#healthcare

Centene's FL Medicaid contract taken up by Molina.

Another pilot - moving SNP associates to HUMCS to address social determinants of health. SNP audit was predicted this year so there has been all this pressure to address GIC’s and review to IHWA and MOP. Now we need to move to HUMCS pilot and cold call members to address social determinant of health needs. How do you help with housing, food, medical equipment, transportation and other needs so that members can go to the doctor and get needed care. Agencies don’t have $$$ to help with food scarcity. There is no low income housing available - Not accepting applications or waitlists. No transportation in rural areas or members cannot afford. Members having to choose between food or meds or housing. Utilities turned off because of reduction in LIHEAP assistance. The democrats gave up. Republicans have cut off financial support for social programs. Without the financial assistance programs, people cannot meet their very basic needs. It shouldn’t be this hard to ensure that people have housing, safety, healthcare, food, etc. Many members have income of $1000 or less per month. Could you live on that? This is not about politics - it’s about people helping people, kindness, and basic humanity. Vote, donate, find little ways to advocate for others, speech up, educate others. Let’s do this together. Let’s believe in and support each other. Let’s lead with love and not hate.

I know this will be downvoted but I figured I’d post it because it may help someone.

Industries less susceptible to layoffs include healthcare, education, government, and essential services like food, utilities, and discount retail, as people need these services regardless of the economic climate. Other sectors like skilled trades and finance also tend to be more stable.

Healthcare
People need medical care during emergencies, chronic illnesses, and for regular check-ups, making it an essential service.
This includes a wide range of roles from doctors and nurses to administrative and support staff.

Education
Educational institutions, from K-12 to universities, are fundamental parts of society and need to be staffed.

Government
Federal government jobs and public safety roles like law enforcement are often more stable, as these services are always needed.

Essential Services
Food and Beverage: Consumers still need to buy food, and companies in this sector tend to perform well during downturns.

Utilities: Electricity, water, and gas are necessary services that people continue to use regardless of economic conditions.

Discount Retail: Consumers often switch to lower-cost stores during an economic slowdown.

Other Stable Industries
Skilled Trades: Essential trades like plumbing and electrical work are often in high demand because they address fundamental needs.

Finance: Roles in accounting, financial advising, and insurance are needed for tax compliance and financial risk management, even in a weak economy.

I've recently noticed several people who were Auditors/Education are now back to working as regular medical coders. Seems like a demotion to me, what happened?

Severed employee here who is nearing the end of my benefits. Considering COBRA for next year, amongst other ACA options, but wondering if anyone has any ideas on 2026 COBRA rates. I called the 'hotline' this week and they still do not have any ideas on rates stating 'call back mid December'. This is getting a bit too '11th hour' for my liking as I'd like to have some time to review options if need be prior to end of year when my WF benefits run out. Wondering if anyone else is in the same predicament and if anyone has any ideas on expected % increase of COBRA benefits compared to 2025 COBRA amounts.

"why are we sending billions in subsidies to insurance companies when we could just give the money directly to Americans to choose their own healthcare"

Won’t people just pocket the money and go uninsured raising the cost for everyone else?

https://www.theguardian.com/us-news/2025/nov/08/senate-republicans-trum

"why are we sending billions in subsidies to insurance companies when we could just give the money directly to Americans to choose their own healthcare"

https://www.theguardian.com/us-news/2025/nov/08/senate-republicans-trump-obamacare

CIGNA stock price in 2010 was around $32 per share. It skyrocketed to near $300 as of November 2025. Amazing what guaranteed taxpayer support can do for your stock price.

What happens when ACA goes away? Free market capitalism!

Healthcare Insurance premiums for 2026.

ACA (Affordable Care Act) Medicaid.

Medicare for (most normal civilian) retirees over 65.

No one knows.

The plight of their future health.

The ACA (Affordable Care Act) Medicaid is (not) free for the Majority that are (actually) enrolled in it..

For many, their ACA Medicaid healthcare premiums will double; starting in 2026.

Many ACA Medicaid participants have Very Serious illnesses like cancer with Very High healthcare, and associated prescription costs.

For (most normal civilian) retirees, once they reach 65; the standard Medicare Part B premium for 2026 will (Increase) to $206.50 per month.

In fact, Medicare premiums for (most normal civilian) retirees Increases every year.

2026 Medicare premiums -

None of this is free (except for Part A much-reduced benefits).

Part A - Payers - $310.00 a month (30-39 work credits) and $563.00 a month (<30 work credits).

Some do the free but with much-reduced benefits.

Part B - Payers - $206.50 per month.

Part D - Prescriptions - $50.00 per month.

Healthcare Insurance premium costs tend to (Increase) every year (no matter the plan) ACA, workplace; Medicaid; Medicare; or private.

Major cuts were announced at Tower Health on Friday and hundreds are now out of a job. The Health Network says the layoffs are due to what it calls financial challenges facing healthcare providers. Tower says expenses are increasing and they need to streamline services.

https://www.wfmz.com/news/area/berks/didnt-see-this-coming-nurses-express-shock-over-sudden-layoffs-and-closures-at-pottstown-hospital/article_9ea52465-1e23-4ef7-b0ac-4773f0416f94.html

When healthcare industry groups, especially insurance providers, publicly support the extension of enhanced premium tax credits, it sounds compassionate on the surface — “helping more Americans afford coverage.” But the real motive often has little to do with public welfare and everything to do with profit stability , greed and guaranteed revenue.
So yes — they support it, but not out of altruism. They support it because it locks in a steady stream of guaranteed income under the banner of accessibility.

Why is the Medicare Advantage leadership still with the company after tanking the MA business? Fire them all.

When Americans talk about why prescription dr-gs cost so much, we often point fingers at pharmaceutical companies. But behind the scenes, a quiet and far more insidious force drives prices higher — Pharmacy Benefit Managers, or PBMs.

These middlemen were supposed to save us money by negotiating discounts and managing benefits between dr-gmakers, pharmacies, and insurance companies. Instead, they’ve built a cartel-like empire that manipulates prices, restricts access, and drains billions from patients and small pharmacies alike.

Three PBMs — CVS Caremark, Express Scripts, and OptumRx — now control nearly 80 percent of the prescription dr-g market. That’s not competition. That’s consolidation, and it gives them unchecked power to dictate what dr-gs Americans can take and how much we pay for them.

Here’s how the scheme works: PBMs negotiate secret rebates with dr-g manufacturers in exchange for preferred placement on insurance formularies. The larger the rebate, the more likely a dr-g will be covered — even if a cheaper or more effective alternative exists. But those rebates don’t go to patients. Instead, PBMs and insurers often pocket the difference, leaving patients at the pharmacy counter paying inflated copays or list prices.

Independent pharmacies suffer too. PBMs reimburse them below cost, while steering patients to their own mail-order or corporate-owned pharmacies. Many small-town pharmacies — often the only healthcare access point for miles — have closed under this pressure.

It’s legalized extortion wrapped in healthcare jargon.

The result? A system where everyone but the patient profits. Dr-gmakers inflate prices to fund rebates. PBMs boast about “savings” that never reach consumers. Insurers look the other way because they share in the cut. And the average American pays more for prescription dr-gs than anyone else on Earth.

The good news is that lawmakers are finally paying attention. Bipartisan bills in Congress and state legislatures aim to require transparency, ban spread pricing, and force rebates to flow directly to patients. But reform will fail unless regulators confront the core problem: PBMs have become too big, too secretive, and too conflicted to serve the public good.

The United States cannot claim to have a free market in healthcare when three corporations act as gatekeepers to every pill that reaches a patient. We broke up oil trusts and telecom monopolies before. It’s time to do the same for the PBM cartel.

Because healthcare should serve people, not middlemen.

Strike or Unionized

U.S. employees are being displaced with offshore workers and/or artificial intelligence. It’s UnAmerican and unconscionable.

Perhaps the only way this can be stopped is if US employees (not in leadership roles) unite and demand changes immediately.

And maybe it is time for Healthcare workers to become unionized.

“We want to let you know that we've made the difficult decision to no longer offer Behavioral Health services in New Jersey“

https://patch.com/new-jersey/hoboken/optum-lay-572-workers-closing-pediatrics-mental-health-offices-nj

https://patch.com/new-jersey/hoboken/optum-lay-572-workers-closing-pediatrics-mental-health-offices-nj

"Optum, a health provider owned by UnitedHealth that took over numerous medical practices in New Jersey in the past several years, will lay off as many as 572 workers over three months, according to WARN notices filed with the state.

The company began sending letters to patients on Monday informing them of medical practices that will close as of Nov. 30 — including some pediatric and specialty medical offices, and all of their mental health practices.

One email received by patients on Monday said Optum will cease offering behavioral health services throughout New Jersey after Nov. 30.

Another message received by patients in Hudson County, one of the most densely populated counties in the country, said four of the company's pediatrics offices will close as of Nov. 30.

According to four WARN notices filed with the state of New Jersey on Oct. 1 — required in advance of mass layoffs — Optum Care will lay off 572 employees statewide, with most paid through Feb. 2. Separately, Optum Medical Care will lay off 122 employees just in Secaucus by February and March. And Optum Select Services and Optum Management are laying off 60 workers total.

Find out what's happening in Hoboken"

Tech support US here.

It seems like we’re seeing a shift in staffing with more roles being filled by people from India. I can’t help but wonder why Dell doesn't consider hiring more people from the US when there are so many qualified candidates ready and willing to work. We’re being told to take ethics courses, which honestly feel more like a chore, yet it seems like the company itself is falling short of its own ethical standards.

It’s clear that the company is gradually moving its US operations overseas, and it’s disheartening to see how this has unfolded. First, we saw changes to our healthcare benefits, and now it feels like the focus is on cheap labor at the expense of loyal workers. It’s tough to continue supporting a company that seems to be disregarding its employees in favor of cost-cutting measures. This needs to be stop.

When you say you work for Humana all providers Roll Their eyes! It
Is not the same!!! I do not see Humana a provider in 5 years! This UM centralization has totally messed Humana up!!

Palo Alto employee here. Will get notified on Dec and last day 60 days later. Question: What kind of continuing healthcare coverage does Broadcom offer during the severance period? Continuing the existing plan for a period of time?

And I assume after that, the option to purchase Cobra coverage?

I believe that as our government and our citizens realize just how potentially DANGEROUS that Artificial Intelligence can be…to our National Security, our electrical infrastructure, our financial banking systems, our social media, our news media, our children’s safety, and yes even our healthcare and PHI data protection.

And as a side benefit to increased regulations, I hope that acts as almost a complete deterrent from corporations having the ability to replace human jobs with Artificial Intelligence.

This is probably a good thing since Humana and most other Large MA Private Insurance Corporations seem to have a difficult job at doing simple accounting math when it comes to accurate Pharmacy RX Rebate numbers being reported to CMS and to Providers.

The company, which moved part of its operations to Thailand last year, told the state Department of Labor and Industry last week that it plans to lay off about 196 workers from its centers in Murrysville, Mount Pleasant and New Kensington.

https://www.post-gazette.com/business/healthcare-business/2025/11/01/philips-respironics-to-slash-nearly-200-jobs-from-pittsburgh-area-facilities/stories/202511010072

Many Providers, Specialists, and Hospitals are exiting being part of Humana’s network and in some cases are outright refusing to accept Medicare Advantage Plans.

This is because they see how difficult Humana, and MA in general, are to work with. Especially in regards to delaying and denying claims and the slowness for which Humana and other MA private companies pay their bills.

The crumbling of the MA infrastructure has already begun. Maybe the mighty companies are not too big to fail…

Someone commented on another board that they are expecting notable layoffs in Abbvie Patient Services. Anyone heard anything?

I work on the clinical team where a nurse practitioner is laid off with no notice. Not sure about severance, I'm sure they got it. But why are they getting no notice prior. Most other workers seem to get 30 days or 90 days notice. This is in the Midwest. It was less then 50 people for 1 location

The U.S. healthcare system is heading into another profit bo-m — for insurers, not patients. Premiums are set to surge an average of 18% in 2026, the steepest increase in over a decade. For millions of Americans already struggling to afford coverage, it’s a blow. For insurance companies, it’s a bonanza.

Behind the numbers lies a troubling truth: the business model of health insurance has become less about protecting patients and more about protecting profits. Advanced algorithms now scan every claim, searching for reasons to deny coverage. Doctors spend hours fighting for payment while patients are buried in appeals and paperwork. Every denied claim is another dollar saved — and another point for Wall Street.

Medicare Advantage, once sold as a way to give seniors more choice, has become a profit machine. Private insurers pocket billions in federal payments while restricting care through narrow networks and prior-authorization hurdles. Meanwhile, these same companies report record revenues, buy back their own stock, and reward executives with multimillion-dollar bonuses.

Healthcare costs rise, but care quality doesn’t. Hospitals close, families skip treatments, and the sick get sicker — all while insurers post double-digit earnings growth.

It’s time to ask what kind of system we’ve built — one where access to care depends not on need, but on profitability. Regulators, lawmakers, and voters must decide whether healthcare remains a public good or continues to serve as one of the most lucrative industries in America.

Because if current trends continue, 2026 will be remembered not as the year healthcare got better, but as the year insurance profits went stratospheric.

I work for Verizon. A little over a year away from qualifying for Medicare. Our new CEO Dan Schulman promised us big layoffs are coming. Our current severance package is 2 weeks per year capped at 35 weeks. I'm guessing that he will reduce that significantly to save money and point to ATT's severance policy as justification. How many older ATT employees have been layed off and negotiated a better severance package from the company? I'm thinking they should bridge my healthcare until I turn 65 and honor the old (current) 35 weeks pay cap.

Funny Veridigm reported its revenue for 2025 will be flat keeping pace with last year which probably keeps pace with many of Paul Blacks, Rick Polton years. Flat Line in Healthcare means death. No sings of life. My question is can anyone point a meaningful sale over past several years?

Someone please explain to me how Homecare dimensions survived the cuts That department has been losing money year over year. HS terrible leadership and so many high paying positions. Therapists making full time salary over 90k and seeing 2 patients a week. Nurses that see less than 4 patients a day and a VP who has not clue what she is doing. So many employees laid off of so many departments that are needed and this department spending money like it’s growing on trees.

There’s been no official communication. Nothing in the media either. We’re completely stumbling in the dark. Why? Do they want to make this even more tense than it already is? Our livelihoods are on the line.

Many nurses and APPs in NYS laid off effective 1/8/25

I believe this is a major concern perhaps being overlooked.

I wonder if the American public or even our government realize how vulnerable transferring sensitive american federal health data across the world globe to another country in the far east.

Please discuss. Maybe not an issue but personally it makes me a little concerned.

Sounds like a lot of people are up in arms about Cigna switching to a "rebate-free" model. Don't those drive a ton of revenue? I'm assuming Cigna is not going to just give up that revenue stream. Anyone know what's actually going on?

Specific departments that will impacted please post here
if you were in impacted post here
Good luck to everyone!

Any confirmation of layoffs within home and community on 10/30?

post here if you got an email.

Cigna's Express Scripts set to shift away from PBM rebates https://share.google/8ogUab3CaPoKA38XB

Hearing mumbling that dozens of positions are set for layoffs between Health Solutions and Carelon case management this week. Does anyone have more concrete information on this?