November 7, 2024
[OSCR, CNC, MOH, ELV] Enhanced Obamacare Exchange Subsidies – How Might They Stay?
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…
November 6, 2024
Lantheus (LNTH): Pylarify Post-Earnings, Still Expecting Cut
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…
November 6, 2024
Trump Winners and Losers
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…
November 5, 2024
Election Day: Political Potpourri
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…
November 4, 2024
UBER, LYFT on the Ballot
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,…
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…
November 4, 2024
[MDT, BSX, LIVN, CVRX] Medtech Medicare Rule Puts & Takes
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…
November 4, 2024
Lantheus (LNTH): Pylarify Hospital Rates Likely Down ~45%, Despite CMS Error
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…
November 3, 2024
[DVA, FMS, ARDX, American Renal] CY25 Medicare Dialysis Rates Offer Slight Improvement, But More Material Policy Headwinds Remain
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…
November 3, 2024
[AMED, EHAB, PNTG]: Final CY25 Medicare Home Health Rates In-Line and Foreshadow Future CMS Rate Pressures
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,…