Memorial Hermann goes out of network with BCBS Texas

Elizabeth Casolo / beckershospitalreview - Houston-based Memorial Hermann Health System’s contract with BCBS Texas expired April 1, rendering the health system out of network. Commercial and ACA exchange (both individual and family) plan members lost access at the end of March. Memorial Hermann ha…

AI Summary: Memorial Hermann and Blue Cross Blue Shield of Texas failed to agree on a new contract, resulting in the health system going out of network for affected plan members. Patients face potential higher costs and care disruptions while negotiators jockey publicly; both sides warn of financial stakes and urge members to stay informed.

Why 131 Hospitals Are Suing HHS Over Alleged Underpayment

Katie Adams / medcitynews - A group of 131 hospitals has sued HHS over a CMS policy they say improperly reduces Medicare disproportionate share hospital (DSH) payments. The lawsuit is the latest in a decade-long legal battle over how the agency counts patient days and calculates pay…

AI Summary: One hundred thirty‑one hospitals have filed suit challenging HHS’s 2023 Disproportionate Share Hospital calculation, arguing the agency’s formula undercounts uncompensated care and systematically underpays safety‑net providers. The plaintiffs seek to overturn the rule and recover alleged shortfalls, warning that ongoing underpayment threatens hospital finances and patient access.

CMS finalizes Medicare Advantage star ratings overhaul, sending billions of dollars more to insurers

Rebecca Pifer Parduhn / healthcaredive - Regulators cut almost a dozen metrics that factor into the quality ratings and reverted back to an older and more generous bonus system. MA plans will get more than $18 billion in additional payments over the next decade as a result.

AI Summary: The Centers for Medicare & Medicaid Services locked in a sweeping overhaul of Medicare Advantage star ratings that will shift billions of dollars in payments and alter plan incentives. The ruling adjusts rating calculations and enrollment provisions, prompting industry and provider concerns about downstream effects on access, plan behavior, and provider-network stability.

When it comes to surgery, your doctor's leadership skills play a crucial role

medicalxpress - You're scheduled for surgery next week. You've likely looked up your surgeon's credentials, years of experience, and perhaps even patient reviews. You want reassurance that your surgeon has steady hands, deep expertise, and a thorough command of the proce…

AI Summary: New research links a surgeon’s leadership and team‑management skills to measurable differences in operating‑room performance and patient outcomes. Hospitals are being nudged to treat leadership training as clinical skill development rather than optional soft training — because apparently who’s in charge matters when someone’s insides are on the line.

Continuous wearable monitoring reduces time with low oxygen after surgery, study finds

medicalxpress - Patients continuously monitored after surgery experienced significantly less time with dangerously low oxygen levels compared to those monitored using routine spot checks, a new study from Wake Forest University School of Medicine found.

AI Summary: An HCA Florida hospital has named a new chief financial officer as part of a leadership shakeup aimed at stabilizing operations and tightening financial oversight. The appointment signals management’s focus on fiscal discipline and strategic planning amid ongoing industry pressures—because nothing says “confidence” like swapping out the person who signs the checks.

Justice Department sues NewYork-Presbyterian in second hospital antitrust case this year

Sydney Halleman / healthcaredive - Federal regulators accused the health system of using its market power to force insurers into “all-or-nothing” contracts. The Justice Department filed a similar lawsuit against OhioHealth last month.

AI Summary: The Justice Department filed suit alleging NewYork‑Presbyterian engaged in unfair contracting and anticompetitive practices that harmed hospitals, physicians, and patients by restricting competition and raising prices. The complaint signals intensified federal scrutiny of hospital consolidation and contractual arrangements that may lock out rivals and drive up healthcare costs.

CommonSpirit, Humana reach new nationwide Medicare Advantage contract

Rebecca Pifer Parduhn / healthcaredive - The new agreement will give Humana’s MA members access to CommonSpirit’s doctors and facilities for the next three years, and returns CommonSpirit to Humana’s networks in Colorado and Texas.

AI Summary: CommonSpirit Health and Humana reached a multi-year Medicare Advantage network agreement expanding MA access across multiple states. The deal secures provider participation, stabilizes reimbursement pathways and affects beneficiary enrollment options, aiming to align hospital networks with Humana’s MA plans while smoothing care coordination and payment arrangements.

Verily raises $300M, sheds Alphabet’s majority control

Shelby Livingston / endpoints - Verily has raised $300 million in new, outside funding that ends parent company Alphabet's controlling position in the healthcare innovation company, Endpoints News has learned exclusively. The funding round was led by Series X Capital ...

AI Summary: Verily secured a $300 million financing round that reduces Alphabet’s majority control, bringing new strategic investors on board including health system partners. The cash infusion aims to accelerate Verily’s healthcare technology and platform ambitions — because nothing says “healthcare disruption” like another well‑funded pivot.

Turquoise Health Snags $40M to Simplify Healthcare Contracts & Payments

Katie Adams / medcitynews - Turquoise Health raised $40 million in a Series C round to expand beyond price transparency into managing healthcare contracts. The startup’s platform aims to simplify payer–provider agreements, reduce administrative waste and enable patients to see guara…

AI Summary: Turquoise Health closed a $40 million funding round to accelerate its platform that standardizes healthcare contracts and payments, aiming to increase price transparency and streamline payer–provider interactions. The cash infusion will support product growth, sales expansion and the company's push to make messy contract data slightly less catastrophic for hospital finance teams.

Rob Winn Appointed Director of NCI-Designated Fox Chase Cancer Center

oncodaily - Fox Chase Cancer Center shared a post on LinkedIn: “Temple Health – Temple University Health System today announced the appointment of Dr. Rob Winn, MD, as the next Cancer Center […]

AI Summary: Rob Winn has been appointed director of the NCI‑designated Fox Chase Cancer Center, taking the reins of clinical, research and strategic operations. His role will focus on strengthening translational research, patient care integration and institutional partnerships to advance the center's mission — you know, the usual: cure more cancer, argue less in committee meetings.

Why Providence Wants to Sell Its Health Plan

Katie Adams / medcitynews - Providence announced its intent to sell its health plan, exiting the “payvider” model as rising costs and operational complexity weigh on smaller regional insurers. The move reflects a broader trend of health systems refocusing on core care delivery and e…

AI Summary: Providence Healthcare is actively weighing the sale of its health insurance arm as mounting fiscal pressures force leaders to consider dramatic options. The move would reshape the system’s payer-provider footprint, potentially easing balance‑sheet strain while unnerving patients, employers and regulators who’ll suddenly have a stake in the decision.

New EPA rule could loosen limits on medical device sterilization gas emissions

medicalxpress - The U.S. Environmental Protection Agency (EPA) is proposing to loosen limits on emissions of ethylene oxide, a gas used to sterilize many medical devices that is also linked to cancer.

AI Summary: The Environmental Protection Agency proposed easing limits on ethylene oxide — the gas hospitals use to sterilize medical devices — arguing the change protects the medical supply chain. Public‑health experts and community advocates warn long‑term exposure raises cancer risks and say rolling back 2024 safeguards could shift the burden onto nearby residents.

Officials examine deaths after plasma donations in Winnipeg

medicalxpress - Canadian health officials are investigating the deaths of two people who donated plasma at private clinics in Winnipeg, Manitoba.

AI Summary: Health officials are investigating the deaths of two people who recently donated plasma at for‑profit clinics in Winnipeg, prompting scrutiny of donation frequency, screening practices and clinic oversight. Regulators are reviewing protocols and collecting evidence as public health teams work to determine whether systemic safety failures or procedural lapses contributed to the fatalities.

Vanderbilt Health president, CEO to retire

Paige Twenter / beckershospitalreview - Jeff Balser, MD, PhD, president and CEO of Vanderbilt Health and dean of Vanderbilt University’s school of medicine, plans to retire from both roles Dec. 31, according to a March 12 news release from the Nashville, Tenn.-based organizations. During his 17…

AI Summary: Jeff Balser, president and CEO of Vanderbilt Health (and dean of Vanderbilt University School of Medicine), will retire at the end of the year, prompting the health system’s board to launch a national search for his successor. Leaders emphasize a careful transition to preserve academic‑clinical stability while navigating complex operational challenges.