CNC (US)


June 3, 2025

Potential Targets for Change Among Healthcare Reconciliation Policies [THC, ARDT, CNC, MOH, ELV]

By Beth Steindecker

As we await the Senate’s likely release of its reconciliation measure over the next week or so, we continue to expect the upper chamber to smooth the edges around some of the House-passed reconciliation bill’s…

Read More >>

May 21, 2025

Medicare Advantage: Ramping Up RADV Audits Clearly a Threat, But Does It Head Off Other Risks? [HUM, UNH, CVS, ELV, ALHC]

By Beth Steindecker

CMS’s announcement late Wednesday to turn the dial up on its risk-adjustment data verification (RADV) audits of Medicare Advantage (MA) contracts with an eye toward the entire landscape raises legitimate fears of recouping sizable past…

Read More >>

May 16, 2025

[CNC, MOH, ELV, OSCR, ARDT, THC, ACHC]: What’s Next for Healthcare in House’s Reconciliation Proposal

By Beth Steindecker

As we head into this weekend, below are our latest thoughts on the healthcare components of the reconciliation bill and where things stand and what changes may be in store. This afternoon’s sidelining of the…

Read More >>

May 13, 2025

[ELV, CNC, MOH, UNH, CVS] CMS Managed Care Provider Tax Proposal

By Beth Steindecker

Yesterday’s CMS proposal confirms our suspicion that the agency would seek to tighten state provider taxes – primarily those on managed care [ELV, UNH, CNC, MOH, CVS, CI, OSCR]– used to secure sizable federal Medicaid…

Read More >>

May 12, 2025

Healthcare & Reconciliation: Worst Case Avoided

By Beth Steindecker

The House Energy & Commerce Committee’s (E&C) reconciliation draft (text and summary) seems to largely align with our expectations regarding cuts / risks in Medicaid, Obamacare, and pharmacy benefit managers (PBM).  While there were still…

Read More >>

May 6, 2025

Optimism for Longer Term Resolution on Obamacare eAPTCs Remains but CMS Suggests Expiration [OSCR, CNC, MOH, ELV, HCA, THC]

By Beth Steindecker

Notwithstanding a recent CMS memo advising insurers to design their Obamacare plan bids assuming expiration of the enhanced premium subsidies at year-end, we remain optimistic that Congress ultimately settles on a middle ground (revision and…

Read More >>

April 29, 2025

[CNC, MOH, ELV, ARDT, UHS, CYH] Rising Risk of Medicaid Expansion Reforms in Reconciliation – Per-Capita Cap in the Lead

By Beth Steindecker

A week away from an anticipated House Energy and Commerce committee (E&C) hearing – and whose timing could easily slip – we do not see any release of pressure on Medicaid insurers [CNC, MOH, ELV,…

Read More >>

April 21, 2025

Medicaid Provider Tax Proposal: Too Little Info to Appropriately Size Threat [UHS, ARDT, MOH, CNC, ACHC, ENSG]

By Beth Steindecker

Today’s Office of Management and Budget (OMB) posting that it is reviewing a proposed CMS regulation about appropriate use of Medicaid provider taxes offers too little information to appropriately size the threat to hospitals (UHS,…

Read More >>

April 7, 2025

[HUM, ALHC, UNH, CNC, AGL, PRVA]: MA’s 5%+ Increase Met Our Expectations, But Longer-Term Coding and Part D Questions Remain

By Beth Steindecker

The final CY26 Medicare Advantage (MA) rate announcement met our previously-published optimistic expectations for a comfortable mid-single-digit YoY benchmark rate increase for MA insurers [HUM, ALHC, UNH, CVS, ELV, CNC] with CMS finalizing a 5.06% increase, largely…

Read More >>

April 3, 2025

Senate Budget Resolution & Healthcare Offsets

By Beth Steindecker

In response to yesterday’s Senate budget resolution proposal and the GOP’s assumption of the current policy baseline for scoring purposes, we think Congress continues to target Medicaid, Medicare hospital site neutrality, and PBM reforms as…

Read More >>