#healthcare

Getting laid off doesn't feel like a neutral “business decision”, it's a gutless move against the people who actually kept the work in healthcare technology running while others coasted and still kept their badges. I spent years cleaning up messes. Now somehow I’m the one pushed out. It’s sickening to watch a company in the health space reward bare‑minimum effort, ignore the impact on real people and communities, and then speak in corporate jargon about “efficiency” and “alignment” as if no one can see through the lies. The worst part is knowing I was singled out not because I failed, but because I refused to be lazy, refused to cut corners, and that commitment to some level of standards made others uncomfortable! What a joke, too bad it's not funny at all.

It’s gonna get worse before it gets better. Ambetter is exiting the NH plan and now this with Arkansas.
https://www.arkansasonline.com/news/2026/jul/06/centene-plans-to-exit-arkansas-medicaid-expansion/

The New York State Nurses Association alleges Montefiore Health System plans to replace nurses with AI. The union claims 12 utilization review nurses are slated for layoff. These nurses use their clinical judgment to review insurance denials. Montefiore denies the union's claims as inaccurate and misleading. Concerns include compromised patient care and potential data privacy issues.

Bronx, New York

https://www.norwoodnews.org/nysna-allege-montefiore-plans-to-replace-some-nurses-with-ai-systems/

Unionized workers at the Solomon R. Guggenheim Museum in New York overwhelmingly voted to authorize a strike. This action follows ongoing negotiations for a new collective bargaining agreement since December 2025. The union, UAW Local 2110, seeks to address healthcare costs and inflation. They propose significant salary increases and reduced healthcare costs for lower-earning staff. Museum management has offered a different four-year contract with smaller raises. No specific strike deadline has been set yet.

New York, New York

https://www.theartnewspaper.com/2026/06/30/guggenheim-museum-workers-new-york-vote-authorise-strike

Artificial intelligence improvements are causing widespread layoffs in the technology industry. Kaiser Permanente and Revere Health are among the first healthcare systems to see AI-driven workforce changes. These initial layoffs primarily affect non-clinical roles such as coding, billing, and scheduling. Clinical jobs are not expected to be permanently replaced by AI soon. However, temporary provider layoffs and increased work expectations are anticipated during this AI trend.

https://kevinmd.com/2026/07/are-physicians-next-in-ai-health-care-layoffs.html

July 1 (Reuters) - Cigna (CI.N), opens new tab said on Wednesday its health services unit Evernorth has launched a new AI-powered ​specialty pharmacy program to reduce the time ‌it takes to process prescriptions and improve customer service.
The program, called Pharmacy Forward, is supported by a $100 million ​investment through 2028, the health insurer said.

Here are more ​details:
The company is launching the AI program first through ⁠its specialty pharmacy, Accredo.
The program uses AI to ​integrate clinical data and insights, generate summaries to free ​up more time for clinicians to focus on patient care.
'Pharmacy Forward' is expected to reduce clinician documentation time by ​up to 50%, the company said.
The program ​uses AI to improve prior authorization requests, halving the time it takes ‌for ⁠patients to receive their medication after Accredo receives a prescription, the company said.
Health insurers are increasingly adopting artificial intelligence tools to streamline documentation processes, reduce ​administrative burdens ​and lower ⁠costs.
Accredo is also expanding capacity, staffing, and capabilities at many of its ​nearly 40 care facilities, Cigna said.
The program ​is ⁠expected to generate about $400 million in value by the end of 2028, with Evernorth expecting to extend ⁠many ​of these capabilities to its ​other pharmacy operations in the coming years, it said.

https://www.reuters.com/legal/litigation/cigna-invests-100-million-new-ai-powered-specialty-pharmacy-program-2026-07-01/

Cape Fear Valley Health announced workforce reductions this week. Approximately 200 positions are being eliminated. This includes 138 currently filled jobs. Declining federal reimbursements and rising healthcare costs drove the decision. The health system aims for long-term financial stability.

https://www.wral.com/news/local/cape-fear-valley-health-cuts-200-positions-july-2026/

https://www.beckerspayer.com/legal/elevance-pays-cms-342m-amid-medicare-

Elevance Health paid CMS $342 million following a Medicare Advantage sanction notice alleging the insurer did not properly address overpayments for years.

June 22 filings in a New York federal court included an email from an Elevance vice president to CMS, confirming the payment was a “remittance of the total overpayment amount” related to the Risk Adjustment Overpayment Reporting module. Elevance conducted the wire transfer May 27, and CMS confirmed receipt the next day.

On May 29, a separate CMS letter informed Elevance that it had received the company’s attestation, but it did not specify the payment amount at the time. That step, along with initial submissions to the appropriate electronic systems, temporarily staved off intermediate sanctions. However, CMS said the insurer has until the end of June and July to complete further tasks — such as resolving issues across other risk-adjustment modules and addressing additional overpayment issues — before sanctions kick in.

The most recent filings also included a June 22 letter from the U.S. attorney’s office to the judge, challenging Elevance’s desire for additional discovery regarding the sanction notice.

“To the extent Anthem [now Elevance] wishes to challenge CMS’ administrative action, this is not the appropriate forum to do so,” the letter said.

CMS told Elevance in February that it would impose sanctions affecting MA prescription dr-g plan enrollment and communications due to a lack of compliance with risk-adjustment data submission requirements, interfering with the return of overpayments.

Elevance CFO Mark Kaye previously said the company had set aside $935 million to address the dispute. As of February, Elevance had about 2 million MA members.

This case is not the only source of tension between Elevance and the federal government right now. A Justice Department lawsuit first filed in 2020 alleges False Claims Act violations.

“Elevance Health continues to engage in constructive dialogue with the Centers for Medicare & Medicaid Services,” an Elevance spokesperson told Becker’s June 26. “We remain optimistic that a resolution can be reached and value our longstanding relationship with CMS.”

CMS said, if any sanctions take effect, current MA beneficiaries will continue to access their coverage and benefits as usual, since the sanctions would only apply to new enrollments and communications.

“CMS is committed to ensuring accurate Medicare Advantage (MA) payments, compliance with federal requirements and the protection of taxpayer dollars. Accurate and timely submission of MA risk adjustment data is essential to ensure Medicare pays appropriately for the beneficiaries they serve,” CMS told Becker’s in a June 29 statement.

I just read that the Office of Personnel Management (federal government) sent VSP's to their health insurance sector yesterday. The whole system might collapse. This is no good.

The University of Vermont Health system announced system-wide layoffs and service closures. 142 roles were eliminated, including 30 at Alice Hyde Medical Center and Champlain Valley Physicians Hospital. UVMH also intends to close the Adirondack Blood Donor Center on July 10. New York State Nurses Association (NYSNA) nurses are protesting these decisions. They demand UVMH save local healthcare services and negotiate a fair contract.

Plattsburgh, New York

https://suncommunitynews.com/news/126391/nysna-nurses-to-speak-out-today-about-blood-center-closure-and-contracts/

The FDA has delayed a decision on Praxis Precision Medicines' rare epilepsy dr-g. The dr-g, relutrigine, treats SCN2A and SCN8A encephalopathies. The agency requires three additional months to review new sensitivity analyses. This pushes the decision date back to December 27. Analysts suggest FDA staff cuts likely contributed to this review extension.

https://www.fiercebiotech.com/biotech/praxis-faces-fda-delay-analysts-point-finger-agency-layoffs

https://medcitynews.com/2026/06/healthcare-moves-layoffs-retirement/

Optum is in talks with New York health systems to sell some orthopedic, general surgery and urology services.

https://www.healthcarefinancenews.com/news/optum-weighs-sale-new-york-specialty-practices

A reliable source mentioned that there will be a radical shift or shake up in healthcare and managed accounts. Getting rid of lots of dead weight employees and removal of on site techs and managers, as to reallocate them for other purposes. Information is coming in slow and in bits and pieces. Beware.

YesCare will permanently close its headquarters in Brentwood, Tennessee. This action will result in the layoff of 150 employees. The correctional facility care provider filed for Chapter 11 bankruptcy on May 8. This bankruptcy followed a default on a $50 million settlement. YesCare previously faced a $307.5 million jury verdict and a canceled $1 billion contract.

Brentwood, Tennessee

https://bhbusiness.com/2026/06/22/correctional-behavioral-health-provider-yescare-to-shutter-cut-150-jobs-after-bankruptcy/

Lee Specialty Clinic has cut most of its staff. This action followed significant funding reductions. Over 1,000 patients are now without care. These patients are individuals with disabilities. The layoffs threaten their access to essential services.

Louisville, KY

https://www.wdrb.com/news/wdrb-video/lee-specialty-clinic-layoffs-threaten-care-access-for-louisville-patients-with-disabilities/video_96ca3a2a-4b99-5352-ba5a-2fb8b9f990a6.html

A seniors home in South Tuxedo laid off 88 percent of its health-care aides. This mass layoff occurred on the same day staff received union certification. Residents were surprised by subsequent changes to the home care program. These changes have reportedly irked many residents. The situation raises concerns about care quality and labor relations.

Winnipeg, Manitoba

https://www.winnipegfreepress.com/breaking

I put this in a reply to another thread but thought it was something that might be it's own topic. VSP is not for the benefit of the employee, it's for the benefit of the Company, Board and Shareholders

Something I don't think anyone is considering, and a point that Centene would like to keep quiet is Unemployment benefit requires you to lose your job through "no fault of your own". (check your state) If you resign or take a standard severance package on your own, you generally won't qualify. So if you do take VSP you should plan on making that money go as far as possible since Unemployment is not going to be an option.

Asking the AI the question, how long someone in our position could expect to be out of work.

In 2026, laid-off professionals from health insurance giants like Centene or Molina can typically expect a job search to last 4 to 6 months. While the general timeline to secure a role can stretch to 5–6 months on average, specialized roles often take longer to fill. Navigating a job search after leaving a payer company involves several factors.

General Insurance Market Average: In the broader white-collar and insurance sector, the typical duration ranges from 3 to 6 months.

Healthcare Specifics: Because of strict credentialing, compliance requirements, and extensive application reviews, hiring processes within the healthcare sector can be slower, sometimes taking up to 8 months to fill specific roles.

Company-Specific Context: Centene (which offered Centene Offers Staff Buyouts Ahead of Potential Layoffs) and Molina (which filed WARN notices for their headquarters Molina Healthcare Layoffs 2026 - 156 Jobs Cut) have recently navigated structural downsizing. This means many former colleagues may be applying for similar roles at competing payers like CVS Health, Elevance Health, or UnitedHealth Group, temporarily increasing competition for equivalent roles.

does anyone have insight into how many H-contracts were not renewed due to policy changes?

please don't turn this into a political vitriol; I'm asking a serious question.

how much trouble is Centene in?

Baystate Health confirmed recent layoffs. The health system faces a $60 million budget shortfall. Patients are delaying non-urgent and elective medical procedures. Insurance changes, economic instability, and inflation are contributing factors. Cuts were made across Baystate Health and Health New England to reduce administrative layers.

Springfield, MA

https://www.westernmassnews.com/2026/06/22/baystate-health-addresses-reported-layoffs-amid-60-million-budget-shortfall/

I bet the corporation is going full on AI where UR and Care Coordination Nurses will be replaced. Instead of paying $70,000 + benefits to nurses. It is cheaper to use AI that work 24/7, no sick time, no PTO, no health benefits.
I can tell you l have seen AI approve claims and misread the clinical criteria that should have been denied. It will actually end up costing the corpration more money loss in the long run.
I see it on a daily basis.

Registered nurses at Baystate Franklin Medical Center expressed concern over recent layoffs. The workforce reductions affected employees across 22 departments and information technology. Nurses believe these cuts immediately impact patient care, citing reduced transport services. They question Baystate Health's resource allocation, noting high executive salaries. Nurses urge the organization to prioritize investment in frontline caregivers and local services.

Greenfield, Massachusetts

https://www.prnewswire.com/news-releases/baystate-franklin-nurses-express-concern-over-latest-layoffs-and-impact-on-local-patient-care-302804628.html

Asante health system is conducting layoffs while simultaneously recruiting new staff. CEO Tom Gessel explained this dual approach in an email to staff. He stated that the jobs being eliminated differ from those being filled. Business support roles are shrinking or going away entirely. The health system is recruiting 93 doctors and other medical staff.

Medford, Oregon

https://kobi5.com/news/asante-ceo-explains-why-its-hiring-during-layoffs-309665/

13 years as a nurse and scared of the unknown. Afraid the final pay out will be leas than the “expected” amount. Want to know what the “agreement” states before hand. Praying for everyone!

They seem to be growing and doing big things

Recent tech sector layoffs are causing a significant talent migration. Healthcare and manufacturing industries are actively absorbing these available workers. Tech-related hiring in healthcare increased by 8% compared to the previous year. Manufacturing also saw a 4% rise in tech-related hiring. Computer programmer is identified as the fastest-growing tech occupation.

https://stlawyers.ca/blog-news/tech-talent-industry-migration-june-2026/

Centene, a massive provider of government-sponsored healthcare, is navigating significant operational shifts under the Trump administration's health and budget policies. With major federal budget cuts to Medicaid and changes to the Affordable Care Act (ACA), the insurer has experienced steep membership losses and is actively undergoing corporate restructuring.Centene & The Affordable Care Act (Obamacare)Enrollment Drops: The expiration of enhanced ACA tax credits alongside Trump's budget packages has forced many consumers to confront higher premiums. Consequently, Centene—one of the nation's largest ACA marketplace insurers—lost over 2 million members, seeing its exchange enrollment drop from roughly 5.6 million to 3.6 million.Repricing and Layoffs: Because of sicker member pools and lost subsidies, Centene has been forced to reprice its health plans and offer companywide employee buyouts to cut overhead costs.

Things seem to be moving fast, anyone with more insider info/dates?

Era – Michael Neidorff (1996–2022)
Peak Quarterly Performance: $535 million (Q2 2021)
Annual Performance: Maintained profitability
Main Drivers: Pharmacy benefit manager legal settlements; COVID-19 utilization spikes

Era – Sarah London (2022–Present)
Peak Quarterly Loss: $6.6 billion (Q3 2025)
Peak Annual Performance: $6.7 billion net loss (Full-Year 2025)
Main Drivers: Federal Medicaid funding cuts; asset write-downs

Why is Sara London still the face of this company if she has cost the company Billions??

What’s the talk around here? I’m working remote so hard to gauge what’s going on in other departments here. Been here for more than 5 years.

Does anyone know or heard a number on how much Centene is trying to downsize? Ive seen articles but they are very hush hush about the target number... only that our membership has decreased by 6%.

I'm considering taking a job working with Rx health plan clients. Is this a good department to work in? Any information is greatly appreciated because I don't want to leave my job for a worse opportunity.

UnitedHealth Group managed to squeeze $12B in pure profit out of the healthcare system last year solely through value extraction. Like Sears, Circuit City, and other notable companies that found themselves in the trash bin of history, they are relying on their size to keep employers, providers, and members with them. At a time when healthcare costs are skyrocketing, they could be creating value in the healthcare system and — gasp! — earning some profit for themselves. Instead, they push out anyone who wants to innovate or question the dirty tactics and legally dubious actions. Hemsley was supposed to make it better. Instead, he’s made the company culture worse and is putting short term gain above not only UnitedHealth Group’s interests, but the already strained healthcare system.

Know this, there is an avoidable trajectory here; but persist down this road and some startup will eat your lunch just like Amazon — a nobody at the time — did to Sears and Circuit City. Change course before it’s too late. Hire some technology people that actually know technology. Hire ethical business leaders that will follow the law. UnitedHealth Group could be the reason the healthcare system gets better or the reason it crashed. Choose wisely.

not even subtle anymore just straight up cutting staff to post lower paying jobs (lvn vs rn), using vendors to take risk loss, cutting anything social work and replacing with an AI resource handout and most gross of all: eyes only on patients just out of the hospital. More to upcode, test, bill. Poor elderly...easy target. But lets have another townhall and discuss values. karma will eventually follow these strategy team vultures.

Sanitas, a clinic operator, laid off nearly 150 employees. These layoffs occurred in South Florida. The affected positions included medical assistants. Nurse practitioners were also among those impacted.

https://www.bizjournals.com/southflorida/news/2026/06/10/sanitas-warn-notice-south-florida.html

https://triblive.com/news/health-now/upmc-to-lay-off-200-mostly-non-medical-employees/

Layoffs have impacted specific industries like technology and media organizations. However, the broader job market continues to evolve with new demands. Demand remains strong in essential services, infrastructure development, and emerging technologies. Healthcare, artificial intelligence, skilled trades, and clean energy are key hiring sectors. This indicates a structural shift in the labor market, not a broad decline.

https://www.storyboard18.com/trending/jobs-hiring-now-where-opportunities-still-exist-despite-layoffs-across-industries-100518.htm

UPMC eliminated 200 positions. These cuts primarily affected non-clinical employees. Roles not directly facing members were also impacted. The health system posted higher operating revenue. However, it experienced a decline in revenue over expenses.

Pittsburgh, Pennsylvania

https://www.bizjournals.com/pittsburgh/news/2026/06/09/upmc-announces-layoffs-200-jobs.html

A couple denied coverage by UntedHealthcare their twins needing care in the NICU:
youtube.com/shorts/4VVE-GO4cbg?si=I0OWMbq7qc5jzxea