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Participation in mandatory value-based payment programs is tied to higher annual administrative costs for hospitals, according to a comparative study published in JAMA Health Forum. The analysis reviewed Medicare cost report data for different types of hospitals that did and did not participate in three mandatory programs initiated by the Centers for Medicare and Medicaid Services (CMS) under the Affordable Care Act. From 2008 through 2020, researchers found more than $3 billion in aggregated additional administrative costs across more than 2,800 hospitals that participated in the programs.
It’s becoming less common for employers to contract with one of the Big Three pharmacy benefit managers, according to a new survey from the National Alliance of Healthcare Purchaser Coalitions. The survey of 408 employers found that the share of employers contracting with one of the Big Three dropped from 63.4% in 2025 to 54.3% in 2026. The Big Three include Optum Rx, CVS Caremark and Express Scripts.
‘The meter is running’: Health system CIOs tame AI token costs
Healthcare’s rush into generative AI has created a cost center many organizations only notice after the bill arrives: the token, the basic unit AI platforms use to bill for every prompt sent and every response generated. As adoption scales from pilots to enterprise-wide rollouts, health system leaders say spending can climb quickly, largely because the employees using these tools have no idea a meter is running.
HCA Healthcare's H1 ACA volume dropoffs 'almost one for one' shifted to uninsurance
HCA Healthcare on Friday affirmed its earlier warnings about Affordable Care Act (ACA) exchange subsidies fallout, telling analysts that patients who dropped off marketplace plan coverage due to increased premiums have "migrated almost one for one" to uninsurance. CFO Michael Marks noted the exchanges' one-for-one migration comprises approximately 80% of uninsured volume growth, with the remaining 20% attributed to Medicaid conversion decreases.
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