Economic trends affect patient volumes at two large health systems
Macroeconomic factors are causing a moderate drop in demand for healthcare services, according to insights from executives with a pair of leading for-profit hospital chains. At Community Health Systems (CHS), the first quarter of 2025 brought strong hospital volumes, but those dipped during the middle part of the year. Same-store adjusted admissions were 0.7% lower…
Aetna delays and modifies new policy that’s set to hit reimbursement for inpatient hospital stays
Hospitals received a brief reprieve from a pending Aetna payment policy that remains likely to decrease reimbursement starting in 2026. In a prior announcement, Aetna said it would apply level-of-severity criteria to all urgent or emergent hospital admissions lasting at least one midnight for Medicare Advantage (MA) and Medicare Special Needs Plans patients. For stays…
Government funding deal would extend key healthcare programs but not Affordable Care Act enhanced subsidies
Note: This article has been updated with additional comments from members of Congress. Important healthcare funding could be restored in a matter of days, with an agreement to end the government shutdown now in sight. The Senate struck a deal Nov. 9 to advance a federal funding bill for a formal vote, with eight Democrats…
The Healthcare C-Suite of the Future: From AI to ROI–Emerging needs drive demand for new skillsets
Read this report on how healthcare C-suite leaders face growing pressures to adapt to rapid technological advancements and unsustainable costs. AI, innovation, and payer relations are key areas for focus.
In annual rule, CMS finalizes new regulatory curbs on Medicare physician payments
Medicare has cued up its first physician payment increase in six years, but policy changes will bring new financial constraints for hospital-based physicians and many specialties. A 2026 final rule ushers in limitations on payments for a wide array of physicians. After factoring in budget neutrality requirements, the policies appear to boost independent primary care…
Rural Health Transformation Program’s application deadline arrives, bringing states and hospitals a step closer to billions in funding dollars
In the final days before the application deadline for the $50 billion Rural Health Transformation Program (RHTP), states and hospitals were scrambling to present the relevant information to CMS in the best possible light. Nov. 5 is the deadline to for states to apply for a share of the $10 billion that will be made…
340B rebate model is set to proceed in 2026 with 9 drugs
A new chapter for the 340B Drug Pricing Program will begin Jan. 1 after the Health Resources and Services Administration (HRSA) formally authorized a rebate model last week. For 2026, eight approved manufacturers can provide rebates rather than upfront discounts to 340B participating providers dispensing nine drugs: The list of drugs for the rebate model…
How specialty drugs are remaking healthcare and driving up costs
This article has been updated with news of additional policies announced by the Trump administration. Accelerating healthcare costs have less to do with traditional hospital and physician services than with surging drug spending, an industry expert says. “When we can’t really see any trends in healthcare utilization increasing, the only thing that consistently shows up…
Senate hearing on 340B reflects congressional interest in altering the program
A leading healthcare policymaker in Congress sounds intent on modifying the 340B Drug Pricing Program. Sen. Bill Cassidy (R-La.), chair of the Senate Committee on Health, Education, Labor and Pensions (HELP), led a 340B-focused hearing Oct. 23 during which he called for changes. “If this committee is serious about making healthcare more affordable, about making…
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…