July 9, 2025
Reconciliation: Final Healthcare Provisions; Clarifying Tweaks to DPP Language and Overlooked Parts of Work Requirements
While we still agree with consensus about the negative bias towards hospitals and Medicaid insurers from the One Big Beautiful Bill Act (OBBA) signed into law last Friday, we note a few tweaks in the…
June 8, 2025
[HCA, THC, CYH, hospitals] White House Memo Adds Another Wrinkle to State-Directed Payment Programs in Medicaid
A new complication has arisen for hospitals [HCA, THC, CYH, ARDT, UHS, non-profit / municipally-backed facilities] – and to a lesser extent nursing homes, behavioral providers, and certain physicians – in the debate over payment…
June 3, 2025
Potential Targets for Change Among Healthcare Reconciliation Policies [THC, ARDT, CNC, MOH, ELV]
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…
May 12, 2025
Healthcare & Reconciliation: Worst Case Avoided
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…
April 29, 2025
[CNC, MOH, ELV, ARDT, UHS, CYH] Rising Risk of Medicaid Expansion Reforms in Reconciliation – Per-Capita Cap in the Lead
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,…
April 16, 2025
Trump Biopharma EO: Laying the Groundwork for Additional Hospital Reconciliation Targets [municipal-backed, HCA, THC, CYH, ARDT, UHS]
President Trump’s executive order (EO) on biopharma yesterday suggests the hospital sector is a larger target than administration officials have let on to date and seems to proffer more substance about additional ways to garner…
March 10, 2025
[OSCR, ELV, CNC, HCA, THC]: Targeting Obamacare Program Integrity in Rulemaking and Legislation
With all eyes focused on whether Congress will extend the enhanced ACA subsidies or let them lapse – we remain optimistic of a middle ground (revision and extension) – we caution investors about the headline…
March 5, 2025
Diving Deeper on Outlook for Hospital-Targeted Medicaid Reforms [ARDT, CYH, HCA, THC, UHS, municipal-backed hospitals]
We do not see any let-up any time soon on policy-related headwinds confronting hospitals [ARDT, CYH, HCA, THC, UHS, municipal-backed systems] as Congress hunts for palatable reconciliation savings. While many of the circulated Medicaid ideas,…
February 23, 2025
Medicaid Reform Watch: Still Early On – What to Watch for [CNC, MOH, ARDT, CYH, ENSG, ADUS]
As the budget resolution process and subsequent reconciliation strategy unfolds, Medicaid reforms that have posed headline enrollment and payment risk to Medicaid insurers [CNC, MOH, ELV], dual eligible insurers [UNH, HUM, ELV, CVS],hospitals [ARDT, CYH,…
November 4, 2024
Hospitals, ASCs, Physicians: Final CY25 Medicare Regs – Some Improvement, Some Disappointment, But Still Meeting Overall Expectations
Key Takeaways: CMS largely met reimbursement and policy expectations with its CY25 final Medicare payment rules for hospital outpatient departments (HOPDs), ambulatory surgery centers (ASCs) and physician firms. This is despite the improvement, relative to…