Fraud and waste in Medicaid: Congressional panel calls for legislative action
The first hearing of Congress’ new government efficiency panel featured a large focus on needed changes to Medicaid. The newly created House Oversight Delivering on Government Efficiency (DOGE) Subcommittee held a hearing Feb. 12 on the $236 billion in 2023 federal improper payments, including fraud, and featured testimony from several witnesses long-experienced in leading anti-fraud…
Hospital industry on track to reach dangerous occupancy levels by 2032
Hospital industry is facing a potential crisis as demographic trends and hospital-bed capacity levels are expected to push the industry to dangerous levels of occupancy, potentially surpassing 85% by 2032, according to a research letter published by JAMA Network Open.
Rural healthcare providers see improving financial outlook, but challenges persist
Rural healthcare organizations, particularly critical access hospitals, are increasingly optimistic about their financial viability, with 96% expressing confidence in their financial stability and 58% reporting that their organization is more stable now than it was five years ago.
Elon Musk-led department of government efficiency targets federal healthcare spending
The Trump administration has launched a cost-cutting effort led by Elon Musk, the Department of Government Efficiency, which is examining spending at CMS, limiting administrative funds, and eliminating diversity, equity, and inclusion programs, and offering buyouts to federal employees, as well as suspending transgender services for minors.
Public’s hospital views dive due to finances
The public's trust in hospitals has flipped during the COVID-19 pandemic, with 76% believing hospitals are primarily focused on revenue rather than patient care, while 24% still prioritizing patient care.
RFK Jr. indicates policy changes on surprise billing, rural healthcare, Medicaid
Increased surprise billing payer requirements, rural healthcare support and Medicaid changes — including work requirements — drew support in written comments from the nominee to lead federal healthcare programs. Robert F. Kennedy Jr. answered a series of follow up questions from senators after his two confirmation hearings in late January. His responses came shortly before…
ACA plan payment denials increase as hospital financial reliance increases
Payment denial rates by Affordable Care Act (ACA) marketplace plans reached their highest point in nine years, at the same time health systems became most reliant on revenue from them. The average total denial rate was 20% for ACA plans sold in the federal marketplace used by most states, according to tracking by the Kaiser…
RFK Jr. criticizes Medicaid, pointing to poor outcomes, 30% three-year growth in spending
The Trump administration’s nominee to lead federal healthcare programs criticized what he says are poor healthcare outcomes for Medicaid enrollees, which come despite a large federal spending increase in recent years. “We’re spending $900 billion and people are getting sicker every year,” Robert F. Kennedy Jr. said about Medicaid during a confirmation hearing as secretary…
7 ways commercial insurance could change in 2025
Republicans are expected to pursue policy changes to expand commercial health plan options and control healthcare costs, including the expansion of Association Health Plan (AHP) arrangements, short-term, limited-duration (STLD) plans, and Employee Retirement Income Security Act (ERISA) protections, while also increasing price transparency and allowing expanded use of health savings accounts (HSAs).
Hospital M&A forecast to increase in 2025
Hospitals are expected to see an increase in mergers and acquisitions in 2025, with non-hospital deals likely to grow faster, according to Anu Singh, managing director for Kaufman Hall.