June 8, 2025
[HCA, THC, CYH, hospitals] White House Memo Adds Another Wrinkle to State-Directed Payment Programs in Medicaid
A new complication has arisen for hospitals [HCA, THC, CYH, ARDT, UHS, non-profit / municipally-backed facilities] – and to a lesser extent nursing homes, behavioral providers, and certain physicians – in the debate over payment…
May 12, 2025
Healthcare & Reconciliation: Worst Case Avoided
The House Energy & Commerce Committee’s (E&C) reconciliation draft (text and summary) seems to largely align with our expectations regarding cuts / risks in Medicaid, Obamacare, and pharmacy benefit managers (PBM). While there were still…
April 29, 2025
[CNC, MOH, ELV, ARDT, UHS, CYH] Rising Risk of Medicaid Expansion Reforms in Reconciliation – Per-Capita Cap in the Lead
A week away from an anticipated House Energy and Commerce committee (E&C) hearing – and whose timing could easily slip – we do not see any release of pressure on Medicaid insurers [CNC, MOH, ELV,…
April 21, 2025
Medicaid Provider Tax Proposal: Too Little Info to Appropriately Size Threat [UHS, ARDT, MOH, CNC, ACHC, ENSG]
Today’s Office of Management and Budget (OMB) posting that it is reviewing a proposed CMS regulation about appropriate use of Medicaid provider taxes offers too little information to appropriately size the threat to hospitals (UHS,…
April 16, 2025
Trump Biopharma EO: Laying the Groundwork for Additional Hospital Reconciliation Targets [municipal-backed, HCA, THC, CYH, ARDT, UHS]
President Trump’s executive order (EO) on biopharma yesterday suggests the hospital sector is a larger target than administration officials have let on to date and seems to proffer more substance about additional ways to garner…
March 5, 2025
Diving Deeper on Outlook for Hospital-Targeted Medicaid Reforms [ARDT, CYH, HCA, THC, UHS, municipal-backed hospitals]
We do not see any let-up any time soon on policy-related headwinds confronting hospitals [ARDT, CYH, HCA, THC, UHS, municipal-backed systems] as Congress hunts for palatable reconciliation savings. While many of the circulated Medicaid ideas,…
January 28, 2025
[CNC, MOH, ARDT, UHS, ENSG, ADUS]: Medicaid Funding & Best Bet on OMB Funding Memo
We lean against yesterday’s OMB directive for temporarily pausing federal funding for grants, loans and programs applying largely to Medicaid’s payments to the states for Medicaid insurers (CNC, MOH, ELV, UNH, CVS) or for reimbursements…
November 25, 2024
[CNC, MOH, ELV, THC, HCA, CYH, UHS]: Growing Overhang from Medicaid Legislative Reforms, But Watch for Vulnerable GOP Pushback
Key Takeaways: The risk overhang from potential Medicaid reforms to managed care organizations, hospitals, behavioral facilities, and other providers focused on these low-income enrollees will likely grow as the Trump administration staffs up and Congress…
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’…