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Walmart Inc. said it will require its employees to use certain hospitals for costly spine surgeries, an effort to weed out unnecessary procedures and lower its health-care spending. The retailer has been trying since 2013 to encourage employees to undergo the surgeries at hospital systems known for their quality by offering to pay the full cost of the procedures and travel. But not all workers took Walmart up on the offer, and the retailer continued to pay for surgery elsewhere. (Evans, 11/14)

An ambitious startup that uses digital coaching and monitoring to try to help patients reverse type 2 diabetes, is making a big change to the way it makes money: Insurers and employers will now only pay Virta if its service works. Under Virta Health‘s new business model, announced on Wednesday, a health plan or employer will pay Virta a fee only if the patient is sufficiently engaged with its program after one month. The second payment comes after a year, only if patients lower their A1C, a measure of glucose in the blood, to a certain level determined on a case-by-case basis. (Robbins, 11/14)

One of the region's largest health employers is offering its more than 30,000 workers an unusual new benefit: free genetic tests. Jefferson, the combination of Jefferson Health and Thomas Jefferson University, told employees in mid-October that they could take a panel of genetic tests that flag people at higher risk for certain cancers and heart problems, as well as those who may metabolize medications in unusual ways that could make them candidates for different dosing or alternative drugs. (Burling, 11/13)

It had been a few years since Deanie Gauntlett's last mammogram, so when the X-ray showed a few unusual spots, her doctor ordered a follow-up diagnostic scan. The diagnostic test had that same uncomfortable, is-this-over-yet squish, but was different in one discernible way: its price tag. Though Gauntlett's screening mammogram was covered in full by her health-insurance plan, she owed a $65 co-pay for the diagnostic version. (Gantz, 11/14)

One of Wyoming’s largest coal companies cut health care benefits for its retired workers. In its third quarter report released October 25, Cloud Peak Energy said the move will provide it with $19.4 million in net income. It was announced to employees in August. The report also recounted an approximately 15 percent reduction in coal shipments compared to Q3 last year. Coal has been costlier to remove from the ground due to additional overburden from digging deeper. Cloud Peak explained it will provide benefits for the remainder of 2018 and give a lump sum contribution for 2019 benefits. It maintains an unfunded medical plan to eligible employees. (McKim, 11/13)