For-profit health systems turn to AI and automation to manage payer denials
Some for-profit health systems are increasingly looking to AI and other automation tools to tackle the worsening problem of payer denial management, as 73% of providers have seen claims denials increase.
Medicaid work requirements gain support in polls, but cuts to federal funding have mixed reactions
Congressional Republicans have proposed several Medicaid cuts, including work requirements, provider tax reductions, and a reduction in the federal match for ACA enrollees, which have received mixed reactions from the public in recent polls.
Hospital employment sees 8.3% increase since pre-pandemic high
Hospital employment has increased by 8.3% since the pre-pandemic high, with the latest data showing a 11% increase in February 2025, and healthcare job creation rate quickened in February 2022, with healthcare jobs outpacing non-healthcare industries for 31 consecutive months.
Medicaid enrollment drops, but many newly insured patients switch to commercial plans
Medicaid enrollment peaked at 94.5 million in April 2023, but after the unwinding process, it fell to 79.3 million in October 2024, with over 25 million people disenrolled, but overall enrollment only decreased by about 13 million due to enrollment of newly eligible.
States push to limit hospital prices amid public discontent
Several state legislatures are advancing bills to restrict hospital prices or charges, amid rising public upset with healthcare cost increases, with varying approaches including price caps, penalties, and facility fees.
Trump administration cuts to CMS staff raise concerns from Democratic lawmakers
Democrats are pushing back against the Trump administration's cuts to CMS' 6,700-employee staff, which they claim may adversely affect the functioning of the U.S. healthcare system, citing concerns that the firings will have a direct and negative impact on the health care of millions of Americans.
What Medicaid cuts hospital executives see as more likely
Health system leaders are urging Congress to minimize Medicaid cuts, with enrollee-focused cuts such as work requirements and tightening of enrollment standards for criteria and verification being more likely at this point.
Medicaid cuts could lead to material negative impact on healthcare providers
Congressional Republicans are considering Medicaid cuts, which could be "materially negative" for providers, according to a debt rating service, with potential reductions in federal funding for Medicaid and changes to implementation such as work requirements or culling of fraudulent expenditures.
Potential government changes are top concern for healthcare finance professionals
Potential government and regulatory changes have become the leading concern for healthcare finance professionals, with a 36% increase in the latest HFMA member poll, while transparency push and AI and automation are expected to revolutionize healthcare finance in the next three years.
Congress could target $35 billion in Medicaid for undocumented patients
The House of Representatives is considering up to $880 billion in Medicaid cuts over the next 10 years, which could include funding for undocumented immigrant care, as well as reducing the federal share of Medicaid funding to any state that uses state-only funding to provide Medicaid coverage to undocumented immigrants.