Sept. 3, 2025
| This week’s payer news for healthcare leaders
ACOs are also improving in quality, according to the CMS data. Still, the Medicare Shared Savings Program has struggled with waning provider buy-in.
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Federal lawmakers have proposed dozens of bills targeting core healthcare issues, including 340B, Medicaid, AI and site-neutral payments.
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The investment in Shields Health Solutions gives Evernorth greater reach into specialty pharmacy services for providers, which Cigna’s COO has called an “important addressable market expansion opportunity.”
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The retail pharmacy giant has also agreed to annually review its practices to ensure the state’s Medicaid program is getting the lowest possible prices for prescription drugs.
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The findings build on other research suggesting that MA insurers restrict care more than they should, especially post-acute services.
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