April 6, 2026
Medicare Advantage: CY27 Final Rates Provide Expected Relief, Longer-Term Risks Punted or Persist [HUM, ALHC, UNH, CVS, ELV, CNC, PRVA, ASTH, EVH]
The final CY27 Medicare Advantage (MA) rate announcement, reflecting a net 2.48% YoY benchmark increase, landed within our expectations and alleviates some of the near term-pressure on MA insurers [HUM, ALHC, UNH, CVS, ELV, CNC]…
April 5, 2026
SNFs, IRFs, IPFs: Proposed Increases in Range, But Future Risks Medicare Lurk for SNFs and IRFs [ENSG, PACS, SBRA, OHI, LTC, CTRE, EHC, SEM, UHS, ACHC]
FY27 Medicare reimbursement proposals for skilled nursing facilities [ENSG, PACS] and related REITs [SBRA, OHI, LTC, CTRE], inpatient rehab facilities (IRFs) [EHC, SEM, Kindred]and inpatient psych facilities (IPFs) [UHS, ACHC] were broadly in-line with our…
April 5, 2026
Hospices: Proposed FY27 Increase In-Line but Softer Than FY26, Program Integrity Risk Builds [CHE, ADUS, PNTG, EHAB, BTSG, AVAH, Gentiva, Compassus, Elara]
FY27 Medicare reimbursement proposal for hospices [CHE, ADUS, PNTG, EHAB, BTSG, AVAH, Gentiva, Compassus, Elara] matched our expectations, reflecting a smaller aggregate increase versus FY26 but consistent with the statutory formula. While modest upside is…
March 30, 2026
Hospitals, Insurer, Home Care, HSAs, PBMs: What Is a Realistic Federal Healthcare Savings Target in Reconciliation?
As the prospects have risen for another budget reconciliation bill, so has the risk for another legislative round of healthcare spending cuts, pressuring insurers, hospitals and home care and hospice agencies as a partial pay-fors…
March 24, 2026
Hospitals, IRFs, SNFs, Hospices, IPFs, LTCHs: Expectations for FY27 Medicare Rate Proposals
With CMS set to release in the coming weeks FY27 Medicare payment proposals for inpatient providers (inpatient hospitals, hospices, inpatient rehab facilities, skilled nursing facilities, inpatient psych facilities, and long-term care hospitals), we expect most…
March 16, 2026
Medicare Advantage: Final CY27 Rates Expectations of 1%-3% Increase [HUM, ALHC, UNH, CVS, ELV, CNC, PRVA, ASTH, EVH, DVA, FRE.DE]
We continue to expect CMS’s final CY27 rate announcement for Medicare Advantage (MA) insurers [HUM, ALHC, UNH, CVS, ELV, CNC], affecting their contracted value-based care providers [PRVA, ASTH, EVH], to produce a low single-digit increase…
March 12, 2026
Hospitals: Latest CMS Batch of Approved Hospital-Specific DPPs [HCA, THC, UHS]
CMS’s latest approvals for hospital-specific Medicaid state directed payment programs (DPPs) provide incremental positive news for HCA, THC and UHS due to their footprint in certain states (Georgia, Michigan, Kentucky, and Nevada) where CMS recently…
March 10, 2026
Medicaid Expansion Levels – Thoughts on Potential 2027 Enrollment Declines [MOH, CNC, ELV]
With Medicaid insurers [MOH, CNC, ELV] projecting more muted Medicaid enrollment changes for 2026 compared with the sizable attrition during the post-pandemic Medicaid unwinding – and little guidance on what comes next – investors are…
March 2, 2026
CMS’s ELV Sanction Warnings Sends MA Risk Adjustment Message, But Does It Up the Ante on a Broader Crackdown?
CMS’s warning letter against ELV of potential sanctions on new Medicare Advantage (MA) enrollment underscores another enforcement lever the agency can deploy to curb improper risk adjustment behaviors and overpayments. As the agency remains committed…
February 23, 2026
Hospital DPPs: Less Dependable, Though Still Relevant Post-OBBB: Questions of Where and How Much Remain? [HCA, THC, CYH, ARDT, UHS, MPT, SGRY, govt hospitals]
While Medicaid funding from state directed payment programs (DPPs) cannot be relied upon as much a key revenue driver – and has received less attention on recent earnings calls – these incremental dollars are still…