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Week in Washington 10/30/25

Shutdown Still no updates on an end to the government shutdown. Senate Majority leader John Thune announced that discussions would be held soon on potentially ending the shutdown. Shutdown effects are expected to grow in the coming weeks. CBO estimated that the shutdown would lower annualized GDP growth in the fourth quarter by 1.0 to ... Continue reading

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Events & More

2026 Star Ratings: Trends, Takeaways, and What’s Next

November 6, 2025
1:00 PM ET

Join Wakely, an HMA Company, for a deep dive into the 2026 Medicare Advantage Star Ratings. We’ll unpack what this year’s results mean for plans, including the projected impact on 2027 Medicare Advantage payments.

Our experts will walk through key program and performance trends, highlight the effects of another annual cut point increase, and share insights on what plans can expect over the next few years. We’ll also explore upcoming Star Ratings changes and their potential implications for Medicare Advantage Organizations (MAOs).

Whether you’re looking to understand the numbers or plan your next steps, this session will help you stay ahead of the curve.

Learn more and register

Value Based Care Advisory Services: HMA and Wakely Put Analysis into Action

November 20, 2025
1:00 PM ET

Join experts from HMA and Wakely, an HMA Company, for an inside look at how our teams help organizations navigate and thrive in the value-based landscape. This session will highlight case studies and recent work that demonstrate a comprehensive advisory solution for any value-based entity. Attendees will gain a deeper understanding of how integrated insights across strategy, analytics, and implementation can drive measurable results in value-based care.

Learn more and register

Newsworthy Findings

Centene Posts $6.6B Loss on Massive Value Writedown

The goodwill impairment charge is meant to realign Centene’s value on its own books with the company’s value in the markets, which has plummeted this year amid medical cost and policy headwinds.

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Editor's Note
Centene reported stronger-than-expected third quarter results, with adjusted earnings improving from the prior quarter despite a $6.6 billion loss driven by a major impairment charge tied to Medicaid cuts and ACA changes. While elevated Medicaid and ACA utilization continue to pressure margins, Centene’s improved clinical management, higher state rates, and ACA repricing are helping stabilize performance, positioning the company for potential margin gains in 2026.

Senators Show Bipartisan Support for Reforming 340B During HELP Hearing

Lawmakers called for more transparency about how hospitals are using 340B revenue, including audits of participating facilities.

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Editor's Note
Federal spending on the 340B drug discount program has surged as the program’s growth has encouraged consolidation and higher-cost prescribing, according to the Congressional Budget Office. Lawmakers from both parties are now pushing for reforms to improve transparency and oversight, as federal agencies lack sufficient data and enforcement to ensure hospitals meet eligibility and compliance requirements.

EmblemHealth Taps Prime Therapeutics, Amazon for New Pharmacy Benefit Collaboration

EmblemHealth is partnering with Prime Therapeutics and Amazon to overhaul its pharmacy-benefit model by leveraging real-time referrals for specialty drugs, digital savings tools, and home delivery options to offer more transparent, convenient, and cost-effective access for members.

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Editor's Note
This move signals a shift away from traditional one-size-fits-all pharmacy plans toward tailored, tech-driven solutions that may reshape how insurers and members interact with prescription benefits.

As AI Pushes Further Ahead of Governance Strategies, Only Some Vendors Are Stepping Up

While the use of artificial intelligence in healthcare vendors is rapidly maturing, the industry has yet to develop and implement consistent governance and evaluation frameworks for overseeing these tools post-deployment.

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Editor's Note
This gap between AI innovation and governance may undermine both trust and effectiveness unless vendors and health systems move quickly to embed oversight mechanisms alongside deployment.

Q3 Earnings Recap: For-Profit Hospitals' Revenues Spike on Medicaid Supplemental Payments

Favorable shifts in patients’ source of insurance coverage played a key role in earnings increase, as did the acuity of cases and services being provided, the rates hospitals were able to demand and revenue cycle teams tasked with promptly winning claims disputes with payers.

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Editor's Note
Funds were flowing during the third quarter, including some awaited payouts from prior periods that the companies framed as one-time items rather than recurring growth.

Bonus Article

Just for Fun

Math Joke:

Why did the polynomial get therapy?

Prior Week

Q: What did zero say to eight?

A: Nice Belt!

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