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November 12, 2026

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

Payers

CVS Caremark Names Keith Reynolds Chief Growth Officer

By Healthcare Technology News ·

CVS Caremark, the pharmacy benefit manager owned by CVS Health, is adding Keith Reynolds as chief growth officer, according to an Aug. 7 LinkedIn post cited by Becker's Hospital Review. Chief Sales Officer Jim Fowler is transitioning into retirement.

Reynolds is an internal promotion with deep roots at the company. He spent 25 years across CVS Health and Aetna and most recently served as a chief operating officer. That continuity signals CVS wants an insider to protect and expand Caremark's client base rather than shift strategy under an outsider.

The move lands as PBMs face intense pressure. Caremark, along with rivals Express Scripts and Optum Rx, is under fire from the Federal Trade Commission, Congress, and employers over drug pricing and rebate practices. A growth chief must defend market share while the business model itself is being challenged by regulators and by newer transparent-pricing competitors. How Reynolds balances expansion with mounting political risk will be worth watching.

Sources

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Payers

Hospitals Split on Owning Health Plans as Systems Exit

Several large health systems have sold or closed their insurance arms in the past two years, exposing a widening divide over whether providers should own health plans.

Why it matters: Whether a hospital owns an insurer shapes its revenue, risk, and leverage against payers, making it one of the defining strategic bets in healthcare.

Payers

Humana, Athenahealth Expand Electronic Prior Authorization

Humana and Athenahealth are scaling electronic prior authorization across 180,000-plus clinicians, with most September transactions requiring no manual staff work.

Why it matters: Prior authorization is a leading driver of provider burnout and administrative cost, and automation embedded in the EHR is how new federal mandates get put into practice.

Payers

How Health Plans Tell If Their Payment Ops Can Scale

Health plans can gauge whether their payment operations can truly scale by watching exception volume, return rates, and digital payment share as transaction counts rise.

Why it matters: Payment infrastructure that fails under growth drives up administrative costs and strains provider relationships just as a plan expands.