January 22, 2025
[OSCR, CNC, HCA, THC, WELL] Optimistic on ACA Subsidies, But Watching Other Risks
While investors in insurers and providers seem most concerned about the fate of the expiring enhanced ACA subsidies, which we still expect to be revised but ultimately extended later this year, other – albeit smaller…
January 17, 2025
MedPAC Provider Recs Likely to Be Ignored in Favor of Savings Targets Like Site Neutrality, Medicaid, Rule Repeals
We doubt Medicare Payment Advisory Commission’s (MedPAC) FY/CY26 Medicare payment recommendations for home health agencies, inpatient rehab facilities, skilled nursing facilities, hospices, dialysis centers, hospitals, and physician offices, which were voted on Thursday in nearly…
December 13, 2024
[PBMs, Hospitals, Docs] Healthcare Extenders: State of Play
While Republicans and Democrats are trying to hash out a healthcare extenders package to add to a short-term government funding measure that needs to be taken up and passed by next Friday, we ascribe just…
November 25, 2024
[CNC, MOH, ELV, THC, HCA, CYH, UHS]: Growing Overhang from Medicaid Legislative Reforms, But Watch for Vulnerable GOP Pushback
Key Takeaways: The risk overhang from potential Medicaid reforms to managed care organizations, hospitals, behavioral facilities, and other providers focused on these low-income enrollees will likely grow as the Trump administration staffs up and Congress…
November 19, 2024
Healthcare Extenders in FY25 Spending Bill: What Is Likely, Unlikely or Toss-Up?
With likelihood growing that Congress focuses on emergency spending and a short-term continuing resolution funding the government into Q1 next year during this lame duck period, we expect that translates to Congress punting on nearly-annual,…
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…
October 25, 2024
[THC, HCA, SGRY] Are the Winds of Medicare Site Neutrality Blowing Again?
Key Takeaways: The need for legislative savings to offset healthcare extenders during the lame duck puts a target on hospital outpatient departments (HOPDs) and ambulatory surgery centers (ASCs). While we doubt Congress will slash operators’…