Healthcare Payers / Providers

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…

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…

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,…

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’…

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….

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…

Key Takeaways: Nursing homes and their post-acute care REIT landlords have legal and legislative reasons to be hopeful about efforts to kill CMS’ minimum staffing rule, but we are skeptical they will secure a full…

Key Takeaways: As we expected, CMS’s release of the CY25 Medicare Advantage (MA)/Part D star ratings continues to limit program “largesse,” making bonus awards more selective and ratings harder to maintain YoY. For CY25, fewer…

We are skeptical of enactment for Vice President Kamala Harris’ campaign proposal to add a Medicare in-home care benefit, along with vision and hearing aid coverage, even if she were to win (our base case)…

Key Takeaways: Developments involving Humana (HUM) and UnitedHealth (UNH) last week show CMS remains intent on limiting the financial “largesse” insurers receive in its Medicare Advantage (MA)/Part D (PDP) star rating quality bonus program by…