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Amazon Pharmacy expands medication services for caregivers and Medicare users: Healthcare service providers and pharmacies can earn customer loyalty by appealing to often overlooked caregivers with services that make their roles easier.

UnitedHealth Group faces reported criminal investigation over Medicare billing fraud: The DOJ may have gathered enough evidence against UnitedHealth, such as allegedly giving doctors kickbacks. Other top players in the Medicare Advantage market should be worried.

UnitedHealth Group CEO Andrew Witty steps down: New leadership will aim to straighten out the company鈥檚 Medicare Advantage business to appease Wall Street. But we鈥檙e also keeping an eye on what they鈥檒l do to improve UHG鈥檚 sinking reputation.

Medicare and Medicaid won鈥檛 have to cover GLP-1s for weight loss: The Trump administration rejected a proposal that would have improved access to the drugs for millions of Americans. The consequences will be greater for patients than for Big Pharma.

Trump considers reviving a proposal that cuts US drug prices to international levels: It could be another blow to the drug industry, on top of ongoing drug price cuts in Medicare and looming tariffs set to hit the sector.

Senate confirms Dr. Oz to lead CMS: Reducing Medicare Advantage overpayments could be a priority for Oz and his team. Looming cuts to Medicaid will be tougher to justify.

Health insurers鈥� digital tools lack basic capabilities: Medicare Advantage insurers must improve the digital experience since members can switch plans each year.

Healthcare stakeholders push Congress to make Medicare coverage of telehealth permanent: It鈥檚 set to expire at the end of March. We explore what鈥檚 at stake for seniors, many of whom are used to getting care remotely.

DOJ will examine UnitedHealth鈥檚 Medicare billing practices: The Trump administration has made 鈥渨aste, fraud, and abuse鈥� a rallying cry. Now, we find out how serious they are about it.

CMS unveils list of drugs for the next round of Medicare price negotiations: Drugmakers鈥� efforts to win over the Trump administration could amend the process in their favor鈥攗p to a certain point.

Drugmakers will push Trump to delay Medicare price negotiations: We believe the drug price negotiation program is well-intended given how much Medicare and US consumers pay for certain medications. While a program reversal is unlikely, we鈥檒l find out soon what the Trump administration thinks.

Ozempic is becoming cheaper for Medicare beneficiaries: Falling prices are welcome news for seniors鈥� wallets. But a new proposal to expand access to GLP-1s for Medicare members could threaten the federal health insurance program itself.

CMS must recalculate UnitedHealthcare鈥檚 Medicare Advantage star ratings: The ruling could be a good omen for Medicare Advantage insurers whose ratings were downgraded.

CMS must recalculate UnitedHealthcare鈥檚 Medicare Advantage star ratings: The ruling could be a good omen for Medicare Advantage insurers whose ratings were downgraded.

Trump taps Dr. Oz to helm the CMS: We detail what the celebrity doctor鈥檚 appointment would mean for the future of Medicare, Medicaid, the Affordable Care Act, and consumers enrolled in these plans.

Prescriptions for Medicare beneficiaries have grown the most over the last five years, up 25%, and nearly triple the growth in the number of program enrollees. Prescriptions per Medicare enrollee reached 36 in 2024, also a new high. Related, we forecast Medicare prescription drug spending to eclipse $343 billion this year, up 34% from 2021.

The bigger picture: With an administration that鈥檚 more likely to fund programs for nutrition than anti-obesity drugs, investors and buyers are eying food-as-medicine companies in the Medicare and Medicaid market. However, the HHS鈥� focus is on big food brands and banning artificial dyes and chemicals from food and drink products.

For context, the Inflation Reduction Act (IRA) passed under the Biden administration in 2022 gives Medicare the authority to negotiate prices for high-expenditure drugs. The program stipulates that small molecule drugs (typically made as pills) can be subject to price cuts nine years following FDA approval.

A Medicare waiver that reimburses hospitals for at-home care might not be extended under the Trump administration. The waiver allowed health systems to free up capacity during the COVID-19 pandemic by providing hospital-level care in patients鈥� homes, and was subsequently extended a few times.

More bad news for Medicare Advantage insurers: Humana鈥檚 huge drop in star ratings is another indicator that MA plans will likely cut seniors鈥� benefits in the future.

There鈥檚 large majority support against federal funding cuts for Social Security (84%), Medicare (79%) and Medicaid (76%). Americans also oppose federal funding cuts for infectious disease tracking (71%), university and medical center research (69%), and HIV prevention programs (65%).

They negotiate rebates with drugmakers and determine which drugs will be included on insurer formularies and Medicare Part D plans. They鈥檙e meant to be intermediaries between drugmakers, insurers and pharmacies, but when companies own multiple players under one roof, it can tilt the playing field.

Nearly half (48%) of US adults who have paid for prescription medications said they are included in their insurance plan, per M3 MI鈥檚 2025 MARS Consumer Health Study. 21% purchase their drugs through a Medicare Part D plan. Far fewer patients pay for their prescriptions all on their own.