A new Trump executive order sets the stage for lower 340B payments
Hospitals can anticipate a regulatory effort to lower the Medicare payments they receive for purchases of Part B drugs through the 340B Drug Pricing Program. President Donald Trump on April 15 signed a wide-ranging executive order on drug costs, and one of the provisions directs HHS to conduct a survey of hospital acquisition costs for…
Medicare’s FY26 inpatient hospital proposed rule includes a restrained payment update
The Trump administration’s first set of Medicare proposals establishing inpatient payment rates continued what hospital advocates describe as a long-term trend in which the annual update is lacking. A 3.2% increase in the market basket would be reduced by a 0.8% statutory productivity adjustment, according to the newly released FY26 proposed rule. Hospitals that meet…
Amid market turbulence, hospitals strive for stability in their financials
At a time of potentially significant headwinds for investment returns, operational performance becomes even more pivotal for hospitals. Recent financial results are mixed as indicators of whether not-for-profit (NFP) hospitals can readily absorb large investment-income losses. Operating margin plateaued for the sector in February, according to Strata Decision Technology’s latest monthly report. Median year-to-date margin…
How the 340B remedy payments will affect upcoming Medicare Advantage payment rates
Hospital advocates found reason for concern in a narrow aspect of the Medicare Advantage (MA) final payment rate notice for 2026. With health plans lauding the average 5.06%, $25 billion revenue increase they’re projected to reap in the upcoming year, hospitals may wonder about adverse impacts from an applied reduction in CMS’s calculation of the…
Hospitals brace for impact of tariffs (updated article)
Note: The article was updated where noted after President Donald Trump’s April 8 remark about upcoming pharmaceutical tariffs. The headline was also updated after originally stating: “Tariff impact on hospitals may be relatively restrained in the short term” Sweeping tariffs announced over the last week by the Trump administration appear to have spared the healthcare…
Final 2026 rule for MA, Part D leaves out proposed GLP-1 drug coverage
The Trump administration’s final rule setting policy and technical changes for Medicare Advantage (MA) in 2026 did not carry forward a proposal regarding GLP-1 drug coverage, but key provider-focused provisions were retained. The rule, which is scheduled for formal publication April 15 and also sets 2026 Medicare Part D policies, excludes a Biden administration proposal…
Questions about Medicaid cuts are unresolved in latest budget reconciliation blueprint (updated)
Note: This article was updated April 10 with the latest news on steps forward in the reconciliation process and a rollback of a specific set of funding by CMS. As released this week, the Senate’s latest budget reconciliation blueprint provides few answers about the impact a final bill could have on federal healthcare spending, in…
5 keys to enhancing automation, expanding capacity and improving efficiency to reduce costs
Healthcare organizations face unrelenting financial pressures, with rising costs and shrinking margins. Dealing with reimbursement challenges, they face an uphill battle to maintain a profitable revenue cycle. This leaves no room for inefficiency. There is a way out, but healthcare leaders must look beyond traditional methods to automation to expand capacity and improve operational efficiency.
New processes for Medicare patient-status appeals have arrived, with implications for finance teams (updated)
If they have not done so already, hospitals should establish processes for responding to new regulations concerning status-appeal rights for Medicare beneficiaries. The regulations have taken effect in early 2025 after being published in an October 2024 final rule. That rule stemmed from the outcome of litigation that had begun 15 years earlier. Per the…
HFMA’s Nelson receives AONL Honorary Member Award
Updated April 4, 2025 Todd Nelson, chief partnership executive and director of healthcare finance policy for HFMA, was selected to receive the American Organization for Nursing Leadership’s Honorary Member Award. The award recognizes Nelson for his support of AONL’s mission and his contribution to advancing healthcare through AONL’s core business. AONL, an affiliate of the…