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September 29, 2026

Takeaways from the most recent news in the technology and policies shaping healthcare.

Payers

CMS Projects Lower MA Premiums, Flat Enrollment for 2027

CMS is signaling calmer waters for Medicare Advantage. In a Sept. 28 news release previewing 2027, the agency projected lower average premiums and enrollment of 34 million beneficiaries, or roughly 47.4% of all Medicare enrollees, according to Becker's Hospital Review. That figure is essentially flat compared with the 2026 projection.

The projection sits below current reality. Actual MA enrollment reached 36.1 million as of June, so CMS is forecasting membership that trails where the program already stands. That gap suggests the agency expects the years of rapid MA growth to plateau as plans absorb tighter payment rules, higher medical costs, and benefit trims.

For payers, lower projected premiums are a competitive marketing point but come amid margin pressure that has pushed insurers to exit markets and cut supplemental benefits. For hospitals and beneficiaries, the practical question is whether stable premiums hold once final bids and star ratings land ahead of the annual enrollment period.

More in Payers

Payers

PBMs Become Rare Bipartisan Target in Washington and States

A bipartisan push in Congress and statehouses aims to rein in pharmacy benefit managers, including proposals to force CVS and rivals to split their PBM and pharmacy businesses.

Why it matters: PBMs sit at the center of US drug pricing, and forced divestiture would upend the business models of the largest healthcare conglomerates.

Payers

Payer AI Is Driving Up the Hidden RCM Tax on Providers

Payer AI is accelerating claim denials and underpayments, fueling a multi-billion dollar cost to providers that some call the RCM Tax.

Why it matters: As insurers automate claim denials, providers that fail to modernize their revenue cycle risk losing significant revenue to rework and unappealed claims.

Payers

Judge Sends Ballad Health's UnitedHealth MA Suit to Arbitration

A federal judge dismissed Ballad Health's Medicare Advantage lawsuit against UnitedHealth, ordering the payment dispute into arbitration.

Why it matters: Arbitration clauses in payer contracts can quietly steer provider-insurer disputes out of court, shaping how health systems fight Medicare Advantage denials.