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November 7, 2024

[OSCR, CNC, MOH, ELV] Enhanced Obamacare Exchange Subsidies – How Might They Stay?

By Beth Steindecker

Key Takeaways: We think investors exposed to insurers in the ACA exchange markets (OSCR, CNC, MOH, ELV) are underestimating the odds that the next Congress temporarily extends some of the enhanced Obamacare subsidies to focus…

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November 6, 2024

Lantheus (LNTH): Pylarify Post-Earnings, Still Expecting Cut

By John Leppard

We continue to believe that CMS is likely to issue a revised hospital outpatient payment rate for Lantheus’ (LNTH) Pylarify in the coming days / weeks that would reduce the Medicare per service rate by…

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November 6, 2024

Trump Winners and Losers

By Joe Lieber

A Trump victory has wide ramifications for taxes, trade, M&A as well as for many various sectors like healthcare, infrastructure, consumer, and others. Republicans have won back the Senate and, as of publication, the House…

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November 5, 2024

Election Day: Political Potpourri

By Joe Lieber

We continue to believe Trump has the slightest of edges in the election. The GOP is likely to win three Senate seats, giving them a 52-48 advantage, and the House is very close with a…

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November 4, 2024

UBER, LYFT on the Ballot

By Joe Lieber

We continue to expect that a Massachusetts ballot measure affecting Uber (UBER) and Lyft (LYFT) is very likely to pass, but we believe it shows that the gig companies are winning the regulatory battle.    Meanwhile,…

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November 4, 2024

Hospitals, ASCs, Physicians: Final CY25 Medicare Regs – Some Improvement, Some Disappointment, But Still Meeting Overall Expectations

By Beth Steindecker

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…

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November 4, 2024

[MDT, BSX, LIVN, CVRX] Medtech Medicare Rule Puts & Takes

By John Leppard

Key Takeaways: We appear to have run the table with our pre-rule expectations [here, here] following CMS’s release Friday of its CY25 hospital outpatient payment rule, which includes the following company-specific implications: MDT & Otsuka…

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November 4, 2024

Lantheus (LNTH): Pylarify Hospital Rates Likely Down ~45%, Despite CMS Error

By John Leppard

Key Takeaways: Consistent with our pre-rule expectations [see here], hospital outpatient rates for LNTH’s Pylarify appear set for a ~45% YoY decline in CY25 following CMS’s final rule. While enactment of “separate payments” for all…

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November 3, 2024

[DVA, FMS, ARDX, American Renal] CY25 Medicare Dialysis Rates Offer Slight Improvement, But More Material Policy Headwinds Remain

By Beth Steindecker

Key Takeaways:  CMS offered slight improvements in dialysis center payments, relative to this summer’s proposal, in its CY25 final rule released Friday, but we do not view this as material for providers or addressing other…

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November 3, 2024

[AMED, EHAB, PNTG]: Final CY25 Medicare Home Health Rates In-Line and Foreshadow Future CMS Rate Pressures

By Beth Steindecker

Key Takeaways:  Changes to Medicare home health payments live up to expectations of a minimal increase, but with future negative adjustments following CMS’s release of its CY25 final rule Friday. As we wrote in mid-October,…

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