Healthcare Brew covers pharmaceutical developments, health startups, the latest tech, and how it impacts hospitals and providers to keep administrators and providers informed.

Healthcare Brew

Maia Anderson

Healthcare Brew delivers the latest news and trends in healthcare.

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How Greycoft VC decides to invest in a healthcare startup

Sharla Grass, a health tech VC at Greycroft, walked us through her process.

How does a VC decide to fund a healthcare startup?

Shannon Young

A female nurse takes care of an elderly male patient

Debate over nurse-patient ratios heats up

Here’s what you need to know about so-called safe staffing policies.

An illustration of two hands, one holding a coin with a dollar sign and the other holding a heart with a plus sign

Hospital operating margins up slightly in November 2022

Lower expenses and increased outpatient revenue helped buoy facility performances.

Hospital finances fared better in November 2022, but they’re still down

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Healthcare Economics

Cassie McGrath

 are rapidly making their way into healthcare, Adrienne Kline is one researcher leading the way in development.

Head of AI and engineering at Illinois-based Northwestern Medicine’s Center for Artificial Intelligence at the Bluhm Cardiovascular Institute, Kline received $1.4 million in research grants in the last year from tech giants Amazon, Microsoft, and Nvidia to develop new AI technologies for both patients and healthcare administrators.

These companies regularly make investments into AI, with Microsoft pledging in January $80 billion to create AI-enabled data centers to train models and deploy AI and cloud-based applications globally.

With this funding, Kline spearheaded the creation of a medical deidentification tool called PixelGuard, which removes identifying data for safe sharing of sensitive health information. The assistant professor at Northwestern also led the creation of a multimodal cardiac platform, Project Corazon, which reads MRI slices to diagnose cardiac abnormalities.

Kline spoke with Healthcare Brew about how she’s used research grants over the past year and what she’s working on now.

While Kline was finishing her postdoctorate in the department of preventive medicine, private tech companies wanted to recruit her. She ultimately decided to stay in academia, though, because she wanted more autonomy to choose what she would work on, she said.

Since Kline was already on these companies’ radars, they contacted her with grant offers and gave her another way to collaborate on ideas she had. With National Institutes of Health funding cuts issued by the Trump administration (funding is 

 at Northwestern), industry financing provided her an opportunity to continue “really important” research, she said.

“Some of these industry partnerships are a bit of a godsend to continue to get your research pushed through and get your research published,” she said, which ultimately helps researchers try “to make a difference in the world.”

De-indeification tools, like the one she built, aren’t “sexy,” Kline said, but they are essential for protecting data sharing, including within hospitals or between industry partners.

PixelGuard does this for images, she said, meaning healthcare providers can safely share MRI slices externally, like, for example, with a health plan that wants to double-check it for billing purposes.

She worked with Amazon and IT company ScaleCapacity to develop the tool, which took about seven months from “pitch to deployment,” she said. 

Working with Nvidia, Amazon Web Services, and tech company Quantiphi, Kline also led the development of a program, Project Corazon that can read cardiac MRI scans and assess medical images “the way a radiologist would.” In other words, the tool uses AI to assist clinicians in making diagnoses.

Project Corazon is not ready to be used in hospitals yet, Kline said, but with the CDC reporting 6.7 million US residents over 20 as having heart failure, she sees the need to ease the diagnostic process.

After sitting in on a faculty meeting and hearing about scheduling challenges, Kline started drawing up plans for a new operating room scheduling tool.

When completed (she’s aiming for November or December), the tool will review items like surgeons, beds, and room availability as well as emergent patient needs to find the most efficient way to conduct procedures.

“We want high utilization, but we also want to ensure that our emergencies are handled without delay, taking into account people going on vacation or [getting] sick,” she said, “because that really ties back to hospital profit margins.”

Headshot of Northwestern's Adrienne Kline on a small blue cloud with darker blue stars nearby

This Northwestern researcher got $1.4m in grants from Amazon, Microsoft, Nvidia. Here’s what she built

Adrienne Kline made de-identification tool PixelGuard and heart diagnoser Project Corazon with private industry research money. 

Nicole Ortiz

It’s time yet again for pharma companies to report their earnings. And while it’s sure to be a mixed bag, one thing is certain: 

That’s because the White House on July 28 announced 15% tariffs on pharmaceutical products imported from Europe to the US. Though this is much lower than the previously threatened 200% tariffs, analysts reportedly told 

 the trade deal could still cost the pharma industry as much as $19 billion.

“Every dollar spent on tariffs is a dollar that cannot be invested in American manufacturing or the development of future treatments and cures for patients,” Alex Schriver, SVP of public affairs at drug industry group PhRMA, said in an emailed statement. “Placing tariffs on medicines would be counterproductive to these efforts.”

 at the end of July to top execs at 17 pharma companies like Pfizer, AbbVie, Novo Nordisk, Bristol Myers Squibb, Johnson & Johnson, and more, giving them 60 days to 

Here’s what some execs in Big Pharma had to say about tariffs this quarter.

The first half of the year has looked relatively positive for New Jersey-based J&J. The company saw $23.7 billion in overall revenue, it reported on its Q2 earnings call on July 16, with a little over $15 billion of that coming from medicine sales (cancer meds, in particular).

In its Q1 earnings, J&J predicted the impact from tariffs would be approximately 

. But a quarter later, it halved that to $200 million instead and predicted tariffs would only impact its medtech division, EVP of Innovative Medicine and R&D John Reed said on the call, which took place before the 15% tariffs were announced.

CEO Joaquin Duato reiterated J&J’s $55 billion investment to build out US-based manufacturing, R&D, and tech efforts, including four new facilities.

“Our goal is to be able to manufacture in the US all the medicines that are consumed in the US,” he added.

Following the call, J&J’s stock increased more than 6%.

The UK-based pharmaceutical showed a positive trajectory, with total revenue up 11% to $28 billion for H1 2025. Its stock has also continued on an 

Group CFO and Executive Director Aradhana Sarin said in the company’s July 29 earnings call that AstraZeneca “will not be significantly impacted by tariffs” largely because the company already has “capacity” to sell its drugs in the US and it only imports “a handful of products” from Europe.

Sarin also pointed to new and expanded manufacturing efforts the company is making across the US, which it had announced a week before its Q2 call, to produce its 

 and other weight loss drugs. The company plans to invest $50 billion through 2030 into bolstering US operations, according to a press release.

Merck has struggled in earnings so far this year. After lowering its full-year guidance during Q1, EVP and CFO Caroline Litchfield said on its July 29 Q2 earnings call that the company plans to cut $3 billion in costs by 2027. That also comes after the New Jersey-based company announced in March it would shut down a manufacturing site in Pennsylvania, 

 that tariffs would cost it roughly $200 million this year. Chairman and CEO Robert Davis said tariff impacts for the year should be “minimal,” thanks to work the company has done moving manufacturing to the US.

But Davis added he needs more clarity from the Trump administration on how tariffs are going to play out before he can comment on how they’ll affect business in 2026 and beyond. It’s not clear, for example, when the 15% pharma tariffs will go into effect, he said.

 the tariffs wouldn’t go into effect until the Trump administration concludes a Section 232 

, initiated in April, which looks into the national security implications of importing goods, including pharmaceutical products, from other countries.

Merck’s shares fell about 6% following the earnings call.

Unlike Merck, AbbVie reported pretty positive Q2 earnings on July 31, raising full-year adjusted earnings per share guidance to $11.88–$12.08, up from $11.67–$11.87. Shares increased about 3.3% after the earnings call.

Though the Chicago-based drugmaker has a large presence in Ireland, Robert Michael, chairman and CEO, said AbbVie is “fairly insulated” from any effects of the EU tariffs—at least for 2025.

“Without policy details, we’re not going to speculate on the longer-term impact,” Michael added, saying it’ll be hard to know what to expect until the results of the Section 232 investigation are released.

“What I can say is that we do not expect our exposure to be outsized relative to peers,” he said.

He noted that Skyrizi, an immunology drug that’s currently the company’s best-selling product, is made in the US, and he highlighted the company’s 

 $10 billion investment into expanding its US manufacturing, which includes adding four new manufacturing sites to make active pharmaceutical ingredients, peptides, and more.

Aug. 5 was a good day for New York-based Pfizer, which beat its Q2 earnings projections, coming in with revenue of $14.7 billion compared to its goal of $13.5 billion.

David Denton, CFO and EVP, said Pfizer has taken into account the current China, Canada, and Mexico tariffs for its full-year guidance.

When asked to comment on the letter the Trump administration sent to major pharma companies, CEO Albert Bourla said the company is in “very active discussions” with the president and other government officials. Similar to Merck, he also added that he’s “waiting for the 232 report.”

Denton expressed more optimism about the future, anticipating the first phase of Pfizer’s manufacturing strategy will result in $1.5 billion in savings by the end of 2027 and an initial impact in the latter half of this year. The company has 11 manufacturing sites in the US, which Reuters 

 in March could help it dodge the impact of tariffs if it were to reshore overseas production.

Stakeholders also questioned whether the Trump administration would take issue with Pfizer’s China-made biotech, but Bourla reiterated Pfizer has exclusive global rights to its recently acquired biotech, which it plans to manufacture in the US and commercialize globally.

“But don’t take me wrong,” he added. “China is something that is very high in the radar of the political life of the US, and we need to be careful with that.”

Despite reporting better-than-expected earnings and raising its yearly outlook (to $60 billion–$62 billion, up from a previous estimate of $58 billion–$61 billion), Indiana-based Eli Lilly’s stock dropped 14% on Aug. 7 following its Q2 earnings call.

That’s because the company reported its 

 study results, which showed the drug was less effective than investors had expected, the 

That higher outlook estimate doesn’t take into account the recently announced 15% tariffs on pharmaceuticals entering the US, according to a press release. Eli Lilly has manufacturing sites in Ireland, Italy, Spain, France, and Germany.

“The potential effect of tariffs remains dynamic, and we will continue to update our estimate as the situation changes,” EVP and CFO Lucas Montarce said on the call. “We expect the 2025 impact of currently announced tariffs to be modest, and this has been factored into our 2025 guidance range.”

The guidance does, however, factor in tariffs already in place, such as those on goods from China, according to the release.

Photo collage of shipping containers and a hand holding a prescription bottle contained in abstract shapes.

Big Pharma talks tariffs, manufacturing in earnings

Largely, major players had pretty positive calls despite pressure from the White House.

Getting clear pricing information from hospitals has 

 in healthcare. Executive orders from both the Biden and 

 have tried—but so far failed—to get providers to share how much different types of care costs.

 these orders, according to the Department of Health and Human Services. And while some fines have been 

, the cost of care is still unclear. Fines can currently run between $300 and $5,500 per day.

A new bipartisan bill that was introduced in July by Sens. Roger Marshall and John Hickenlooper aims to address these challenges and provide clear pricing information once and for all.

The problem exists because hospitals negotiate prices independently and in private, and therefore have varying costs for different procedures compared to other hospitals—and sometimes even 

“You could have your hip replaced at a surgical outpatient center for $10,000–$15,000, but some medical centers would charge $50,000,” Marshall, who is also a medical doctor, told Healthcare Brew. “The consumer needs to know that.”

 If passed, the law would require providers—including hospitals, ambulatory surgery centers, imaging centers, and clinical labs—to publicly report their negotiated insurance rates and cash prices.

In support of another price transparency bill last year, the PIRG, a nonprofit, reported that additional price transparency could save 

 in healthcare costs, as a lot of healthcare spending is due to administrative waste, overcharging, and fraud.

The new bill says providers would also have to give patients an itemized bill that clearly outlines the cost of each service if multiple were provided, reiterating that estimates are not sufficient. Executives from both the hospital and patient’s health plan would also be required to sign an acknowledgment of the “accuracy and completeness” of the prices shared.

In a July 21 letter to the Centers for Medicare and Medicaid Services (CMS), the American Hospital Association’s SVP of Public Policy Analysis and Development Ashley Thompson wrote that “hospitals and health systems are dedicated to improving price transparency” and plan to work with the Trump administration to meet those goals.

“We urge CMS to focus future efforts to reform price transparency on streamlining policies to remove complexity and administrative burden,” she added.

Marshall also hopes the law will help CMS have “more teeth” to enforce these rules. He supports the idea of preventing hospitals that don’t turn over data from participating in Medicare and Medicaid.

“I just don’t know how else to make hospitals do it,” Marshall said, adding he thinks there’s “absolutely” enough Senate support for the bill to move forward this fall.

The law would also give insurers offering employer-sponsored plans the right to access their claims data so they can clearly see the cost of care and design plans accordingly. 

Right now, insurers cannot clearly see how much care costs since providers do not share it. Under the law, they would have access to financial information about subsidiaries and subcontractors, like 

Mark Newman, co-founder and CEO of health technology company Nomi Health, said he supports the bill from an employer perspective.

“When employers can see where their dollars go, they can eliminate waste, negotiate better rates, and close care gaps before they turn into expensive claims,” he said in an emailed statement.

A 2D animation of a hospital with a bunch of pharma pills and dollar bill signs coming out of the top of it

Senate bill seeks to secure hospital price transparency 

Getting clear cost information from providers has long been a challenge. 

Welcome back to Signed and Scrubbed, a monthly roundup of hospital deals, developments, and bankruptcies.

This month, there were at least seven deals and closures on July 1 alone. But don’t fret, there was more news from the rest of the month as well.

We compiled noteworthy provider transactions from July. Here’s what you need to know.

Providence, Rhode Island-based physician group Anchor Medical Associates permanently closed all three of its locations on July 1, leaving a 

On July 1, St. Louis-based health system Ascension subsidiary Ascension Seton acquired 

 of Texas-based Cedar Park Regional Medical Center, a 126-bed facility, for $436 million.

. Alhambra, California-based Astrana Health acquired Los Angeles’s Prospect Health System, which includes the 177-bed Foothill Regional Medical Center, for $708 million on July 1.

Baystate Health, which has 900 beds across five hospitals, is allegedly considering acquiring 182-bed Mercy Medical Center, which would bring together the two biggest hospitals in Springfield, Massachusetts, 

Beacon Health System finalized its acquisition of Ascension Southwest Michigan on July 1, adding four hospitals to the South Bend, Indiana-based system. The hospitals include 422-bed acute care hospital Beacon Kalamazoo, 25-bed Beacon Allegan, 25-bed Beacon Dowagiac, and 43-bed Beacon Plainwell. The deal also includes 35 outpatient clinics and an ambulatory surgery center.

Chippewa Valley Health Cooperative (CVHC).

 Chippewa Falls, Wisconsin-based Chippewa Valley Health Cooperative bought the former St. Joseph’s Hospital from Hospital Sisters Health System on July 1. Now called the Chippewa Valley Cooperative Hospital, the facility will serve patients while CVHC builds a new hospital in Lake Hallie, which is set to open in the beginning of 2028.

On July 8, Hugh Chatham Health, which includes an 81-bed facility and is based in Elkin, North Carolina, announced a merger with Winston-Salem, North Carolina-based Atrium Health Wake Forest Baptist. Under the partnership, Atrium pledged a $100 million investment in Hugh Chatham Health, which has 25 locations and 70 providers.

Rockford, Illinois-based system Mercyhealth announced a “temporary suspension” of services at its main 195-bed hospital Javon Bea Hospital-Rockton on July 1.

 Bedford, New Hampshire-based SolutionHealth filed a “disaffiliation agreement” to return to two independent systems. In 2018, Manchester-based Elliot Health System and Nashua-based Southern New Hampshire Health had signed an affiliation agreement to become one health system, but 

 July 16 they’re looking to separate again.

 Bethlehem, Pennsylvania-based St. Luke’s University Health Network finalized the acquisition of its 16th hospital on July 1: the 207-bed Grand View Health in Sellersville, Pennsylvania.

 Marlton, New Jersey-based Virtua Health and Wilmington, Delaware-based ChristianaCare signed a letter of intent on July 16 to co-found a “regional not-for-profit health system” across New Jersey, Delaware, Pennsylvania, and Maryland. The plan would include 600 care sites and 30,000 employees.

Hospital building split in half collaged with briefcase and $100 bill. Credit: Illustration: Anna Kim, Photos: Adobe Stock.

Signed and Scrubbed: July 2025 hospital M&A

July 1 alone saw seven deals and closures. 

illustrated headshot of caroline catherman, healthcare brew reporter

Caroline Catherman

It’s been a bleak Q2 for the insurance industry.

 have fallen short of expectations or lowered their 2025 predictions, blaming rocketing medical costs amid a sicker-than-expected pool of members across their health plans over the last few quarters. They’ve pointed to the 

 (ACA) marketplace and Medicaid in particular.

The issues have largely been attributed to increased utilization, providers coding for more conditions, and a continued 

 between state Medicaid reimbursement rates and member acuity.

 could make it more expensive and difficult to enroll in government plans, driving away healthy people and creating an even sicker Medicaid and ACA pool, execs said in Q2 earnings calls.

Insurers are reassuring investors that they will 

 unprofitable markets to make up for this. But Hal Andrews, president and CEO of data science, analytics, and market research firm Trilliant Health, told Healthcare Brew it isn’t that simple.

Andrews feels perhaps the biggest issue contributing to earnings misses isn’t being emphasized enough in payers’ calls.

“They’re not talking about the fundamental larger issue, which is specialty pharmacy,” he said.

A July 16 report by professional services network PwC shares that insurers’ medical costs rose 8.5% for the group market and 7.5% for the individual market in 2025—a trend that’s expected to stay the same in 2026. UnitedHealth, for instance, expects medical costs for the year to be $6.5 billion more than predicted. It has recorded $152 billion in medical costs from Jan. 1 to June 30.

Yet drug spending seems to be increasing even more than that. The PwC report found that industrywide it increased by 11.4% ($50 billion) to reach $487 billion in 2024 at net manufacturer prices, according to the report.

 are the usual suspects when it comes to high drug spend in recent years, but there are also quite a few pricey specialty drugs to treat chronic illness and genetic disorders.

There are other issues insurers emphasized that Andrews agrees are big factors. For instance, upcoding.

 by independent actuarial firm Wakely said an initial review found there was an increase in the number of members coding with more than two conditions.

Payers like Elevance, Centene, and UnitedHealth called out “aggressive” coding in their calls. 

Andrews pointed out that national hospital chains like Nashville, Tennessee-headquartered HCA Healthcare and Dallas, Texas-headquartered Tenet Healthcare have not reported substantially increased admissions (in fact, Tenet’s decreased) in their recent earnings calls, suggesting it’s not that patients have used much more care but that providers are charging for more things.

 (AI) is now sometimes used for coding, Andrews added. In recent years, AI programs 

from patient medical records and even to automate claim submissions.

“It doesn’t have to mean that coding intensity is a bad thing. It could just be that the machines are more consistent at coding than the humans are,” Andrews said.

 beat the slump that seemed to plague everyone else, topping Wall Street predictions and even raising their full-year earnings guidance for their companies by $2 billion and $9 billion, respectively. Both have 

, and execs attributed this “transformation” to concerted turnaround efforts.

 this success could be because it’s gotten out of the government insurance game, selling off its Medicare business 

. Plus, though it still faced high medical costs, Cigna’s Evernorth healthcare services unit, which includes its pharmacy benefit management business, rose 17% to $57.83 billion.

pill bottle with money and pills falling out on bright green background

Medical costs are hitting payers hard in Q2

Experts suggest specialty drugs and upcoding could be fueling the issue.

Another day, another example of CVS not beating the vertical integration 

Earlier this month, Aetna enacted a new policy for its commercial medical plans mandating drugs be supplied by third-party specialty pharmacies under CVS, the health plan’s parent company, and shipped directly to suppliers. Previously, these facilities have purchased drugs for patients independently and billed for them under a health plan’s medical benefit.

The policy, effective as of July 1, is a sign of vertical integration and puts infusion centers in a difficult financial position that could eventually lead to their closure, experts told Healthcare Brew.

Now, five drugs treating conditions like multiple sclerosis, uncontrolled asthma, and rheumatoid arthritis for Aetna patients are covered under a pharmacy benefit, meaning they will be delivered from a CVS specialty pharmacy.

An easy way to understand the challenges for infusion centers is comparing it to if customers brought their own steak to a restaurant and asked a chef to cook it, Robert Gelfand, founder and president of New York treatment facility American Infusion Centers, told us.

“Part of the business model we operate on is being able to buy the medication and bill for it,” Joshua Katz, director of Massachusetts-based medical clinic the Elliot Lewis Center, said. “If the specialty pharmacy buys the drug and bills for it, that eliminates that source of revenue for us. It’s hard to be profitable.”

Gelfand said his center runs on “relatively modest profits” and policies where a company yields higher returns on a few drugs (which can turn into more and more over time) like this are “insidious.”

 found clinics could lose out on nearly $2,000 per month if their drugs are delivered via an insurance company (aka “bagging”) rather than when they directly purchase the drugs. The study showed on average a $300+ per month rise in out-of-pocket payments for patients under the bagging method as well.

Right now, CVS is in the spotlight, but Gelfand is worried this kind of policy could spread to other drugs or payers. If it does, his business may no longer be able to sustain itself, he said, and may even be at risk of closure.

He may need to stop taking Aetna patients due to these financial challenges, Gelfand added.

Working with specialty pharmacies is also a “big administrative burden” on infusion centers, Katz said, as it requires phone calls, benefits verification, and shipment coordination. Without specialty pharmacies, the infusion centers can simply order drugs on their own.

If there’s a problem with drug temperatures or a drug is contaminated during shipment, or if a delivery is sent to the wrong address, the infusion center isn’t allowed to substitute a medication with another drug they have on hand, Elliott Warren, executive director of advocacy group Infusion Providers Alliance, said.

Considering that many patients at infusion centers have serious illnesses, Warren said he’s worried quality of care will suffer.

“It’s another example of a big payer and insurance company standing between a physician and their patient, all for, frankly, their own self-interest,” he said.

The Infusion Providers Alliance was informed about the policy before it went into effect and 

 on June 12 to Aetna outlining the group’s concerns, highlighting potential patient care, cost, legal, and supply chain issues.

When asked about the reasons behind the new rule, CVS spokesperson Phil Blando told us in an emailed statement the policy will allow the pharmacy chain “to better control the cost of the drugs and keep premiums more affordable, while still providing members with safe, convenient access” to certain drugs.

In recent years, CVS, UnitedHealth, and Cigna have 

 the healthcare industry. Essentially, these top three companies, which control 80% of the prescription medicine market, can set the cost of drugs while also operating the pharmacies that dispense them.

The infusion center leaders said this new Aetna policy is another practice in which CVS is pushing business into its own specialty pharmacy arm through beneficiaries covered under its health plan.

“It’s a theoretical death knell for infusion centers,” Glefand said.

Aetna’s new specialty drug policy ‘insidious’ for infusion centers, one leader says

Infusion center leaders accuse CVS of trying to funnel business back into itself. 

Investors lost an adjusted 16 cents a share in Q2, a huge fall from last quarter’s adjusted gain of $2.90 per share. The company also gave a new projection for earnings per share in 2025: $1.75. The Wall Street Journal 

 this is far less than the previously projected $7.25+.

Centene, which focuses on government subsidized plans, 

 its revenue guidance on July 1 following a report from actuarial firm Wakely suggesting fewer people would get marketplace coverage than expected, and those who did would need more expensive care.

Centene CEO Sarah London said the company is adjusting 2026 pricing for its marketplace plans, which have nearly 5.9 million members as of the end of Q2.

“We continue to believe that we will be able to reprice the 2026 portfolio to account for a substantial majority of our marketplace membership, and our goal is to reprice 100% of the book,” London said.

Though marketplace plans have been getting most of the attention, Friday’s call also shed light on another major pressure point: the company’s 12.8 million Medicaid members.

Centene’s overall health benefits ratio—the percent of premium dollars spent on medical care—jumped from 87.5% to 93% between quarters. London said its Medicaid health benefits ratio reached “an unanticipated and unacceptable” 94.9%.

London said behavioral health was the biggest factor in Q2’s “step up” in medical costs, followed by home health and high-cost drugs. Elevance also called out increased use of behavioral health and emergency room services in its July 17 earnings call.

But one specific service in particular is hitting Centene hard.

London said applied behavioral analysis (ABA)—a therapy for people with autism and other developmental disabilities that provides positive reinforcement for desired social behaviors—was a growing contributor to the spike in care costs in multiple states, especially Florida.

Florida Medicaid previously covered ABA therapy on a fee-for-service basis, but on Feb. 1, started requiring the service be provided through Medicaid managed care plans.

Centene oversees one of the state’s nine managed care plans called the Children’s Medical Services Health Plan, which serves people under 20 on Medicaid with special healthcare needs. This program served nearly 123,000 people in 2024, according to state data.

London said this population “transitioned with inadequate rates” and Centene is seeking future and retroactive rate adjustments.

It’s not clear how much Centene will pay for ABA services, but the state expects to spend $2.6 billion on them in the current year, according to 

London went on to allege “fraud, waste, and abuse” is spiking in behavioral health, “partly because of the fragmented provider base.”

She said the company has formed behavioral task forces to push for behavioral health rate adjustments and educate state partners on how to ensure behavioral health treatments are quality and evidence-based.