Healthcare Payers / Providers

With the briefing in a federal lawsuit having concluded and Congress on the hunt for legislative savings, the question is when, not if, CMS’s minimum nurse staffing rule is killed, eliminating the overhang and potential…

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…

While investors in insurers and providers seem most concerned about the fate of the expiring enhanced ACA subsidies, which we still expect to be revised but ultimately extended later this year, other – albeit smaller…

We doubt Medicare Payment Advisory Commission’s (MedPAC) FY/CY26 Medicare payment recommendations for home health agencies, inpatient rehab facilities, skilled nursing facilities, hospices, dialysis centers, hospitals, and physician offices, which were voted on Thursday in nearly…

UnitedHealth’s (UNH) comments during its 4Q and full year 2024 earnings call about changes its it taking to head off certain public policy concerns (PBMs, prior authorization/claim denials) seem like the company is in catch-up…

The FTC’s unanimously-supported release of its second interim report on pharmacy benefit managers (PBMs), focused on specialty drug dispensing at affiliated pharmacies [CVS, CI, UNH] that generated an extra $7.3B in revenue over six years,…

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…

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…

Following Tuesday night’s release of a short-term continuing resolution (CR) funding the government through March 14, we outline some key differences from previously-reported iterations of the healthcare extenders package, involving PBMs [CI, CVS, UNH, ELV],…

While Republicans and Democrats are trying to hash out a healthcare extenders package to add to a short-term government funding measure that needs to be taken up and passed by next Friday, we ascribe just…