HHS restructures for the DOGE era
A massive HHS restructuring announced March 27 could have an indirect impact on providers. Secretary Robert F. Kennedy Jr. announced HHS would reduce its workforce by 10,000 FTEs, part of a 25% downsizing from 82,000 to 62,000, with previously announced early retirements and buyouts also factoring into the count. The department’s agencies will be pared…
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What DOGE’s actions mean for U.S. healthcare
The federal government’s perennial search for fraud, waste and abuse (FWA) in its healthcare spending has become a key focus of the Trump administration and could presage deeper financial changes. The gathering storm has left health systems scrambling to prepare for the major financial headwinds that could come from the initiatives. President Donald Trump has…
Hospitals’ Medicaid appeal options may be more limited after court ruling
A recent appeals-court ruling restricts options for hospitals seeking to use litigation to ensure prompt Medicaid payment. The March 14 ruling by the U.S. Court of Appeals for the Seventh Circuit in Saint Anthony Hospital v. Whitehorn essentially states that hospitals do not have a legal right to sue state Medicaid programs under federal law…
Hospital financial metrics suggest need for added Medicare payment, MedPAC says
Hospital metrics suggest FY26 Medicare payment should increase by more than what’s provided in the statutory formula, according to a formal recommendation by the Medicare Payment and Advisory Commission (MedPAC). Beneficiary access to care appeared to be strong in 2023, the latest year for which data was available, but quality indicators were mixed, according to…
6 steps for defining hospital finance to meet today’s pressures and patient needs
Finance functions do not typically make the list of innovations being pursued at hospitals and health systems. In fact, given the stereotype of finance teams having a laser focus on cutting costs and finance leaders being the “no” people, this function is at times perceived as a barrier to innovation. While finance teams must necessarily…
GLP-1 drugs present an uncertain opportunity for healthcare and the nation
The wave of weight-loss drugs being prescribed to patients across the country may be behind a new era in obesity treatment. The drugs not only could be an appropriate treatment for millions of Americans but also could disrupt the industry’s existing bariatric surgery efforts and have other far-reaching consequences. The soaring demand for GLP-1 drugs,…
Trump administration keeps up the fight on 340B, Inflation Reduction Act concerns
The issue of drug pricing is proving to be an area of harmony and continuity between the Trump and Biden administrations, at least for now. In recent days, the Trump administration moved to defend the Biden administration’s stance in opposition to drug manufacturers that are looking to offer 340B Drug Pricing Program discounts through a…
Trump administration charts a new course at the Center for Medicare & Medicaid Innovation
The Trump administration has started to streamline the portfolio of alternative payment models sponsored by the Center for Medicare & Medicaid Innovation (CMMI), recently announcing the early expiration of four models. CMS said the decision resulted from an assessment of whether the models could meet statutory criteria to be expanded into the full Medicare program.…
Dr. Oz describes changes he would bring to Medicare, Medicaid as CMS administrator
April 3 update: The Senate formally confirmed Oz as CMS administrator via a 53-45 party-line vote. He is expected to be sworn in and begin work within days. March 25 update: The Senate Finance Committee voted 14-13 along party lines to send Oz’s nomination to the full Senate for a formal confirmation vote. Democrats voting…