CVS breakup to separate pharmacies from insurance CVS to break up $117 billion business, separating pharmacies from insurance
CVS Health said this past week it will split in two, separating its retail pharmacies from the Aetna insurance business and pharmacy-benefit operations in a major unwinding of the $117 billion healthcare conglomerate it spent years building.
The company forecast 2027 adjusted earnings of at least $8.65 per share, ahead of analysts’ estimates of $8.53 per share. But Kevin Gade, chief operating officer at Bahl & Gaynor, said that forecast compared unfavorably to rivals, some of which are more focused on government-sponsored plans that could receive more political backing next year after Democrats decisively won control of Congress in Tuesday’s midterm elections.
Patients want a human in the loop for AI healthcare tools
Patients say they’re open to doctors using AI for more administrative tasks, but they’re less enthusiastic about using it for diagnosing or claims adjudication.
The survey of 3,488 U.S. adults showed that healthcare consumers primarily consider AI effective for low-level tasks, but don’t find it appropriate for clinical decision-making.
About half of respondents think AI could be useful for translating medical jargon for patients, but only if there is a human reviewing the output. Only a quarter think AI can do this without any human input. Similarly, 44% of respondents think AI can effectively orchestrate appointment scheduling if there’s a human in the loop.
Your Phone Knows You’re at the Doctor, and Data Brokers Do, Too — Then Profit From It
Chris McQueen finished treatment for leukemia a year and a half ago, but the ads for fake cures never stopped.
Juice cleanses to cure cancer, “natural” cancer treatments, clinics in Mexico promising full recovery with little chemotherapy — all appeared on McQueen’s mobile phone during routine oncologist visits and monthly bloodwork.
How to Optimize Open Enrollment
Experts share best practices for sponsors to help encourage wise benefit elections by participants this fall.
Open enrollment season is in full swing, and employees are tasked with selecting the workplace benefits that will serve them best in the year ahead. But surveys show employees might need all the help they can get in making the best choices for themselves this fall.
MEDICARE
CMS postpones RPM payment halt for 2 years
The agency is delaying the end of Medicare payments for third-party remote patient monitoring services until 2029 following outcry from the virtual care industry.
The CMS sent shockwaves through the virtual care industry in July when it announced plans to end payment for RPM services provided by third-party vendors. In many cases, healthcare providers contract with companies for RPM services, where care teams remotely monitor vital signs and other health metrics and step in when patients fall outside established ranges, indicating changes to their condition.
Medicare Drug Price Negotiation Program and Medicare Prescription Drug Benefit Program Final Rule (CMS-4215-F)
On Nov. 5, 2026, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that codifies policies established in guidance documents for the Medicare Drug Price Negotiation Program (“Negotiation Program”) for initial price applicability year 2029 and beyond (CMS-4215-F). For initial price applicability years 2026 through 2028 of the Negotiation Program, statute directed CMS to implement the Negotiation Program through program instruction and other forms of program guidance.
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ICYMI (In Case You Missed It)
