money?
5+ mon, 5+ day ago (657+ words) Healthcare leaders can’t tell whether value-based care and Medicare Advantage are truly lowering costs. Some see promise in these models and ongoing innovations, while others say the programs haven’t delivered measurable savings and point to direct contracting as a more…...
Included Health Launches Alternative Plan Design for Employers
7+ mon, 1+ week ago (425+ words) Included Health is launching an alternative health plan centered on primary care, AI support, price transparency and easier navigation. Included Health, a navigation and virtual care company, is launching into the insurance space with its alternative plan design for employers,…...
CMS: ACOs in Shared Savings Program Saved Medicare $2.4B in 2024
1+ year, 1+ week ago (398+ words) Out of the 476 ACOs that participated in the Medicare Shared Savings Program in 2024, 75% earned $4.1 billion in performance payments, CMS reported. Accountable care organizations (ACOs) in the Medicare Shared Savings Program saved $2.4 billion in 2024, according to data released last week by…...
2026 Star Ratings Shift: 4 Strategies for MA Plans
6+ mon, 2+ week ago (224+ words) Further change in the Star Ratings program is inevitable, but one thing won’t change: plans that make targeted investments in improving the member experience and clinical outcomes, driven by data, are the most likely to succeed and achieve a higher…...
What’s Missing from Your Tool Chest? How Health Plans Can Improve Star Ratings in Medicare Advantage
1+ year, 1+ week ago (266+ words) The pathway for health plans to achieve better Star ratings performance in their MA business depends on creating an ecosystem where providers are supported with the right tools and resources, incentives are properly aligned, and the member experience remains central…...