The One Big Beautiful Bill Act of 2025 (OBBBA) funded most of its ambitious program through a series of Medicaid cuts, not only through work requirements but also through curbing state methods of provider compensation designed to boost the federal...National News
Last month, MedPAC published a slew of data, including an update on the commission's analysis of the growing role of value-based care in the lives of Medicare FFS beneficiaries. About 200,000 Arizona Medicare beneficiaries received care through an accountable care organization in 2024, according to the latest state-level enrollment data...White Papers, E books, Reports and more
In the 2027 Inpatient Prospective Payment System (IPPS) rule, the Centers for Medicare and Medicaid Services finalized a new payment model that its calling the Comprehensive Care for Joint Replacement Expansion (CJR-X), which resurrects a formerly sunset payment model for Medicare joint replacement reimbursement and expands it as a...Arizona News
Voting is underway among Banner Health doctors to determine if they will form Arizona's first physician's union at the state's largest private employer.
Working with the Union for American Physicians and Dentists (UAPD), which has worked to form more than 30 bargaining units across 100 healthcare settings nationwide, Banner's doctors...
This week, Medicare Advantage insurers are innovating new ways to enter markets and boost margins as J.D. Power finds that plans are struggling to keep their members satisfied.
Over the past two years, Medicare Advantage plans have pivoted from customer satisfaction to shoring up their bottom lines as rising costs and plan usage rates...
As calls to end the practice of prior authorization mount, the Centers for Medicare and Medicaid Services (CMS) are scrambling to assuage public concerns by offering new guidance for plans to publicly report prior authorization data and accompanying requirements for posting the reporting.
CMS posted the new guidance in compliance with...
Requests for Rural Health Transformation Program (RHTP) funding applications are live and providers have a short window to apply for program funds as reporting deadlines already loom large. States remain optimistic that the program's funding will facilitate much needed improvements to health delivery in rural areas.
In Arizona,...
Hospital operating margins remained stable through June, but Kaufman Hall found growing financial pressure beneath the surface, particularly for smaller and rural facilities with limited cash reserves.
Bad debt and charity care increased both in dollars and as a share of hospital revenue during the first half of 2026. Emergency...National Reports & Surveys
With the Annual Enrollment Period for Medicare Advantage right around the corner, Brookings researchers argue that traditional Medicare’s 61-year-old benefit structure is increasingly uncompetitive with Medicare Advantage and leaves beneficiaries vulnerable to catastrophic healthcare expenses.
Unlike Medicare Advantage, traditional...Arizona Comings & Goings
Banner – University Medicine has named Charles Socci, RN, MBA, chief operating officer for its Tucson operations, effective Sept. 14.
Socci will oversee daily operations at Banner – University Medical Center Tucson and Banner – University Medical Center South, with responsibility for quality, patient safety, service, employee...National News
The Center for Medicare and Medicaid Innovation (CMMI) was created by the Affordable Care Act of 2010 to creatively work through issues of healthcare quality and rising health costs through demonstrations of payment mechanisms that prioritize health outcomes, commonly referred to as "value-based care." The expectation has been that at...
On Monday, President Donald Trump unveiled a new executive order that would overhaul the childhood vaccine schedule and reduce the number of vaccines recommended for all children.
The executive order is meant to circumvent ongoing litigation against the administration for changes made to vaccine policy, and the White House assured...
Last month, a federal judge vacated a 2023 Medicare payment rule that limited payouts to disproportionate share hospitals (DSH) which could deliver a significant boost to embattled safety-net providers facing compounding market and regulatory stressors.
The federal crackdown on Medicaid provider taxes and a sharp increase in...National News
The Trump administration's efforts to rescind federal support for transgender healthcare services continued this week as the Centers for Medicare and Medicaid Services (CMS) announced that Medicaid will stop paying for gender affirmative treatments for transgender minors.
The policy is set to go into effect beginning October 13, with...Arizona News
Arizona health insurers are requesting double-digit premium increases for small-employer plans covering at least 83,404 people and policyholders in 2027, according to the most recent filings.
The total reflects enrollment disclosed in Rate Review filings reviewed by The Hertel Report and excludes Cigna plans and a Blue Cross Blue...
Nearly half of Arizona hospitals operate in highly concentrated or monopoly markets, giving some health systems greater leverage to negotiate higher prices with commercial insurers, according to newly available hospital pricing and market data.
The Health Care Affordability Lab at Yale University found that 35 of the 77 Arizona...
The former director of the Office of Policy Planning at the Federal Trade Commission under President Joe Biden is leading the charge for a ban on prior authorizations with a new policy paper.
Hannah Garden-Monheit worked at the FTC on efforts to ban noncompete clauses in contracts and to investigate pharmacy benefits managers before...White Papers, E books, Reports and more
Arizona eliminated its broad certificate-of-need program more than three decades ago, placing the state ahead of a deregulatory policy now gaining renewed attention as states adjust to Medicaid funding changes under the One Big Beautiful Bill Act and implement projects supported by its $50 billion Rural Health Transformation...White Papers, E books, Reports and more
Noting the similarities inherent in the Ryan White HIV/AIDS Program (RWHAP), which provides federal funding for services for low-income people living with HIV and the Ending the HIV Epidemic in the United States (EHE) Initiative, the Assistant Secretary for Planning and Evaluation published a report on initiatives to end the HIV epidemic...Arizona News
AHCCCS has opened two Requests for Grant Applications (RFGAs) under the Arizona Rural Health Transformation Program (RHTP). The funding totals $13.5 million and the grants are designed to help rural healthcare organizations share operating costs and expand access to behavioral health and substance-use services.
Arizona received nearly...
Medicare Advantage enrollment is shifting rapidly as Humana and other major insurers withdraw from subpar markets en masse. This could spell coverage losses for up to hundreds of thousands of Medicare beneficiaries.
Across the board, Medicare Advantage (MA) enrollment has continued to rise into 2026 with an additional 1.1 million...
Five of the six insurers seeking to return to Arizona’s Affordable Care Act Marketplace in 2027 are requesting average premium increases of at least 24%, according to The Hertel Report’s review of rate filings submitted to the state.
The proposed increases remain subject to review and approval by the Arizona Department of...
The Medicare payment model for joint replacement care is back and mandatory for nearly all acute care hospitals, resurrected in the now final Hospital Inpatient Prospective System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS).
The final rule includes a pay boost for hospitals of 2.3%, which the Centers for...Arizona News
Steadfast Medicare Advantage insurer Humana will change direction and pull back from the program, according to an announcement made by the company in its second quarter earnings call. It is anticipated to withdraw from underperforming markets that will affect 600,000 beneficiaries. In 2025, Humana offered MA plans in three Arizona...
A federal judge has rejected the effort from a coalition of 25 states, including Arizona, to enjoin a rule by the Centers for Medicare and Medicaid Services (CMS) that would require patients to prove "medical frailty" in order to obtain an exemption from the federally mandated Medicaid work requirement authorized by the One Big Beautiful...
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