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Prior authorization pledge: employers in, enforcement on TPAs

Amazon, Google and other self-funded employers have joined CMS' voluntary prior authorization pledge, but ERISA plans sit outside the federal rule, so the milestones only bind through ASO and TPA contracts.

The HealthMatics Desk6 min read
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A deserted, dimly lit hallway with tiled walls and overhead lights.

Hospital divestitures reshape 2027 portfolio strategy

Q3 2026 earnings show health systems deliberately shrinking hospital counts, and the hard part is not the sale price but the stranded overhead, EHR separation and referral loss that follow.

Closeup of switch in server with connectors and adapters connected to plastic device in dark room on blurred background inside

Epic Connectors AI agents expose a contract gap for CIOs

Epic's forthcoming Connectors tool will let its AI agents complete work inside other vendors' systems, raising audit, liability and approval questions most health systems have not written into contracts.

Close-up of a businessman signing a contract at an office desk.

Digital health vendor viability is now a 2027 contract term

Capital is concentrating into a few AI-native platforms while M&A stays flat and the IPO window stays shut, leaving health systems exposed to mid-contract failure in scheduling, monitoring and virtual care.

Female technician operates lab equipment in a clinical setting, wearing gloves for safety.

Healthcare vendor data extortion breaks the downtime playbook

The newest breaches hit labs, distributors and revenue-cycle software instead of hospital networks, producing zero clinical downtime and maximum legal exposure that incident response plans were never built to handle.

A healthcare professional administering an injection to a patient inside a clinic.

Keytruda biosimilar 2028: hospitals need a plan now

The first publicly announced pembrolizumab biosimilar is under FDA review just as Merck accelerates subcutaneous conversion abroad, leaving oncology service lines roughly 18 months to model two very different futures.

Hands holding financial papers for tax preparation and analysis.

Employer health plan cost shifting hits its limit

KFF's 2026 benchmark survey shows worker contributions for family coverage rising 9% against 5% premium growth, pushing payers toward network and site-of-service levers for 2027 contracting.

Health IT & AIAll stories →

Health IT

Interoperability, EHR modernization, and enterprise AI, covered for the leaders making technology decisions that reshape how care is delivered.

Closeup of switch in server with connectors and adapters connected to plastic device in dark room on blurred background inside

Epic Connectors AI agents expose a contract gap for CIOs

Epic's forthcoming Connectors tool will let its AI agents complete work inside other vendors' systems, raising audit, liability and approval questions most health systems have not written into contracts.

Middle aged African American female doctor in disposable gloves and mask reading paper on clipboard

HTI-5 certification criteria cuts shift EHR proof burden to providers

ASTP/ONC's deregulatory package would retire roughly half the Health IT Certification Program's criteria while narrowing information blocking exceptions, leaving hospital IT, informatics and compliance teams to absorb validation work vendors once attested to.

Hospitals & Health SystemsAll stories →

Hospitals & Health Systems

Operations, M&A, capital planning, and strategy, covered for the executives running hospitals and health systems in a margin-pressured market.

A deserted, dimly lit hallway with tiled walls and overhead lights.

Hospital divestitures reshape 2027 portfolio strategy

Q3 2026 earnings show health systems deliberately shrinking hospital counts, and the hard part is not the sale price but the stranded overhead, EHR separation and referral loss that follow.

Payers & InsuranceAll stories →

Payers & Insurance

Reimbursement, claims automation, value-based contracts, and data sharing, decoded for the teams navigating a tougher payer landscape.

Healthcare worker in scrubs reviewing patient files with a stamp and clipboard.

Prior authorization pledge: employers in, enforcement on TPAs

Amazon, Google and other self-funded employers have joined CMS' voluntary prior authorization pledge, but ERISA plans sit outside the federal rule, so the milestones only bind through ASO and TPA contracts.

Hands holding financial papers for tax preparation and analysis.

Employer health plan cost shifting hits its limit

KFF's 2026 benchmark survey shows worker contributions for family coverage rising 9% against 5% premium growth, pushing payers toward network and site-of-service levers for 2027 contracting.

Digital HealthAll stories →

Digital Health

Virtual care, remote monitoring, and patient engagement, covered for the teams building the next generation of connected health experiences.

Close-up of a businessman signing a contract at an office desk.

Digital health vendor viability is now a 2027 contract term

Capital is concentrating into a few AI-native platforms while M&A stays flat and the IPO window stays shut, leaving health systems exposed to mid-contract failure in scheduling, monitoring and virtual care.

Female doctor in a white coat conducting an online consultation from home using a laptop.

AI triage virtual care shifts clinical risk to health systems

Automated intake is scaling into enterprise virtual front doors faster than the governance, liability and reimbursement frameworks around it, leaving health systems holding standard-of-care exposure they did not fully price.

Healthcare CybersecurityAll stories →

Cybersecurity

Risk, resilience, and regulatory compliance, covered for the leaders protecting healthcare organizations from growing cyber threats.

Female technician operates lab equipment in a clinical setting, wearing gloves for safety.

Healthcare vendor data extortion breaks the downtime playbook

The newest breaches hit labs, distributors and revenue-cycle software instead of hospital networks, producing zero clinical downtime and maximum legal exposure that incident response plans were never built to handle.

Pharma, Biotech & MedTechAll stories →

Pharma & Biotech

Drug development, commercial strategy, device innovation, and AI in the pipeline, covered for the teams bringing therapies and technologies to market.

A healthcare professional administering an injection to a patient inside a clinic.

Keytruda biosimilar 2028: hospitals need a plan now

The first publicly announced pembrolizumab biosimilar is under FDA review just as Merck accelerates subcutaneous conversion abroad, leaving oncology service lines roughly 18 months to model two very different futures.

A diverse group of professionals engaging in a business meeting in a conference room with a speaker at the podium.

FDA advisory committee conflicts cloud launch planning

Fresh scrutiny of industry ties among FDA adcomm members turns a once-predictable regulatory milestone into a variable that payers, P&T committees and commercial teams now have to price in.

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