A new report by the Paragon Health Institute shows that Medicare spending is a pressing concern for the long-term sustainability of the U.S. budget.
The report, "Medicare Reforms for Reconciliation," notes that Medicare spent $1.5 trillion in...
The first 100 days of President Donald Trump's second term have been nothing short of eventful across all facets of the healthcare sector. From hirings to firings to rehirings, to unceremonious funding severances, to the appointment of a conspiracy theorist as Secretary of Health and Human Services, the shakeup has been historic and will...
Secretary of Health and Human Services (HHS) Robert F. Kennedy, Jr., recently announced that he would be taking steps to research the causes of autism, in the hopes of addressing the roots of chronic illness in the U.S.
Kennedy characterized autism as a "rapidly growing epidemic," and explained that he personally suspects that there...
Despite covering 5.8 million Medicare Advantage (MA) enrollees—second only to UnitedHealthcare—Humana was the only major insurer to avoid significant first-quarter losses tied to the MA program.
Humana left Medicare Advantage markets in 13 counties in 2025, affecting about 560,000 members—roughly 10% of its MA enrollment, and...
The biomedical research community is reeling from federal cuts as Arizona's bioscience sector tracks its ongoing success and significance as an economic force for the state.
Universities are facing a loss of $6.5 billion in total funding, and while a judge has issued a permanent injunction on cuts after a lawsuit brought by the...
This week, Congressional Republicans continue the search for Medicaid tax cuts, this time by returning to reductions of the federal match and the implementation of a per capita spending cap to the negotiating table. It remains clear that Medicaid work requirements alone will be insufficient for total cuts, especially as plan utilization...
Elevance Health executives tried to calm investor fears around Medicare Advantage in its first quarter (Q1) returns call last week, but the company took drastic action to end its involvement in the program shortly after the call.
Chief Financial Officer Mark Kaye said on the company call that while costs of care were higher than...
Envision Healthcare will transfer operations of roughly 95 imaging centers to Radiology Partners as part of its exit from the radiology business, the companies announced Wednesday. The move could include onboarding up to 400 radiologists, though a detailed timeline has not been disclosed. The transition is expected to continue through...
When providers cut ties with Medicare Advantage insurers, members are often locked into shrinking networks for the rest of the year. But in the past 15 months, CMS has quietly approved temporary special enrollment periods in about a dozen states, giving thousands of beneficiaries a chance to switch plans. Now, a key resource for...
In April, NAACOS signaled its intent to work with new CMS Administrator Mehmet Oz on the future of value-based care, as new JAMA studies this week highlighted savings from MSSP and shortcomings in the REACH ACO model. Oz also faced pressure from Congressional Republicans this week, who accused CMMI of advancing costly models that miss...
The Arizona State Legislature passed a bill that will increase oversight of sober living homes following a major statewide scandal over a Medicaid fraud scheme targeting Native Americans seeking drug and alcohol treatment.
Senate Bill 1655, proposed by Democratic State Senator Theresa Hatathlie, failed to pass the House Health and...
We know that Medicaid cuts are on the table for the upcoming Trump budget negotiations, but until recently, the form that those cuts would take was unclear. Now, consensus among supporters of the cuts appears to be coalescing around work requirements for state Medicaid programs, despite decades of data demonstrating that they are...
A new study shows the vast differences in health status and demographics for dual-eligible Medicare and Medicaid beneficiaries in different Medicare Advantage plans.
The study was published in JAMA and examines the data of 147,923 dual-eligible beneficiaries. It sought to compare the health and demographic characteristics of full...
A leaked draft of the Trump administration's goals for budget cuts at the Department of Health and Human Services is the first real look into the administration's disruptive plans for the agency, and the U.S. healthcare industry writ large.
The budget draft illustrates the priorities of President Donald Trump's Office of Management...
Key members of the U.S. Supreme Court appeared unlikely to overturn a key provision of the Affordable Care Act during a hearing on Monday. Plaintiffs argued that the requirements for preventative care coverage under the ACA are unconstitutional because the volunteer board that oversees recommendations on the services should be...
UnitedHealth Group, which owns the health insurance titan UnitedHealthcare, has reported some fiscal turbulence over the past year, culminating in a first quarter (Q1) earnings report to investors that was decidedly disappointing.
In its Q1 report last Thursday, UHG decided to downgrade its annual net earnings guidance from $29.50-$30...
Rural communities are seeing a rapid decline in independent physicians and practices as corporate ownership expands, according to new research from the Physicians Advocacy Institute and Avalere. The report builds on recent national data to offer a focused analysis of how healthcare consolidation is reshaping the rural practice...
According to a recent study in Health Affairs, the pace of private equity acquisitions in physician practices has accelerated, raising concerns about workforce instability and care continuity. Researchers examined changes to physician employment and turnover after PE acquisition of 200 ophthalmology practices with 1,980...
The Medicare Payment Advisory Commission admits the inconsistency is "hard to reconcile with rural hospital administrators' strong preference for fee-for-service (FFS) Medicare over Medicare Advantage (MA)" as it reports "no statistically significant effects on rural hospital finances through 2023."
The commission's staff visited...
President Trump went big last week, signing an executive order packed with measures to cut prescription drug costs, targeting Medicare price negotiations, PBM broker fees, hospital outpatient drug pricing, and 340B discount enforcement, all aimed at delivering savings for American patients and taxpayers.
Several of the EO’s...
Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr. is settling into his new role as firings within the agency continue to disrupt the agency.
The Reduction in Force (RIF) initiative was announced to have reduced the U.S. Department of Health and Human Services (HHS) by 10,000 earlier this spring, and National Law Review...CMS Rules
The Centers for Medicare and Medicaid Services issued a proposed rule for the Medicare inpatient prospective payment system (IPPS) for fiscal year (FY) 2026. The rule includes a proposed pay bump of 2.4% for hospitals.
CMS said that the rate reflects a 3.2% projected hospital market basket increase with a 0.8% productivity adjustment...CMS Rules
The Centers for Medicare and Medicaid Services (CMS) has proposed a rule under the Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) and the IRF Quality Reporting Program (QRP) for Fiscal Year (FY) 2026.
The agency proposes updating the payment rates by 2.6% based on the IRF market basket update of 3.4%, minus...CMS Rules
The Centers for Medicare and Medicaid Services announced its proposed Hospice Wage Index and Payment Rate Update proposed rule for FY 2026.
The proposed reimbursement update will raise the base payment rate by 2.4%, lower than the 2025 increase of 2.9%. The increase represents $695 million rise in total hospital payments, Hospice News...CMS Rules
The skilled nursing industry was elated by the Centers for Medicare and Medicaid Services (CMS) proposed Skilled Nursing Facility Prospective Payment System (SNF PPS) proposed rule, which included a 2.8% pay bump for FY 2026 and some other breaks that could reduce SNF costs.
The rate hike falls far short of the 4.2% raise that SNFs...
CMS Rules
