January 11, 2025
[HUM, UNH, CVS, ELV, ALHC] CY26 Medicare Advantage Rates: Likely Upswing in the Final
CMS’s Friday release of the CY26 Advance Notice (AN) for Medicare Advantage (MA) insurers [HUM, UNH, CVS, ELV, ALHC, CLOV, CNC] came in better than our net YoY benchmark expectations with a proposed net increase…
January 10, 2025
Medtronic (MDT): Renal Denervation Coverage Read-Through?
This morning’s opening of a Medicare National Coverage Determination (NCD) for privately-held Impulse Dynamics’ Optimizer System bolsters our view that coverage for renal denervation (RDN) systems [Medtronic (MDT), Otsuka / ReCor (4578.JT)] is unlikely to…
January 10, 2025
2025 Tax Primer: Extending the Trump Tax Provision et al.
We continue to believe that Congress is likely to pass a massive $5 trillion- plus tax bill that would extend the 2017 Trump tax cuts, known as the Tax Cut and Jobs Act (TCJA). We…
January 8, 2025
Conference Policy Prep Pack: Healthcare Providers & Insurers
With a handful of healthcare provider and insurance companies headed to San Francisco next week for a key investor conference, below we provide a set of significant policy-related questions we would like to see management teams address…
January 8, 2025
Exact Sciences (EXAS): Cologuard Plus Coverage Questions
A Jan. 1 update to CMS’s colorectal cancer (CRC) screening guide appears to support our view that Medicare coverage of EXAS’ Cologuard Plus (0464U: $592) and its 16% rate premium over the legacy version (81528:…
January 6, 2025
Conference Policy Prep Pack: Devices, Diagnostics, & Tools
With medical device, equipment, diagnostics, and life science tools (LST) companies set to descend on San Francisco next week for a key investor conference, below we provide a set of significant policy-related questions for clients…
January 6, 2025
DC Quick Takes: Reconciliation (Tax bill), Immigration (GEO, CXW) and Cabinet Hearings
While most of the action in DC this week will be ceremonial with Congress certifying the election of President Trump and Vice President JD Vance, much of the talk in town will be on the…
January 2, 2025
DC Quick Takes: Speaker’s Vote, the Debt Limit and Healthcare Extenders
We think House Speaker Mike Johnson (R-LA) faces uphill odds on retaining his Speaker’s role. It’s close to a tossup but if Johnson is re-elected, it isn’t likely to be on the first ballot. Keep…
December 20, 2024
Government Shutdown Update and What the Divide Might Mean for the Next Congress
When Speaker Mike Johnson (R-LA) initially pulled his negotiating continuing resolution (CR) with the Democrats, our view was that a government shutdown was unlikely. Yes, we might have technically had one over the weekend, but…
December 20, 2024
EW: Tricuspid Coverage Positive, With Some Caveats
We view CMS’s draft coverage policy for transcatheter tricuspid valve replacement (TTVR) as incrementally more positive for EW’s Evoque relative to our initial expectations. The lack of facility / operator volume thresholds will likely allow…