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September 26, 2026

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

Payers

Panel: Drug Costs Need Transparency, Not Just More Spending

Drug spending in the U.S. keeps climbing, but that growth is not translating into better access for patients, according to a panel at MedCity News' Bullseye event. The disconnect is the core problem: more money flowing through the system does not mean the people who need medicines are getting them.

Panelists tied the dysfunction to a lack of transparency in how drugs are priced and paid for. The prescription supply chain runs through layers of intermediaries, including pharmacy benefit managers, whose rebates and negotiated discounts are largely hidden from patients and often from the plan sponsors paying the bills. That opacity makes it hard to know what a drug actually costs or where the money goes.

The proposed remedy is straightforward in principle: inject transparency into pricing and rebate flows, and redesign benefits so cost savings reach patients at the pharmacy counter. Doing so would help align spending with actual access, rather than letting rising totals mask growing affordability gaps.

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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.

Payers

Medicare Advantage Plans Rethink Post-Discharge Care Transitions

Medicare Advantage plans are refocusing on the post-discharge period to reduce readmissions and protect Star Ratings.

Why it matters: Star Ratings drive billions in bonus payments and enrollment, and better care transitions are becoming a key way plans defend those scores.

Payers

Vertical Integration Is Quietly Inflating Patient Bills

KFF Health News details how vertical integration across hospitals, insurers, and pharmacies steers patients toward higher-priced care and inflates their bills.

Why it matters: As a handful of integrated companies control care, coverage, and drugs, patients face higher costs with little visibility into why.