Supreme Court: HHS can maintain DSH formula approach that results in lower payments
The Supreme Court dealt hospitals a loss in a case about Medicare disproportionate share hospital (DSH) payments, saying HHS can continue using a disputed interpretation of the payment formula. Published April 29, a 7-2 decision for the federal government in Advocate Christ Medical Center, et al. v. Kennedy allows for continuation of a policy whereby…
Upcoming regulations and budget talks could be consequential for Medicaid supplemental payments
Note: This article was updated May 2. The system of directed payment programs (DPPs) has helped make Medicaid more financially viable for providers, but that system is under increasing political pressure. CMS has queued up a proposed rule that is undergoing a standard review at the Office of Management and Budget (OMB) and then is…
340B changes loom as the program attracts congressional, White House scrutiny
Both Congress and the White House are proposing 340B Drug Pricing Program changes that could add administrative burdens and ultimately limit the available savings for hospitals. A new report issued by Republican members of the Senate Health, Education, Labor and Pensions (HELP) Committee calls for changes that include requiring 340B covered entities to “provide detailed…
How one health system trimmed clinical spending waste by improving decision support
An effective clinical decision support (CDS) system is paramount in initiatives to curb wasteful spending in clinical settings, says Arun Mathews, MD, regional chief medical officer with MultiCare, a 13-hospital system based in Tacoma, Wash. CDS technology incorporated in MultiCare’s electronic health record has helped save $179.14 per accepted recommendation regarding lab and medication orders,…
CMS seeks feedback on applying MAHA guidelines in the U.S. healthcare system
The Medicare FY26 proposed rule for hospital inpatient payments offers clues as to how the Trump administration will seek to integrate principles of the Make America Healthy Again (MAHA) movement in the healthcare infrastructure. The rule includes a request for information (RFI) on using mandatory hospital quality measurement to foster improvements in nutrition and physical…
A new Trump executive order sets the stage for lower 340B payments
Hospitals can anticipate a regulatory effort to lower the Medicare payments they receive for purchases of Part B drugs through the 340B Drug Pricing Program. President Donald Trump on April 15 signed a wide-ranging executive order on drug costs, and one of the provisions directs HHS to conduct a survey of hospital acquisition costs for…
Medicare’s FY26 inpatient hospital proposed rule includes a restrained payment update
The Trump administration’s first set of Medicare proposals establishing inpatient payment rates continued what hospital advocates describe as a long-term trend in which the annual update is lacking. A 3.2% increase in the market basket would be reduced by a 0.8% statutory productivity adjustment, according to the newly released FY26 proposed rule. Hospitals that meet…
Amid market turbulence, hospitals strive for stability in their financials
At a time of potentially significant headwinds for investment returns, operational performance becomes even more pivotal for hospitals. Recent financial results are mixed as indicators of whether not-for-profit (NFP) hospitals can readily absorb large investment-income losses. Operating margin plateaued for the sector in February, according to Strata Decision Technology’s latest monthly report. Median year-to-date margin…
How the 340B remedy payments will affect upcoming Medicare Advantage payment rates
Hospital advocates found reason for concern in a narrow aspect of the Medicare Advantage (MA) final payment rate notice for 2026. With health plans lauding the average 5.06%, $25 billion revenue increase they’re projected to reap in the upcoming year, hospitals may wonder about adverse impacts from an applied reduction in CMS’s calculation of the…
Hospitals brace for impact of tariffs (updated article)
Note: The article was updated where noted after President Donald Trump’s April 8 remark about upcoming pharmaceutical tariffs. The headline was also updated after originally stating: “Tariff impact on hospitals may be relatively restrained in the short term” Sweeping tariffs announced over the last week by the Trump administration appear to have spared the healthcare…