#healthcare

Many Providers, Specialists, and Hospitals are exiting being part of Humana’s network and in some cases are outright refusing to accept Medicare Advantage Plans.

This is because they see how difficult Humana, and MA in general, are to work with. Especially in regards to delaying and denying claims and the slowness for which Humana and other MA private companies pay their bills.

The crumbling of the MA infrastructure has already begun. Maybe the mighty companies are not too big to fail…

Someone commented on another board that they are expecting notable layoffs in Abbvie Patient Services. Anyone heard anything?

I work on the clinical team where a nurse practitioner is laid off with no notice. Not sure about severance, I'm sure they got it. But why are they getting no notice prior. Most other workers seem to get 30 days or 90 days notice. This is in the Midwest. It was less then 50 people for 1 location

The U.S. healthcare system is heading into another profit bo-m — for insurers, not patients. Premiums are set to surge an average of 18% in 2026, the steepest increase in over a decade. For millions of Americans already struggling to afford coverage, it’s a blow. For insurance companies, it’s a bonanza.

Behind the numbers lies a troubling truth: the business model of health insurance has become less about protecting patients and more about protecting profits. Advanced algorithms now scan every claim, searching for reasons to deny coverage. Doctors spend hours fighting for payment while patients are buried in appeals and paperwork. Every denied claim is another dollar saved — and another point for Wall Street.

Medicare Advantage, once sold as a way to give seniors more choice, has become a profit machine. Private insurers pocket billions in federal payments while restricting care through narrow networks and prior-authorization hurdles. Meanwhile, these same companies report record revenues, buy back their own stock, and reward executives with multimillion-dollar bonuses.

Healthcare costs rise, but care quality doesn’t. Hospitals close, families skip treatments, and the sick get sicker — all while insurers post double-digit earnings growth.

It’s time to ask what kind of system we’ve built — one where access to care depends not on need, but on profitability. Regulators, lawmakers, and voters must decide whether healthcare remains a public good or continues to serve as one of the most lucrative industries in America.

Because if current trends continue, 2026 will be remembered not as the year healthcare got better, but as the year insurance profits went stratospheric.

I work for Verizon. A little over a year away from qualifying for Medicare. Our new CEO Dan Schulman promised us big layoffs are coming. Our current severance package is 2 weeks per year capped at 35 weeks. I'm guessing that he will reduce that significantly to save money and point to ATT's severance policy as justification. How many older ATT employees have been layed off and negotiated a better severance package from the company? I'm thinking they should bridge my healthcare until I turn 65 and honor the old (current) 35 weeks pay cap.

Funny Veridigm reported its revenue for 2025 will be flat keeping pace with last year which probably keeps pace with many of Paul Blacks, Rick Polton years. Flat Line in Healthcare means death. No sings of life. My question is can anyone point a meaningful sale over past several years?

Someone please explain to me how Homecare dimensions survived the cuts That department has been losing money year over year. HS terrible leadership and so many high paying positions. Therapists making full time salary over 90k and seeing 2 patients a week. Nurses that see less than 4 patients a day and a VP who has not clue what she is doing. So many employees laid off of so many departments that are needed and this department spending money like it’s growing on trees.

There’s been no official communication. Nothing in the media either. We’re completely stumbling in the dark. Why? Do they want to make this even more tense than it already is? Our livelihoods are on the line.

Many nurses and APPs in NYS laid off effective 1/8/25

I believe this is a major concern perhaps being overlooked.

I wonder if the American public or even our government realize how vulnerable transferring sensitive american federal health data across the world globe to another country in the far east.

Please discuss. Maybe not an issue but personally it makes me a little concerned.

Sounds like a lot of people are up in arms about Cigna switching to a "rebate-free" model. Don't those drive a ton of revenue? I'm assuming Cigna is not going to just give up that revenue stream. Anyone know what's actually going on?

Specific departments that will impacted please post here
if you were in impacted post here
Good luck to everyone!

Any confirmation of layoffs within home and community on 10/30?

post here if you got an email.

Cigna's Express Scripts set to shift away from PBM rebates https://share.google/8ogUab3CaPoKA38XB

Hearing mumbling that dozens of positions are set for layoffs between Health Solutions and Carelon case management this week. Does anyone have more concrete information on this?

For those who have been laid off, is medical coverage for your dependent(s) good through thre severance payments or does it only cover you?

Healthcare costs are going to continue to go up (for everyone) virtually everywhere.

Even has AI continues to displace (entry-level white collar jobs) over time (the unemployment rate rising will continue will show it).

Thread dedicated to 10/30. Please share only credible information.

What a shame. Every year 1000s of companies renegotiate with insurers to cut benefits... Sick... Millions of Americans fight, every day, to avoid medicl bankruptcy. They pay taxes close to those in European countries with universal healthcare, yet get almost nothing in return. Healthcare +education are sooooooooo essential for a strong society. Still we Americans make sure both cost the most in the world (and reach the fewest)...

Tonight’s episode on the 6:30pm news, showcased a gentleman Mr. Middleton, whom has Bile Duct Cancer was denied a life extending dr-g Ziihera that hos Oncologist and team recommended.

Cigna denied and suggested another dr-g that most likely would not extend Mr. Middleton’s life long enough to obtain the liver transplant he needs. Unlike the recommended dr-g Ziihera most likely would

Just another example as to how profits are being placed before member’s health. Our healthcare system is truly broken.

Oftentimes I hear persons say that reason why healthcare is so expensive in the U.S. is because of all the state of the art technology and research. And although I do not doubt that is the case, I think persons would take maybe less state of the art technologies and research, if they could at least have their healthcare actually save their life in an affordable way, when needed.

To use a metaphor, what good would it be if all commercial planes got replaced with an equivalent to airforce one, if because of that now, it would cost a person $20k to fly from San Diego to San Francisco?

Also, I think there is a lot of greed going on where C-Suite executives are getting paid millions, Large Bank Investors are making major profits, and because of that, which has been recognized by hospitals and providers now figure they might as well not be left out of the profit gains and charging exponential costs for services that would have cost a fraction in the 50’s, 60’s, and 70’s. And I won’t even bother mentioning Pharmaceutical manufacturers. I really do not know what to think about it nor what can be done.

Anyway, here below is a little about that news program, if you want to check it out.

(Not sure yet if Humana has ever been mentioned yet on this program but would not be surprised. Unless of course they pay off NBC a big fat check for millions to keep them out of any episodes.)

"The Cost of Denial" is an NBC News series that investigates the financial and emotional impact of insurance companies denying claims for health, home, or auto coverage. The series features stories of people struggling to get coverage for medical treatments, repairs, and medications, highlighting how insurers use processes like prior authorization to deny claims. NBC News provides an email, CostofDenial@nbcuni.com, for individuals to share their experiences with insurance denials.

Hello all, any new information on potential Layoff 10/30? thank you

I have an upcoming interview with Humana but also have an offer at the moment, I feel as though Humana would offer more money & the potential team I would be joining may be different than what everyone is saying here.... helppp

Too many occasions where someone wants to do good work but blocked by another. Too many emails don not get a response and this includes leadership. How are employees supposed to do their jobs or fulfill the asks and goals given by our leaders? Impossible. One cares anymore.

Check out the link below to read a story from a whistleblower. This is exactly what has been happening at HCSC since ITOM in 2017. Don't believe me? Take a look at the ORG chart sometime and tell me this isn't happening. There has been a replacement of not only leadership, but all levels inside HCSC. Stories like this are just the tip of the iceberg too. Do you want to know who is responsible and allow it to keep happening? The Board of Directors that oversee this company and most likely the first two levels of our ORG chart.

They don't care about any of the people that have built this company or the people who work hard day and day out to support it. This post is not about politics and this is not about race. If you offended by it - take a breather, calm down, and try to process the information logically and not emotionally.

The New Centralized UM leadership is out of touch with the employees ! It is chaos, disastrous and not doable. Huge stress and unbearable!!!

Hospital workers protested outside the University of California at San Francisco, or UCSF, Benioff Children’s Hospital Oakland this past Friday in response to 38 layoffs announced Oct. 6. The rally organized by California Nurses Association, or CNA, and University Professional and Technical Employees, or UPTE, drew about 50 people at peak.

https://www.dailycal.org/news/city/nurses-protest-ucsf-layoffs-at-children-s-hospital-oakland/article_26446e41-e69f-4fae-91b0-687ea094a56b.html

Point32Health, the state’s second largest health insurance company, is eliminating 254 jobs in its second workforce reduction of the year. The layoffs will impact approximately 6.5% of Point32’s workforce.

https://www.nbcboston.com/boston-business-journal/point32health-more-layoffs/3830594/

Just saw email taking about the changes upcoming during enrollment period. Atleos mentions about the “staggering increases in healthcare” requiring an increase of rates.

That’s now a double whammy as they took away the benefit of being healthy (non smoking, sugar levels, etc) providing a discount on healthcare per pay period. Smokers actually benefited the most cause their rates came down!

Add that to worsening 401k company match, things keep going in reverse.

I can only imagine how many people will experience identity theft as a result of this.

“ LOUISVILLE, Ky.--(BUSINESS WIRE)-- Humana Inc. (NYSE: HUM) and Providence, a Washington-based health system, today announced a pioneering initiative to streamline and secure data exchange between payers and providers – setting a new standard for interoperability in support of value-based care.”

I bet in coming days, we will hear about lawsuits where major data breaches occurred as a result to this. Mark your calendars.

• Women's health startup Tia just slashed about 23% of its workforce, Business Insider has learned.
• CEO Felicity Yost told employees that Tia got feedback in a recent fundraise that led to the cuts.
• In-person healthcare clinics, like those Tia operates, have proven difficult to sustain financially.

https://www.businessinsider.com/womens-health-startup-tia-cut-23-of-workforce-layoff-2025-10

It’s already a big number in HIH. But how long will they continue to hire there? Or is it a moving target and they don’t know until we find a way to be profitable in other ways.

We called it on this board several months ago due to inside sources. More benefit cuts announced today. Healthcare and life insurance changes will save about $2m. The increase in premium hits lower wage worker hardest. There should be a sliding scale based on percentages and income level. Premium rise is a regressive tax. Anthem is rolling out these Platinum BS Providers--probably the ones getting the biggest kickbacks in a ponzi like scheme. CHRO and Data Czar not in attendance at the price hike inflation meeting today.

Did we hear Stephen correctly say HS brand wins, no more Blue Medicare?

I hope everyone being laid off will land on their feet soon. And I truly hope this will be the last round of layoffs for a long time, because these cuts hurt not only employees but also our patients.

any insight on the salesforce issue with no new patients loading?

Citing financial challenges and economic uncertainty, the Lucile Packard Children’s Hospital is preparing to reduce its workforce by 87 positions in December, according to a notification that the Palo Alto medical institution filed with the state this week.

https://www.paloaltoonline.com/health-care/2025/10/14/dozens-face-layoffs-at-lucile-packard-childrens-hospital/