The Hertel Report

2026 Medicare Advantage Market Shows Slowing Growth Nationally & Arizona

Arizona News

National News

HHS Deputy and Acting CDC Director Resigns and HHS Top Lawyer Relieved of His Position

Leadership at the Department of Health and Human Services (HHS) has been shaken up once again as Secretary Robert F. Kennedy's deputy secretary and acting director of the Centers for Disease Control and Prevention (CDC) Jim O'Neill recently left the administration. On Wednesday, The Washington Post reported that the White House and...

Arizona News

Arizona: Family Sues Abrazo Hospital After Patient Dies Hours Following Discharge

A Phoenix-area family has filed a wrongful death lawsuit against Abrazo Health Arrowhead, alleging hospital staff discharged their 27-year-old son and transported him alone via rideshare to a downtown Phoenix location where he collapsed and died hours later, according to local reporting. The lawsuit claims Kaelen Lachica, who had...

White Papers, E books, Reports and more

Milliman Reports on Medicare Advantage

This week, international insurance and healthcare consulting firm Milliman published its annual white paper on the state of the Medicare Advantage industry. The annual paper relies on proprietary analysis called the Milliman Medicare Advantage Competitive Value Added Tool (MACVAT®), which evaluates the relative value of Medicare...

CMS Rules

CHCs, FQHCs and RHCs Struggle with Primary Care Models

New policies from the Centers for Medicare and Medicaid Services are disrupting rural health clinics' participation in value-based payment models. But a new study shows that while federal programs have increased patient access and quality of care, they have thus far failed to curb rising costs. When the Trump administration entered...

National News

Humana's CenterWell Acquires Arsenal's MaxHealth

While most insurers are downsizing their Medicare Advantage market presence, Humana is doubling down and acquiring healthcare services to support its expanding network. Last week, Humana's CenterWell Senior Primary Care, a value-based care provider, completed the acquisition of MaxHealth from Arsenal Capital Partners (Arsenal), a...

National News

HHS Ends and then Quietly Resurrects 340B Rebate Pilot Program

Last week, the Department of Health and Human Services (HHS) agreed to end a pilot program for a 340B Drug Pricing Program rebate model. This week, the agency is reportedly exploring the possibility of launching another model with the same premise. The HHS Health Resources and Services Administration (HRSA) announced the pilot program...

News

White House Announces TrumpRx Website

Late last week, the White House announced the launch of TrumpRx.gov, a website that implements President Donald Trump's Most Favored Nation drug pricing policy to offer drugs to American consumers at lower prices. As many as two-thirds of Americans report rising healthcare costs as a major financial concern, and the Trump...

White Papers, E books, Reports and more

ASPE Issue Brief: Approaches to Dementia Care in Medicare Advantage Special Needs Plans

The brief suggests Medicare Advantage (MA) plans could be directed to be more precise about how they will serve people living with dementia through their models of care (MOCs). Authors recommend states require dual-eligible, special needs plans (D-SNPs) to meet the needs of their members with dementia and said government agencies could...

National News

Humana, Centene and Cigna Outline 2026 Strategy Amid Cost Pressures

Three national insurers delivered earnings this week that, when taken together, sketch a market still adjusting to higher medical cost trends and shifting program economics. Humana’s update centers squarely on Medicare Advantage (MA). The company reported fourth-quarter revenue of $32.5 billion and full-year revenue of $129.7...

Arizona News

Banner Health's Brett Bingham Named to Modern Healthcare's 40 Under 40

Brett Bingham is a nationally recognized Arizona healthcare executive who currently serves as the chief network development officer for Banner Plans & Networks and president of several Banner networks. He holds accountability for provider network strategy, growth, and performance across multiple lines of business and 35,000...

Arizona News

Phoenix Children's Pediatrician on Modern Healthcare's 2026 Under 40 List

National recognition of Arizona-based physicians continues to underscore the state’s growing appeal as a destination for highly specialized clinical talent. Phoenix Children’s announced that Dannah Raz, MD, MPH, the pediatric health system's division chief of developmental and behavioral pediatrics, has been named to Modern...

Arizona News

AHCCCS Director Ginny Rountree to Step Down for Health Reasons

Virginia “Ginny” Rountree announced yesterday that she will resign as director of the Arizona Health Care Cost Containment System (AHCCCS), citing personal health concerns. Her final day with the agency will be Friday, Feb. 13. After deep consideration and conversations with my family, I have made the difficult decision to step down...

Arizona News

CommonSpirit To Sever Ties With Tenet's Conifer for $1.9B

CommonSpirit Health is moving to end its revenue cycle management relationship with Conifer Health Solutions, a subsidiary of Tenet Healthcare. Instead, the nonprofit health system is breaking its contract to move the work in-house. CommonsSpirit is the nation's largest nonprofit health system, known best locally by its subsidiary...

Arizona News

ICE Actions Keep Many Families Sheltered at Home & Avoiding Medical Care

As ICE efforts to deter illegal immigration increases in the US, legal immigrants and US citizens in mixed-status families are avoiding and even some are skipping health appointments as patients fear what might happen if they show up. Despite Federal law that forbids undocumented individuals from receiving coverage under the low-income...

National News

Know the Rules: OIG Releases MA Industry Segment-Specific Compliance Program Guidance

Not updated since 1999, the new guidance applies to all individuals and entities involved in the healthcare industry and serves as the Office of Inspector General's updated and centralized source of voluntary compliance program guidance for Medicare Advantage (MA). Entities and individuals can use the ICPG to help identify risks and...

Arizona News

Arizona Complete Health Awards Nearly $1M in Capital Grants to Local Community Organizations

Arizona Complete Health, a subsidiary of Centene and one of Arizona’s largest AHCCCS insurers, has awarded $950,000 in capital grants to 32 nonprofit and public-sector organizations statewide. According to the insurer, the grants are intended to strengthen community infrastructure supporting healthcare access, housing stability,...

Arizona Comings & Goings

Banner Health Hires Shelby Arveson as Senior VP of Finance

Arveson brings more than 25 years of healthcare finance experience to Banner Health.  She was formerly the chief financial officer of the South Division of Providence, California's $9.3 billion non-profit Catholic integrated health system. At Providence, she served in various local operational and corporate roles, including chief...