October 25, 2024
[THC, HCA, SGRY] Are the Winds of Medicare Site Neutrality Blowing Again?
Key Takeaways: The need for legislative savings to offset healthcare extenders during the lame duck puts a target on hospital outpatient departments (HOPDs) and ambulatory surgery centers (ASCs). While we doubt Congress will slash operators’…
October 24, 2024
Congressional Agenda and the Lame Duck Session
While the main focus of the upcoming lame duck session, beginning Nov. 12, is for Congress to address a FY25 government funding bill, we count no fewer than 15 other issues impacting the financial markets…
October 23, 2024
Lantheus (LNTH): Pylarify Medicare Rate Expectations
Key Takeaways: With CMS due to release its CY25 hospital outpatient rule ~Nov. 1, we expect it to finalize separate payments for diagnostic radiopharmaceuticals, though with slight odds to the impact being a ~45% reduction…
October 22, 2024
Potential Top Officials in a Trump Administration
While the presidential race is basically a tossup, we recently moved our odds to slightly favor Trump (see note here). With that in mind, we offer a comprehensive list of potential candidates for key Cabinet…
October 21, 2024
Managed Care Policy Puts and Takes
Key Takeaways: We remain optimistic about the long-term policy outlook for the managed care industry, despite the puts and takes for different business lines associated with the outcome of the upcoming elections on Nov. 5….
October 18, 2024
Trump by a Nose: Market Impacts of a GOP Sweep
While the outcome of the presidential election hovers around the 50/50 mark, we are moving our odds from a slight advantage for Vice President Kamala Harris to one for Donald Trump. Republicans are very likely…
October 17, 2024
[AMED, EHAB, PNTG]: History Suggests Slight Home Health Medicare Rate Increase, But Risk of a Cut Remains Unappreciated
Key Takeaways: Medicare reimbursement history suggests home health agencies are in store for a very low single-digit increase YoY in overall Medicare payments and their 30-day base rate when CMS issues its final CY25 payment…
October 16, 2024
Senate and House Election Update
We continue to give the Republicans a ~70% chance of winning the Senate even as two Republican incumbents, Sens. Ted Cruz (R-TX) and Rick Scott (R-FL) have recently moved into our top 10 Senate races…
October 15, 2024
[INSP, LIVN, NYXH] Sleep Apnea: Codes, Coverage, & Value Accretion
Key Takeaways: We suspect Inspire Medical’s (INSP) next-generation Inspire V implant procedure can secure Medicare coverage / reimbursement under the legacy product’s billing code [CPT 64582: $816], where the shorter procedure time should increase physicians’…
October 14, 2024
Trump Tariff Scenarios
We want to offer a competing view to some comments in a recent CNBC.com article highlighting that tariffs by President Trump may come sooner than expected if he wins in November. We, in fact, think…