Projected Medicare Advantage 2027 payment rate draws concern from plans and providers
CMS’s proposed Medicare Advantage (MA) 2027 payment rate would result in minimal overall growth for health plans, with average payments to MA plans projected to increase by only 0.09%, according to the MA advance rate notice published this week. MA policy increasingly has grabbed headlines in conjunction with the program’s enrollment surge from 33% of…
Hospitals not yet a fraud focus
The Trump administration has ramped up high-profile healthcare fraud prevention efforts across a range of areas. Hospitals are not yet in the crosshairs. Ryan Thurber, an attorney with Polsinelli, said the focus of much of the administration’s healthcare and Medicaid fraud detection is on “nontraditional providers” of services around the periphery of healthcare, such as…
Federal scoring system spurs state action on certificate-of-need laws
Spurred on by the Trump administration, five states plan to undertake changes in their certificate-of-need (CON) laws this year: Their plans were highlighted in late 2025 applications for a share of the $50 billion Rural Health Transformation (RHT) program, authorized by the One Big Beautiful Bill Act (OBBBA). That law allowed the Trump administration to…
How price transparency improves patient trust and collection rates
Price transparency in healthcare has moved well beyond being a regulatory obligation. In today’s consumer-driven environment, it has become a strategic capability that directly influences patient trust, access to care and revenue cycle performance. Patients increasingly expect clear, upfront information about what care will cost, what their insurance will cover and what they will be…
Health insurers tell Congress their operations aren’t the cause of high healthcare costs
The debate over the root causes of surging healthcare costs came to Capitol Hill this week as health insurance executives defended their business models to Congress. While acknowledging bipartisan criticism after a year when the cost of employer-sponsored family coverage grew by 6%, with similar or larger projections for 2026, the executives said the crux…
Site-neutral payment emerges as Medicaid savings tool in GOP reconciliation plan
Congressional Republicans are touting healthcare competition and consumer choice, along with expanded site-neutral payment, in a preliminary framework for a second reconciliation bill. The Republican Study Committee in the U.S. House of Representatives put forth ideas geared toward healthcare policies, home prices, energy prices, credits for stay-at-home parents and more, along with proposals to cut…
New administrative mandate for hospitals signed into law as part of FY26 appropriations
Note: The headline and lead section of this article were updated with news that Congress passed the appropriations bill. The FY26 appropriations bill signed Feb. 3 by President Donald Trump leaves hospitals with two years to prepare for a new administrative obligation pertaining to off-campus outpatient departments (OPDs). The package, which passed the Senate last…
Hospital labor trends in 2025 show slower hiring but continued workforce growth
High profile layoffs were dwarfed by new hires in 2025 at hospitals, as organizations positioned for coming turmoil. Hospitals added 163,000 positions in 2025 to reach 5,804,200 positions, seasonally adjusted, by December, according to the Bureau of Labor Statistics (BLS). Hospital hiring averaged 13,600 personnel each month. That hiring pace was the fastest among various…
340B program changes in 2026 test compliance, cash flow and margins
Beyond a high-profile legal battle over a rebate pilot, a range of changes are poised to hit the 340B program in 2026, say policy watchers. The latest development came Jan. 15 when Eli Lilly expanded its requirements for covered entities to submit claims-level data for its own pharmacies, in addition to previously requiring that data…
HFMA’s Vitalic Health launches the Vitals Tracker to measure the health of the industry
The Healthcare Financial Management Association’s Vitalic Health today released the U.S. Vitals Tracker, a first-of-its-kind tool that measures the health of U.S. healthcare. Vitalic Health – powered by HFMA – is designed to bring together healthcare stakeholders to address issues negatively impacting affordability, health outcomes and industry financial sustainability. The Vitals Tracker scores each year…