THC (US)

We view today’s federal court ruling broadening medical frailty exemptions from the Medicaid expansion work and community engagement requirements as incrementally favorable for Medicaid insurers [CNC, MOH, ELV] and acute care and behavioral hospitals [HCA,…

We view CMS’s 2028 ACA pre-eligibility verification proposal, released late Friday, as an incremental risk to exchange insurers [OSCR, CNC, ELV] and hospitals and dialysis centers [HCA, THC, ADRT, DVA, FRE.DE], rather than a new…

Despite lopsided stakeholder opposition, we continue to expect CMS to finalize largely as initially sought its CY27 proposal cutting Medicare reimbursement for 337 common non-contrast imaging procedures at grandfathered off-campus hospital outpatient departments (HOPDs) while…

With CMS likely to release its final CY27 Medicare Hospital Outpatient Prospective Payment System (OPPS) rule in early November, we continue to expect a substantial cut to Medicare payment for 340B-acquired drugs administered in participating…

This afternoon’s White House announcement of additional Obamacare anti-fraud actions does not change the direction of the ACA reset underway over the past year, nor our expectations for 2027 and 2028. While the actions appear…

With the November elections less than two months away, we assess how different congressional outcomes could reshape the healthcare legislative agenda for hospitals, dialysis centers, value-based care (VBC) providers, skilled nursing facilities (SNFs), post-acute care…

The FY27 Medicare inpatient hospital (IPPS) final rule was modestly more favorable than the proposal for acute care hospitals [HCA, THC, CYH, ARDT, UHS, MPT, muni-backed systems], increasing CMS’s projected aggregate payment increase by $1B….

We think the July 28 federal court hearing on the 25 states and the District of Columbia’s request to preliminarily enjoin CMS’s interim final rule (IFR) for Medicaid community engagement (CE) requirements for the Medicaid…

For-profit hospitals [THC, HCA, CYH, ARDT, UHS] received some expected positive news – though the magnitude surprised us – in the CMS’s proposed CY27 hospital outpatient prospective payment system (OPPS) rule. Ambulatory surgery centers (ASCs)…

Last week’s ACA-related court ruling permanently, which enjoined key portions of the CY25 Obamacare regulation, may initially reassure insurers [OSCR, CNC, ELV] and hospitals [HCA, THC, CYH, UHS, ARDT] about certain enrollment-related program integrity headwinds….