Site-neutral payment emerges as Medicaid savings tool in GOP reconciliation plan
Congressional Republicans are touting healthcare competition and consumer choice, along with expanded site-neutral payment, in a preliminary framework for a second reconciliation bill. The Republican Study Committee in the U.S. House of Representatives put forth ideas geared toward healthcare policies, home prices, energy prices, credits for stay-at-home parents and more, along with proposals to cut…
FY26 appropriations bill includes new administrative mandate for hospitals
Hospitals soon will face new administrative requirements around billing for services provided at off-campus outpatient departments (OPDs), based on text in an appropriations bill agreed to in bipartisan negotiations. The primary purpose of the bicameral bill is to fund the Departments of Labor, HHS and Education for the remainder of FY26. Without passage, funding for…
Hospital use and service intensity helped fuel healthcare spending growth in 2024
Increasing use and intensity of hospital care, physician and clinical services, and retail prescription drugs led a continued surge in U.S. healthcare spending in 2024, according to newly released data. National health expenditures (NHE) reached $5.3 trillion, a 7.2% increase year-over-year and comparable with the 7.4% jump recorded in 2023. Except for the pandemic year…
Trump releases healthcare plan that would have major implications for the industry
President Donald Trump’s newly released healthcare plan would promote transparency and consumerism and usher in significant changes to coverage, with some stakeholders saying more information is necessary to make a valid assessment of the pros and cons. Touted as a push to address wider issues with affordability, the plan requires Congress to fill in the…
No Surprises Act IDR enforcement uncertain after Supreme Court declines review
Inaction by the Supreme Court this week raised new questions about enforcement of the No Surprises Act’s independent dispute resolution (IDR) process. The high court denied a petition by two air ambulance companies to review a circuit court’s 2025 decision that IDR awards are not enforceable in federal court. That opinion by the U.S. Court…
Hospital-insurer contract disputes could intensify as cost pressures persist
Relationships between hospitals and health insurers are expected to undergo further strain this year, according to analysts with a leading credit ratings agency. “Providers are still dealing with rising operating costs, labor supplies and infrastructure that outpace what insurers have been willing to pay in recent years,” said Bradley Ellis, senior director for the U.S.…
Affordable Care Act subsidy extension progresses, but many questions persist (updated Jan. 13)
Note: A section of this article has been updated with the latest ACA enrollment numbers for 2026 Momentum in Congress is building toward an extension of the enhanced subsidies for buying Affordable Care Act (ACA) marketplace coverage, although successful passage would not negate the ongoing uncertainty. On Jan. 8, the House of Representatives passed a…
CMMI payment models signal broader Medicare reimbursement shifts
CMS’s Center for Medicare & Medicaid Innovation (CMMI) was busy during the last two months of 2025, announcing a number of new models designed to improve healthcare and keep costs in check. Some address specific priorities of President Donald Trump or HHS Secretary Robert F. Kennedy Jr. New models scheduled for implementation over the next…
CMS distributes $10 billion for states to use to improve rural health
CMS awarded states $10 billion in rural health funding for 2026, implementing a widely anticipated provision of the legislation known as the One Big Beautiful Bill Act (OBBBA). The Rural Health Transformation Program (RHTP) funding is intended to help rural healthcare providers succeed amid the projected cutbacks in federal Medicaid funding over the next decade…
340B rebate model no longer beginning Jan. 1 after court issues preliminary injunction (updated Jan. 12)
Note: The last section of this article was updated with news that HHS is stepping back from its appeal of the litigation. A federal court stopped implementation of a 340B Drug Pricing Program rebate model that had drawn fierce opposition from providers. The Dec. 29 preliminary injunction by a Trump-appointed judge at the U.S. District…