Healthcare Reimbursement News

The healthcare payroll hit stemming from termination of the Affordable Care Act enhanced subsidies

Healthcare providers would be at risk of losing more than 150,000 jobs in 2026 if the higher Affordable Care Act (ACA) marketplace subsidies expire at the end of this year, according to a new analysis. In the analysis published by the Commonwealth Fund, researchers used economic modeling to project that providers would lose 154,000 jobs…

By Nick Hut October 21, 2025

Oct. 6, 2025: The healthcare impacts of a federal government shutdown

HFMA Senior Editor Nick Hut and HFMA Policy Director Shawn Stack discuss the latest in healthcare finance news.

By Erika Grotto October 6, 2025

No Surprises Act arbitration has been a bonanza for a few provider groups

In a span of 2.5 years through 2024, providers reaped more than $2.2 billion from the No Surprises Act’s arbitration process, relative to the applicable in-network payment rates for the disputed care episodes. The awards received through the NSA’s independent dispute resolution (IDR) process largely arise from “disputes that are primarily initiated and won by…

By Nick Hut October 3, 2025

HFMA Comments on CY 2026 Hospital OPPS and ASC Proposed Rule

HFMA submits comments to CMS pertaining to CMS-1834-P CY 2026 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center Proposed Rule.

By HFMA October 2, 2025

Hospitals still face a heavy lift getting ready for the TEAM bundled payments model

For the quarter of U.S. hospitals that will participate in the mandatory Transforming Episode Accountability Model (TEAM) starting Jan. 1, 2026, the preparation curve has been steep. In early August, among more than 90 client hospitals of the solutions company Rainfall Health, none was where participants soon need to be, said Eddie Qureshi, founder and…

By Nick Hut October 2, 2025

News Briefs: Medicare offers a restrained inpatient payment update for FY26

Hospitals collectively will receive a base payment increase of 2.6% in Medicare reimbursement for inpatient care provided in FY26, according to a final rule published Aug. 6 in the Federal Register. Advocates were seeking a bigger update. With rising costs and reimbursement constraints projected in upcoming years, especially after passage of the budget reconciliation bill known as the…

By Nick Hut October 2, 2025

Government shutdown watch: Various hospital funding sources to be curtailed (updated 11/17/25)

Nov. 17 update: Sizable Medicare payment cut avoided The continuing resolution to fund the government through Jan. 30 has language canceling a looming PAYGO reduction to federal programs, including a 4% cut to Medicare that would have taken effect in 2026. PAYGO is a statutory across-the-board spending reduction to be implemented when legislation increases the…

By Nick Hut September 30, 2025

Contract Year 2026 Medicare Advantage Plan Provider Directory Data Requirements Final Rule Summary

HFMA provides a detailed summary of the final rule finalizing a previously proposed Medicare Advantage plan provider directory requirement.

By HFMA September 23, 2025

CMS describes how $50 billion will be distributed for rural healthcare

The Trump administration announced the application period for the Rural Health Transformation Program, giving states an opportunity to claim a piece of a $10 billion FY26 allotment on behalf of their hospitals and clinics. Created by the budget reconciliation bill known as the One Big Beautiful Bill Act, the fund is set to disburse up…

By Nick Hut September 15, 2025

A large health system says revenue could fall by at least $50 million if the ACA subsidies expire

With time running short to maintain enhanced subsidies for the Affordable Care Act (ACA) insurance marketplaces, health system leaders are trying to gauge the consequences of a potential mass disenrollment. Universal Health Services (UHS), a for-profit system that operates more than 400 care sites, is one of the few healthcare organizations to have publicly released…

By Nick Hut September 12, 2025
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