Healthcare Payers / Providers


November 19, 2024

Healthcare Extenders in FY25 Spending Bill: What Is Likely, Unlikely or Toss-Up?

By Beth Steindecker

With likelihood growing that Congress focuses on emergency spending and a short-term continuing resolution funding the government into Q1 next year during this lame duck period, we expect that translates to Congress punting on nearly-annual,…

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November 14, 2024

(ENSG, PACS, OHI, CTRE, SBRA) Nursing Home Relief from Minimum Staffing Rule Still Likely But as Part of FY25 Spending Bill

By Beth Steindecker

Key Takeaways:  We still expect nursing homes and their post-acute care REIT landlords to secure a reprieve from the Biden CMS rule imposing minimum nurse staffing requirements on these long-term facilities. However, we see that…

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November 12, 2024

(UNH, AMED) Reported Threat of DOJ Complaint Brings Overhang and Extended Invitation to Negotiate

By Beth Steindecker

Key Takeaways: We continue to expect that UNH’s acquisition AMED will be completed, despite reports that the DOJ is preparing to sue to block the $3.3B deal on antitrust concerns. While clearly a setback, this…

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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 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 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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October 25, 2024

[THC, HCA, SGRY] Are the Winds of Medicare Site Neutrality Blowing Again?

By Beth Steindecker

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’…

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October 21, 2024

Managed Care Policy Puts and Takes

By Beth Steindecker

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….

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October 17, 2024

[AMED, EHAB, PNTG]: History Suggests Slight Home Health Medicare Rate Increase, But Risk of a Cut Remains Unappreciated

By Beth Steindecker

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…

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