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…
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 15, 2026
Trump’s Great Healthcare Plan – We’ve Seen and Heard It Before
President Trump’s long-teased “Great Healthcare Plan”, released this morning, does little to meaningfully move the needle on healthcare redesign or cost containment beyond our prior expectations for legislative action affecting Obamacare insurers, non-ACA managed care…
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…
December 4, 2025
ACA Situation Stuck in Place but We Remain Optimistic of Eventual HIX Deal with a Slipping Timeline
The recent fits-and-starts for around a compromise to avert expiration of the ACA enhanced premium tax credits (eAPTCs) at year-end unsurprisingly remains stalled, with no meaningful concessions from either side’s leaders. As we head into…
November 24, 2025
ACA HIX Fix: Enactment Odds Improve But Details TBD [OSCR, CNC, ACHC, THC, CYH, UHS, DVA, HQY]
Media reports (here, here, here) indicate that an ACA compromise may be imminent, with President Trump reportedly offering to support extension of the enhanced premium tax subsidies (with limitations) while channeling a portion into health…
November 23, 2025
ASC Wins in Final CMS Rate Rule, Slight Hospital Wins but Lingering Concerns
Ambulatory surgery centers (ASCs) [SGRY, AmSurg, THC, HCA, UNH] secured some policy wins in the final CY26 Medicare outpatient prospective payment system (OPPS) rule, consistent with the July proposal (notably a broadened covered procedure list,…
November 17, 2025
CMS Provider Tax Guidance: More Details, But Not Necessarily Stricter or More Aggressive Interpretation [ARDT, CYH, HCA, THC, UHS, CNC, MOH, ELV]
CMS’s preliminary guidance to states on its interpretation of the One Big Beautiful Bill’s (OBBB) Medicaid provider tax provisions does not appear to tighten the screws on states, and thereby threaten hospitals [ARDT, CYH, HCA,…