May 21, 2026
CMS Proposal Pushes DPP Restrictions but Near-Term Impacts on Hospitals, Nursing Homes Still Limited Due to Grandfathering
CMS’s long-awaited proposed rule implementing the One Big Beautiful Bill’s (OBBB) restrictions on state directed payment programs (DPPs) pushes the envelope a bit further than the statute itself, particularly for hospitals [HCA, THC, CYH, UHS,…
May 18, 2026
Hospitals: Latest CMS Batch of Approved Hospital-Specific DPPs [HCA, CYH, THC]
Two long-anticipated hospital-specific Medicaid state directed payment programs (DPPs) in Florida and Indiana, benefitting HCA, CYH, and THC and other hospitals in those states, appear to have been approved by CMS in recent weeks, according…
May 1, 2026
Medicaid Work Requirements: Despite Certain Restrictive Actions, Overall State Flexibility Likely Limits Risk [CNC, MOH, HCA, THC, UHS]
A wave of state actions (AR, IA, ID, IN, MO, MT, NC, NE, NH) on Medicaid community engagement requirements (aka work requirements), spanning both accelerated implementation like today’s launch in NE and in some cases,…
April 12, 2026
Inpatient Hospitals: Slight Medicare Growth for FY27, But Future Holds Mandatory Bundles and Less Automatic Bonuses for New Tech [HCA, THC, CYH, ENSG, PACS, PNTG]
FY27 Medicare reimbursement proposals for inpatient hospitals [HCA, THC, CYH, ARDT, UHS, MPT, muni-backed systems] largely met expectations for a smaller increase, versus FY26, with most changes appearing formulaic and math-based rather than policy-led. Despite…
March 12, 2026
Hospitals: Latest CMS Batch of Approved Hospital-Specific DPPs [HCA, THC, UHS]
CMS’s latest approvals for hospital-specific Medicaid state directed payment programs (DPPs) provide incremental positive news for HCA, THC and UHS due to their footprint in certain states (Georgia, Michigan, Kentucky, and Nevada) where CMS recently…
February 23, 2026
Hospital DPPs: Less Dependable, Though Still Relevant Post-OBBB: Questions of Where and How Much Remain? [HCA, THC, CYH, ARDT, UHS, MPT, SGRY, govt hospitals]
While Medicaid funding from state directed payment programs (DPPs) cannot be relied upon as much a key revenue driver – and has received less attention on recent earnings calls – these incremental dollars are still…
February 10, 2026
Ongoing Obamacare Market Evolution: Lower-Cost Plans Mix Shift Amidst Design Changes and Program Integrity Focus [OSCR, CNC, HQY, HCA, CYH]
Recent Obamacare developments (ACA proposal, House committee subpoenas, and OSCR’s earnings) reinforce this market’s durability and clear directional shift toward more-streamlined, lower-cost coverage and greater encouragement of enrollees to be more involved in their healthcare,…
January 16, 2026
MedPAC Thoughts, Congress Unlikely to Listen
We expect the Medicare Payment Advisory Commission’s (MedPAC) FY/CY27 provider payment recommendations to meet the same fate as in prior years: largely ignored by Congress, though selectively cited by CMS to justify future regulatory tightening…
January 13, 2026
ACA Subsidy Deal Delayed, Not Derailed; 55% Odds Still Intact [OSCR, CNC, THC, CYH, DVA, FRE.DE]
Despite reports this afternoon that a bipartisan compromise on enhanced Obamacare premium subsidies will not be ready this week and is now expected to slip to the week of January 26, we continue to expect…
December 17, 2025
Obamacare Subsidy Developments: Lots of Movement but Still in Same Place for Now; Path Remains for Subsidy Deal in 1Q
Today’s news that four House Republicans joining House Minority Leader Hakeem Jeffries’ (D-NY) discharge petition for a straight three-year extension of the enhanced Obamacare subsidies – and with House GOP leadership narrowly passing its own…