Reimbursement

Hospitals still face a heavy lift getting ready for the TEAM bundled payments model

For the quarter of U.S. hospitals that will participate in the mandatory Transforming Episode Accountability Model (TEAM) starting Jan. 1, 2026, the preparation curve has been steep. In early August, among more than 90 client hospitals of the solutions company Rainfall Health, none was where participants soon need to be, said Eddie Qureshi, founder and…

By Nick Hut October 2, 2025

News Briefs: Medicare offers a restrained inpatient payment update for FY26

Hospitals collectively will receive a base payment increase of 2.6% in Medicare reimbursement for inpatient care provided in FY26, according to a final rule published Aug. 6 in the Federal Register. Advocates were seeking a bigger update. With rising costs and reimbursement constraints projected in upcoming years, especially after passage of the budget reconciliation bill known as the…

By Nick Hut October 2, 2025

Government shutdown watch: Various hospital funding sources to be curtailed (updated 11/07/25)

Nov. 13 update: The shutdown ends The longest federal government shutdown on record ended on its 43rd day, Nov. 12, when the House narrowly passed a short-term continuing resolution (CR) and President Donald Trump signed it into law. The bill funds government operations through Jan. 30. With Medicare telehealth waivers restored in the CR, healthcare…

By Nick Hut September 30, 2025

Contract Year 2026 Medicare Advantage Plan Provider Directory Data Requirements Final Rule Summary

HFMA provides a detailed summary of the final rule finalizing a previously proposed Medicare Advantage plan provider directory requirement.

By HFMA September 23, 2025

CMS describes how $50 billion will be distributed for rural healthcare

The Trump administration announced the application period for the Rural Health Transformation Program, giving states an opportunity to claim a piece of a $10 billion FY26 allotment on behalf of their hospitals and clinics. Created by the budget reconciliation bill known as the One Big Beautiful Bill Act, the fund is set to disburse up…

By Nick Hut September 15, 2025

A large health system says revenue could fall by at least $50 million if the ACA subsidies expire

With time running short to maintain enhanced subsidies for the Affordable Care Act (ACA) insurance marketplaces, health system leaders are trying to gauge the consequences of a potential mass disenrollment. Universal Health Services (UHS), a for-profit system that operates more than 400 care sites, is one of the few healthcare organizations to have publicly released…

By Nick Hut September 12, 2025

HFMA Comments on Revisions to Payment Policies under the CY 2026 Medicare PFS, Quality Payment Program and Other Revisions to Part B

HFMA submits comments pertaining to Proposed Rule CMS-1832-P Revisions to Payment Policies under the Medicare Physician Fee Schedule, Quality Payment Program and Other Revisions to Part B for CY 2026.

By HFMA September 11, 2025

CMS gives updates on upcoming Medicaid state-directed payment limits

CMS has issued guidance to Medicaid programs about implementing required restrictions on the state-directed payments (SDPs) made through Medicaid managed care organizations (MCOs). The budget reconciliation law known as the One Big Beautiful Bill Act (OBBBA) includes a provision that all SDPs submitted after July 4 for hospitals must be limited to the Medicare rate…

By Nick Hut September 9, 2025

Senate, House release diverging HHS budget proposals for FY26 (updated-2)

Note: This article was updated Sept. 16 with news about a short-term continuing funding resolution and Sept. 10 with new numbers for some provisions in the House appropriations bill. Sept. 16 update Republicans in the House are focusing on a short-term continuation of FY25 federal funding as the most direct route to avoiding a partial…

By Nick Hut September 5, 2025

FY 2026 Hospice Payment Rate Update Final Rule Summary

HFMA presents a detailed summary of the final rule updating the Medicare hospice payment rates, wage index, and Hospice Quality Reporting Program for FY 2026.

By HFMA September 3, 2025
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