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I have multiple people across my teams that if are not renewed or converted will bring us to a screaming halt at Healthspring. They were hired on a contract-to-hire basis and I have only had 1 have it fully converted as promised.
As a manager I am not in the financial meetings but to those that are, does anyone know?
Agilent Technologies will acquire Proscia for $240 million in cash. An additional $30 million may be paid based on future performance. Proscia provides digital pathology software and AI tools. This acquisition will enhance Agilent's position in the digital pathology market. The deal is anticipated to finalize in early fiscal year 2027.
Santa Clara, California
https://www.modernhealthcare.com/mergers-acquisitions/mh-healthcare-deals-live-updates/
Endeavor Health and Rush University System for Health are planning a significant merger. This combination will create the largest health system in the Chicago area by hospital count. The new entity will operate under the Rush name and encompass twelve hospitals and over 400 care sites. Leaders anticipate job growth and expanded community health programs. Regulatory approval is pending for the anticipated early 2027 closure.
https://www.lakemchenryscanner.com/2026/10/14/endeavor-health-and-rush-plan-merger-that-would-create-the-chicago-areas-largest-health-system-by-hospital-count/
Any news on upcoming health insurance rate hikes ?
Several healthcare organizations have recently announced significant workforce reductions. Montrose Regional Health is restructuring and eliminating 77 positions, while City of Hope is laying off 73 employees. Kaiser Permanente is also cutting 147 business and administrative roles. These widespread cuts reflect ongoing financial pressures and strategic realignments within the healthcare sector. Many organizations are emphasizing that these layoffs do not directly impact patient care.
https://www.fiercehealthcare.com/finance/fierce-healthcare-layoff-tracker-2026-job-cuts-eliminations-health-systems-hospitals
Montrose, Colorado
Brookdale Community College's Board of Trustees has approved a plan to eliminate 61 positions. This decision is primarily driven by a projected $8 million deficit in the fiscal year 2028 budget. A significant factor contributing to this deficit is an anticipated $6.6 million increase in healthcare costs. The college aims to reduce salary and benefit expenses by $7.36 million through these workforce reductions. These layoffs are scheduled to occur in two rounds, with the first effective December 31, 2026, and the second on June 30, 2027.
Middletown, New Jersey
https://tworivertimes.com/citing-increased-healthcare-costs-brookdale-approves-staff-layoffs/
There's always the chance of unforeseen obstacles, and temporary enthusiasm especially in managed care, where enthusiasm can blind investors to operational lag and policy risk.
Market reactions usually pull forward years of future expectations in a matter of days. A pull-back on Friday down to around $413 shows the initial euphoric momentum digest as the market separates long-term structural improvement from near-term execution realities.
The Three "Obstacle Zones" Humana Still Has to Navigate
--The Reality: The 2027 Star Ratings rebound (jumping to 95% of members in 4+ star plans) is a legitimate regulatory win. However, CMS quality bonus payments do not hit Humana’s P&L until 2028.
--The Risk: Humana must bridge late 2026 and all of 2027 on current baseline margins. If medical cost utilization spikes over the next 12 to 18 months, earnings could still face headwinds before the bonus money arrives.
--The Reality: Across the senior healthcare industry, outpatient surgeries, hip/knee replacements, and expensive dr-g therapies (like GLP-1s) continue to push medical claims higher.
--The Risk: A high MLR directly eats into operational earnings. Reclaiming Star status gives Humana a massive financial safety net for 2028, but it does not magically lower the cost of caring for members in 2026.
--The Reality: After pushing above $430+ (and touching $456.50), HUM’s trailing price-to-earnings (P/E) ratio expanded well beyond its 5-year historical average (~21.5x) toward ~39x.
--The Risk: When a stock trades at a premium valuation based on future earnings expectations, it leaves zero room for operational error. Any minor earnings miss or conservative guidance update in upcoming Q3/Q4 reports can trigger quick 5%–10% profit-taking pullbacks.
How to Frame the Current Setup
While the fundamental floor of the company has undoubtedly been raised (thanks to de-risking the balance sheet via BlackRock and securing future quality bonuses):
--Short-Term (Next 3–6 Months): Expect volatility and digestion. The initial pop was "temporary enthusiasm" pricing in the news. The stock will likely chop between value-support levels ($380–$400) and resistance ($435–$450) as traders weigh high valuation against near-term medical costs.
--Long-Term (2–4 Year Horizon): The core thesis is durable. The Star Ratings recovery prevents a multi-billion dollar revenue cliff in 2028, which is why institutional price targets are sitting much higher ($475 to $590+).
The news fixed the existential tail-risk, but it didn't eliminate the day-to-day work of managing healthcare costs.
Do not be alarmed but according to the news, BlackRock has simultaneously taken over 150 CenterWell Health Clinics in a single day. No reported casualties as of yet. I am sure we will get more from the news media as more details come to light.
UVM Health and Dartmouth Health are implementing significant layoffs affecting more than 300 employees. These workforce reductions are a direct consequence of ongoing budget cuts within both healthcare systems. The organizations have not yet provided specific details regarding the roles or departments impacted by these decisions. This news highlights financial pressures currently facing healthcare providers. Further information on the exact nature of the cuts is anticipated.
https://www.mychamplainvalley.com/video/dartmouth-health-uvm-health-announce-layoffs/12172780/
For health insurance corporations looking for a turnkey product to calculate health provider settlements, the selection depends on whether you are analyzing fee-for-service (FFS) reimbursement contracts, processing complex bulk provider payments, or needing a data extraction layer for your core adjudication system.
The industry's leading turnkey software options specialized for health plan/payer settlement calculations include:
https://finimize.com/content/humana-brings-blackrock-in-to-run-150-centerwell-clinics
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BlackRock’s HPS Investment Partners is buying Welsh Carson’s stake for $2.8 billion, with CenterWell keeping day-to-day operations and a 2028 option to buy clinics.
What's going on here?
Humana is bringing BlackRock’s HPS Investment Partners into a new joint venture that will own and operate nearly 150 CenterWell Senior Primary Care clinics.
What does this mean?
The health insurer said the new setup replaces its current clinic ventures with Welsh, Carson, Anderson & Stowe, a private equity firm, with HPS buying that stake for $2.8 billion. Even with HPS as majority owner, CenterWell will keep a minority stake and continue running the clinics day to day, while the partners add capital over the next two years to support existing sites, open new locations, and pursue acquisitions.
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Moving to government run Medicare for All would completely eliminate the private health insurance industry. It would wipe out hundreds of BILLIONS in market value, cut approximately 2 MILLION jobs and devastate the commercial real estate market.
Corporate slogan update. America is aware of your racket.
What will happen to Quantum Laureates once it becomes a commodity. How will they be absorbed in margin pressured healthcare sector. It will be fun to watch all these Harvard/MIT inventors getting canned.
After 30 years with ExxonMobil, deciding where to spend your retirement is a major milestone. While the allure of moving to a coastal town or mountain retreat is strong, staying right here in Houston makes the most logical, financial, and—most importantly—medical sense.
When you retire, your healthcare needs change from preventative wellness to managing longevity. No city in the world is better equipped to handle that transition than Houston, especially given your unique advantages as an ExxonMobil retiree.
The Ultimate Healthcare Anchor: The Texas Medical Center
The strongest argument for staying in Houston is having the Texas Medical Center (TMC) in your backyard. It is the largest medical complex in the world.
• Global Leaders in Care: TMC is home to world-renowned institutions like Houston Methodist (consistently ranked the No. 1 hospital in Texas) and the St. Luke’s Health - Baylor St. Luke's Medical Center.
• The ExxonMobil–MD Anderson Advantage: As an ExxonMobil retiree, you have a massive structural healthcare advantage. The company partnered with MD Anderson Cancer Center—consistently ranked the number one cancer hospital in the nation—to offer a dedicated, exclusive phone line and email service specifically for ExxonMobil retirees. If you or an eligible family member ever face a complex diagnosis, this partnership gives you direct, streamlined access to the world's best oncologists without the typical bureaucratic hurdles. Moving away means leaving this seamless safety net behind.
• Proximity in Critical Moments: In retirement, time-to-care matters. Living in Houston means you are never more than a short drive from top-tier specialists, clinical trials, and emergency cardiac or neurological care.
Financial Harmony: Protecting Your Exxon Retirement Wealth
Moving to another state often disrupts a carefully planned financial ecosystem. Staying in Texas maximizes the value of your hard-earned ExxonMobil pension and savings.
• No State Income Tax: Texas does not tax personal income. This means your ExxonMobil pension payouts, 401(k) distributions, and Social Security income are entirely free from state taxation, allowing you to keep significantly more of your wealth compared to retiring in states like California or New York.
• Seamless Insurance Coverage: Staying local ensures you face zero disruptions with your ExxonMobil Retiree Medical Plan networks. You won't have to worry about finding new out-of-state doctors who accept your coverage or dealing with out-of-network penalties during a health crisis.
Community and Continuity
After three decades with the same company, your roots run deep.
• The Exxon Mobil Network: The Houston area (especially around the Spring campus and greater Montgomery/Harris counties) has the highest concentration of ExxonMobil retirees in the world. Staying means maintaining your built-in social network of former colleagues, friends, and shared community groups.
• Familiarity Breeds Comfort: Navigating aging is easier in a city you already know inside and out. You know the neighborhoods, the infrastructure, and the culture, which minimizes the psychological stress of "starting over" in a new place.
Remaining in Houston isn't just about staying put; it's a strategic decision to anchor your retirement years next to the best medical care on earth while legally protecting your retirement income.
I wasn’t planning on posting twice today, but some new numbers crossed the NoCenteam desk, and they definitely need to be discussed.
Bear with me, because I’m diving right in. We’ve already explored a few pieces of this story separately. The new information is what starts tying them together. And when you put the pieces next to each other, the picture isn’t pretty.
Centene recently reaffirmed adjusted EPS guidance above $4.80.[1] Great, that means Wall Street can unclench.
Now let's look at the other report card. CMS just released its 2027 Medicare Advantage Star Ratings, and seven Wellcare contracts landed at just 2.5 stars, covering more than 64,000 members across seven states.[2][3]
Oppenheimer says Centene's average ratings fell 9% year over year.[4] Meanwhile, Humana says approximately 95% of its Medicare Advantage members are now in plans rated four stars or higher, up from just 20% for 2026.[5] Same CMS. Same rating year. So spare us the excuses about the environment being difficult.
Centene paid $17.3 BILLION for WellCare.[6] Now it's cutting roughly a third of its MA plans, bailing out of hundreds of counties, reorganizing the company, eliminating employees, shipping work to vendors, and betting harder on dual-eligible members.[7]
And somehow we're supposed to applaud because EPS is holding up? That's the fu--ing point. The financial numbers can look better because you cut things. Let’s discuss what was cut:
People.
Markets.
Products.
Overhead.
Internal expertise.
Quality doesn't work that way. You don't lay off your way to better care coordination. You don't outsource your way to institutional knowledge. And you sure as he-l don't get four stars because somebody found another few hundred million dollars of "efficiency."
These ratings also aren't some meaningless Consumer Reports sticker. They affect 2028 Medicare Advantage quality bonus payments.[2]
Four stars matters.
2.5 stars matters too. Just not in the way SLT would like.
And remember what Centene keeps selling investors: get Medicare Advantage back toward break-even in 2027 while focusing more heavily on D-SNPs.[7]
In other words, take on more members with complex needs while simultaneously squeezing the operation hard enough to repair the economics.
What could possibly go wrong?
Industry-leading health outcomes with an industry-leading cost structure.
How about we nail the health outcomes part before taking a victory lap on the cost structure?
Centene reports earnings October 27.[8]
Wall Street will undoubtedly ask about EPS, margins, Medicaid rates, and the MA turnaround.
Here's a free question:
If the Medicare Advantage turnaround is actually working, why did the newest quality report card get worse?
You can cut your way to an EPS target. You can’t cut your way to four stars.
Sources
[1] Centene SEC filing, Sept. 16, 2026 — 2026 adjusted EPS guidance reaffirmed above $4.80:
https://www.sec.gov/Archives/edgar/data/1071739/000107173926000172/cnc-20260916.htm
[2] CMS, 2027 Medicare Advantage and Part D Star Ratings, Oct. 8, 2026:
https://www.cms.gov/newsroom/fact-sheets/2027-medicare-advantage-part-d-star-ratings
[3] Becker's Payer Issues, Medicare Advantage contracts rated 2.5 stars or lower, Oct. 9, 2026:
https://www.beckerspayer.com/payer/medicare-advantage/medicare-advantage-plans-with-2-5-stars-or-lower-in-2027/
[4] Reuters, Oct. 8, 2026 — Oppenheimer analysis of 2027 Star Ratings, including Centene's year-over-year decline:
https://www.reuters.com/business/healthcare-pharmaceuticals/cms-says-71-medicare-advantage-prescription-dr-g-enrollees-4-star-or-higher-2026-10-08/
[5] Reuters, Oct. 9, 2026 — Humana reports approximately 95% of MA membership in four-star-or-better plans for 2027 versus 20% for 2026:
https://www.reuters.com/legal/litigation/humana-surges-after-emerging-top-beneficiary-2027-medicare-star-ratings-2026-10-09/
[6] Centene, WellCare acquisition announcement — transaction valued at approximately $17.3 billion:
https://investors.centene.com/2020-01-23-Centene-Completes-Acquisition-of-WellCare
[7] Centene/Wellcare, 2027 Medicare Advantage offerings, Oct. 1, 2026:
https://investors.centene.com/2026-10-01-Wellcare-Unveils-2027-Medicare-Offerings-Focused-on-Affordability-and-Integrated-Care
[8] Centene Investor Relations — Q3 2026 earnings scheduled for Oct. 27:
https://investors.centene.com/
Texas AG announces second investigation into UnitedHealth Group over delayed, denied care.
Insurers say AI could add billions in health costs. Billing companies disagree
https://www.healthcaredive.com/news/insurers-say-ai-could-add-billions-in-health-costs-billing-companies-disag/831497/
Hospital trade group pushes back on report linking ai to $942m in added health costs
LinkedIn · Prachi Sahoo60+ reactions · 1 week agoThe $942 Million Question: Did AI Make Hospital Billing More Honest, or Just ...
Several health systems are implementing workforce reductions to address financial challenges and improve efficiency. Brown University Health has eliminated leadership positions and offered buyouts. City of Hope is laying off employees primarily in support roles. Kaiser Permanente is cutting administrative staff, while Catholic Health is eliminating positions across clinical and non-clinical areas. PeaceHealth is also reducing its workforce, particularly in its IT division.
http://www.modernhealthcare.com/providers/staffing/mh-layoffs-closures-healthcare-live-updates/
Another round of layoffs feared in 2027....and now Sharp no longer accepts Medicare Advantage plans??
Quality clinical staff have left SMV (lay-offs, quitting). More unit consolidation, elimination of programs.
So this is optimizing healthcare!!?? :-(
Yet the Sharp Experience event still happened....something is really wrong here.
Health insurers rarely announce layoffs by citing specific software. Instead, they frame software implementation around "auto-adjudication" and operational efficiency.The Goal of Software: Platforms like TriZetto are designed to increase a health plan's auto-adjudication rate—meaning claims are processed, edited, and paid entirely by the system without a human ever looking at them. The Impact on Roles: Cognizant has documented case studies where its automated workflows and robotic process automation (RPA) reduced manual data processing workloads by 50%
Reposted from @b5+1m1h3embr, 100 percent on point.
Washington state employees have ratified a new contract for the 2027-29 biennium. This agreement secures healthcare funding and workplace protections. General wage increases are deferred to the second year of the contract through a reopener clause. The contract also includes new provisions regarding generative artificial intelligence. Additional personal leave days and expanded bereavement leave are also part of the deal.
Olympia, Washington
https://lynnwoodtimes.com/2026/10/04/wfse-contract/
A nurses' union has filed a lawsuit against Kaiser Colorado, alleging the company replaced local workers with remote staff from out of state. The United Food and Commercial Workers International Union Local 7 is seeking to halt layoffs while negotiations continue. Kaiser Colorado claims the move to hire nurses in Georgia is to improve efficiency and manage rising healthcare costs. The union argues this violates their collective bargaining agreement and harms patient care. Kaiser Colorado maintains it followed proper procedures and offers affected employees other positions.
Denver, Colorado
https://kdvr.com/news/local/nurses-union-sues-to-stop-layoffs-at-kaiser-colorado/amp/
https://www.cascadiadaily.com/2026/sep/30/optum-closing-anacortes-clinic-in-december/
Therefore, it is critical that we find a way to breakdown the Monopolistic Predatory Abuse of the 5 Major Private Health Insurance Corporations (e.g., Humana, United, Elevance/Anthem, Cigna, Centene) that use Government Funded (Tax Payer) Dollars to continuously delay and deny legitimate lifesaving healthcare to the elderly, disabled, and indigent on Medicare Advantage plans.
The CMS released draft star ratings, including the thresholds for reaching those ratings, to plans earlier this week. The grading sheet got stricter, which doesn’t bode well for insurers.
Entire Article Regarding the above Teaser
https://www.healthcaredive.com/news/medicare-advantage-stars-cutpoints-2027-cms/829963/
CMS Facts Sheet for 2027
https://www.cms.gov/files/document/2027-medicare-advantage-part-d-landscape-state-state-fact-sheets.pdf
So, I guess CareFirst thinks they are going to further price-gouge their members to try and fix their upper management/CEO financial incompetencies/mistakes. Just got my medical policy renewal on the exchange for 2027, and it increased by 18%. They are just going to lose more members with this asinine move -- including this member. I will NOT be renewing. Good luck, CareFirst. You best start asking somebody for your bailout now. You're not coming back from this one.
760,000 Marketplace Members Federally Impacted
Centene employees may appreciate the irony. After years of Centene “impacting” employees in the name of efficiency, CMS has apparently adopted the operating model.
On August 31, the government impacted about 315,000 Marketplace policies covering 760,000+ people, with roughly $2.2 billion in subsidies expected to be clawed back.
Here’s the fun part: insurers apparently couldn’t find claims for these members or even establish contact with them.
That matters for Centene, the country’s largest Marketplace carrier. Remove people generating subsidized premiums but little or no medical expense, and that certainly makes the economics get interesting.
Sarah London says the expected impact is already baked into guidance. So Q3 should be fun.
The government isn’t downsizing Centene’s Marketplace business. Centene is simply experiencing an involuntary federal optimization event. 😂
SOURCES:
CMS Federal Marketplace Anti-Fraud Actions
https://www.cms.gov/newsroom/fact-sheets/federal-marketplace-ffe-sbe-fp-anti-fraud-actions
Federal Register Marketplace Program Integrity / Unauthorized Enrollments
https://www.govinfo.gov/content/pkg/FR-2026-09-23/html/2026-19493.htm
Heard there are talks for Q1 ent pub will take k-12, hi-ed healthcare, and slg and combine them into just pub. Any confirmation here?
If health insurance truly cared about “preventative maintenance” like they say, then they would be all for two things, GLP-1s and annual full body MRIs.
If they approved and paid for those two things alone, the percentage of persons reaching in their 90’s or even over 100, would exponentially increase.
But they won’t because “sick” people are more profitable.
The benefits were the reason people have stayed and powered through fidelity. Now with united healthcare and delta dental… this is the real attrition strategy. Both companies su-k so bad and my doctors and billing hate UHC. They have monologued me more than once for having sh---y insurance
Several healthcare organizations have recently announced significant workforce reductions. PeaceHealth is cutting 150 positions, while Elevance Health is eliminating 216 roles in Louisiana. Catholic Health is also reducing its workforce by 40 positions and realigning 34 others. These widespread layoffs reflect ongoing financial pressures and strategic realignments within the healthcare industry. Affected employees are often offered transition support and opportunities for redeployment.
https://www.fiercehealthcare.com/finance/fierce-healthcare-layoff-tracker-2026-job-cuts-eliminations-health-systems-hospitals
Hamilton Health Sciences announced significant layoffs impacting 413 positions, including 143 nursing roles. This decision aims to address a projected $150-million budget deficit for the 2026-2027 fiscal year. Union representatives and patients have expressed strong concerns about the potential negative effects on patient care. They argue that existing staff are already overburdened, and further reductions will exacerbate the strain on the healthcare system. The organization stated that one-third of the affected jobs are currently vacant and that their priority is to maintain access to high-quality care.
Hamilton, Ontario
https://www.chch.com/chch-news/patient-care-at-risk-as-more-layoffs-announced-for-hamilton-hospitals/
https://247wallst.com/personal-finance/2026/09/21/humana-is-dropping-plans-covering-600000-members-and-hopes-240000-choose-humana-again-the-replacement-is-not-the-same-plan/
Well
Beyond
Ridiculous
And getting worse by the year.
Beacon Health System is implementing job cuts at Elkhart General Hospital due to significant financial pressures. The organization cited rising healthcare costs outpacing insurance reimbursements as a primary driver for these difficult decisions. These changes are focused on administrative and operational areas to ensure the system's long-term sustainability. Beacon is committed to supporting affected employees and exploring internal opportunities where possible. The health system aims to maintain its mission of providing outstanding care to the communities it serves.
Elkhart, Indiana
https://wsbt.com/news/local/beacon-health-system-cites-financial-pressure-for-layoffs-at-elkhart-general-hospital-budget-job-cuts-social-media-out-job-care-costs-reimbursement-statement-indian
Trinity Health has announced the layoff of 557 employees, directly attributing the decision to federal cuts in Medicare and Medicaid. These cuts stem from the One Big Beautiful Bill Act, which significantly reduces Medicaid funding over the next decade. This legislation places millions at risk of losing health coverage and increases uncompensated care costs for providers. In Michigan, 23 healthcare providers are already facing service cuts or closure due to these changes. The article criticizes Senator Mike Rogers for supporting the bill despite its projected impact on Michigan residents.
Livonia, Michigan
https://michiganadvance.com/2026/09/23/trinity-health-layoffs-expose-the-danger-of-the-one-big-beautiful-bill-act/
So I just wanted to give an update on this after my surgery
While lantern says they require bariatric surgery on the insurance card, UCH ended up covering my OP 100% so I ended up not having to wait.
Whats sc--wy is if you call lantern, they'll say some backwards stuff going back on the "bariatric surgery required" thing.
I hope Dell removes lantern from offerings in the future, that deceptive statement can really backfire at some point in my opinion and delay care. I have once been harassed over my BMI. UCH PPO is fine, I reached my pocket maximum earlier this month. I just wanted to update anyone out there that was curious on it. If you need help just go through UCH, its not that bad.