Rich Daly

HFMA has written to Republican congressional leaders to suggest a three-year delay of Medicaid funding cuts while a national commission studies a comprehensive overhaul of Medicaid financing, in order to avoid immediate cuts and ensure a sustainable and predictable program for vulnerable populations.

CMS has issued new sub-regulatory hospital price transparency guidance effective immediately, requiring hospitals to remove nine 9s as placeholder amounts from their machine-readable files and replace them with actual estimated allowed amounts, or risk facing enforcement actions.

The Senate Finance Committee has introduced a new version of the budget reconciliation bill that would cut Medicaid more aggressively than the House-passed version, primarily through provider taxes and state-directed payments, which would result in lower limits for provider rates and a cap on future SDPs to Medicare rates.

A study found that a proposed Medicare site-neutral payment policy would cut payments by 50% across affected services, with the most aggressive proposal saving $7.4 billion annually, with the majority of savings coming from larger nonprofit hospitals.

Florida Attorney General James Uthmeier has launched a hospital price transparency enforcement initiative, while several other states have enacted laws requiring hospitals to disclose prices for services and impose penalties for non-compliance.

CMS is launching a series of reviews to crack down on federal Medicaid funds going to cover those unlawfully present in the country and plans to recoup any affected federal funds, while a proposed rule would reduce Medicaid funding by $52 billion over the next five years and the House has passed a bill that would end federal funding for illegal immigrants and restrict federal dollars until their citizenship or immigration status is verified.

The House-passed budget reconciliation bill includes numerous healthcare provisions, including Medicaid changes that would reduce future increases in federal Medicaid spending by $625 billion and result in 8.6 million more uninsured over a decade, as well as changes to tax-advantaged accounts and the Affordable Care Act, which would allow Medicare Part A enrollees to contribute to HSAs and allow HSAs to be used for fitness and exercise programs.

Employers are expected to experience a similar increase in healthcare costs in 2026, driven by factors such as disease prevalence, aging workforce, and government spending reductions, and are responding by increasing employee premium contributions, using wellness programs, and employing plan design and network strategies to steer patients to lower-cost, higher-quality providers.

Hospitals have been hiring changes have decreased in the number of staffed beds despite patient volumes surpassing pre-pandemic levels.

Most providers expect their value-based care revenue to increase this year, but financial risk remains the top barrier to adoption, with 20% of providers receiving over half of their revenue from fully capitated or downside risk.