2026 Medicare final rule postpones a significant payment cut for hospitals
While implementing several policies that could constrain hospital finances next year and beyond, CMS offered temporary relief on one count. The Medicare 2026 final rule for hospital outpatient departments and ambulatory surgical centers (ASCs) was proposed to include an across-the-board 2% cut to base payments. But CMS, acknowledging the concerns of hospitals, kept the scheduled…
Senate hearing doesn’t resolve 2026 funding for Affordable Care Act marketplace plans
Senate Republicans used a recent hearing to press their case for enacting immediate reforms to part of the Affordable Care Act (ACA), with little sign they will agree to extend the subsidy framework that has been in place for more than four years. During the Nov. 19 hearing of the Senate Finance Committee, members of…
CMS gives new guidance on upcoming restrictions to Medicaid provider taxes
CMS issued preliminary guidance about how it will implement new restrictions on Medicaid provider taxes as required by the budget reconciliation law known as the One Big Beautiful Bill Act (OBBBA). OBBBA language will curb provider taxes as a Medicaid funding mechanism through which states can increase their allotment of federal matching dollars that, in…
Economic trends affect patient volumes at two large health systems
Macroeconomic factors are causing a moderate drop in demand for healthcare services, according to insights from executives with a pair of leading for-profit hospital chains. At Community Health Systems (CHS), the first quarter of 2025 brought strong hospital volumes, but those dipped during the middle part of the year. Same-store adjusted admissions were 0.7% lower…
Aetna delays and modifies new policy that’s set to hit reimbursement for inpatient hospital stays
Hospitals received a brief reprieve from a pending Aetna payment policy that remains likely to decrease reimbursement starting in 2026. In a prior announcement, Aetna said it would apply level-of-severity criteria to all urgent or emergent hospital admissions lasting at least one midnight for Medicare Advantage (MA) and Medicare Special Needs Plans patients. For stays…
Government funding deal would extend key healthcare programs but not Affordable Care Act enhanced subsidies
Note: This article has been updated with additional comments from members of Congress. Important healthcare funding could be restored in a matter of days, with an agreement to end the government shutdown now in sight. The Senate struck a deal Nov. 9 to advance a federal funding bill for a formal vote, with eight Democrats…
The Healthcare C-Suite of the Future: From AI to ROI–Emerging needs drive demand for new skillsets
Read this report on how healthcare C-suite leaders face growing pressures to adapt to rapid technological advancements and unsustainable costs. AI, innovation, and payer relations are key areas for focus.
In annual rule, CMS finalizes new regulatory curbs on Medicare physician payments
Medicare has cued up its first physician payment increase in six years, but policy changes will bring new financial constraints for hospital-based physicians and many specialties. A 2026 final rule ushers in limitations on payments for a wide array of physicians. After factoring in budget neutrality requirements, the policies appear to boost independent primary care…
Rural Health Transformation Program’s application deadline arrives, bringing states and hospitals a step closer to billions in funding dollars
In the final days before the application deadline for the $50 billion Rural Health Transformation Program (RHTP), states and hospitals were scrambling to present the relevant information to CMS in the best possible light. Nov. 5 is the deadline to for states to apply for a share of the $10 billion that will be made…
340B rebate model is set to proceed in 2026 with 9 drugs
A new chapter for the 340B Drug Pricing Program will begin Jan. 1 after the Health Resources and Services Administration (HRSA) formally authorized a rebate model last week. For 2026, eight approved manufacturers can provide rebates rather than upfront discounts to 340B participating providers dispensing nine drugs: The list of drugs for the rebate model…