Trump releases healthcare plan that would have major implications for the industry
President Donald Trump’s newly released healthcare plan would promote transparency and consumerism and usher in significant changes to coverage, with some stakeholders saying more information is necessary to make a valid assessment of the pros and cons. Touted as a push to address wider issues with affordability, the plan requires Congress to fill in the…
No Surprises Act IDR enforcement uncertain after Supreme Court declines review
Inaction by the Supreme Court this week raised new questions about enforcement of the No Surprises Act’s independent dispute resolution (IDR) process. The high court denied a petition by two air ambulance companies to review a circuit court’s 2025 decision that IDR awards are not enforceable in federal court. That opinion by the U.S. Court…
States advance hospital price caps
Three states enacted hospital price caps in 2025 and more could act this year. The new state laws varied widely but all targeted some type of limit on hospital prices. Indiana The highest profile new law came in Indiana. That law (HB1004) went into effect in July 2025 and imposes price controls and additional price…
Some states to focus on rural hospital solvency
Some of the states that recently received a share of $50 billion in federal rural health funding explicitly aim to use some of it to bolster the finances of struggling rural hospitals. The funding comes through the Rural Health Transformation Program (RHTP), which intended to help rural healthcare providers succeed amid the projected cutbacks in…
Hospital-insurer contract disputes could intensify as cost pressures persist
Relationships between hospitals and health insurers are expected to undergo further strain this year, according to analysts with a leading credit ratings agency. “Providers are still dealing with rising operating costs, labor supplies and infrastructure that outpace what insurers have been willing to pay in recent years,” said Bradley Ellis, senior director for the U.S.…
Operational resilience is the revenue cycle management imperative of the OBBBA era
The One Big Beautiful Bill Act (OBBBA) has altered Medicaid eligibility in ways hospitals can no longer treat as a background policy issue. Reverification of Medicaid coverage now happens so frequently that patients lose coverage for administrative reasons that have nothing to do with whether they actually qualify. Much of the industry dialogue has centered…
Affordable Care Act subsidy extension progresses, but many questions persist (updated Jan. 13)
Note: A section of this article has been updated with the latest ACA enrollment numbers for 2026 Momentum in Congress is building toward an extension of the enhanced subsidies for buying Affordable Care Act (ACA) marketplace coverage, although successful passage would not negate the ongoing uncertainty. On Jan. 8, the House of Representatives passed a…
CMMI payment models signal broader Medicare reimbursement shifts
CMS’s Center for Medicare & Medicaid Innovation (CMMI) was busy during the last two months of 2025, announcing a number of new models designed to improve healthcare and keep costs in check. Some address specific priorities of President Donald Trump or HHS Secretary Robert F. Kennedy Jr. New models scheduled for implementation over the next…
Epic lawsuit filed by Texas aims to help health system finances
A range of alleged financial damages against hospitals and health systems underpins the recent anti-competitive lawsuit by Texas against dominant electronic health record (EHR) system vendor Epic. Although not mentioned in a press release accompanying the Dec. 10 lawsuit against Epic, the Texas attorney general’s filing details a range of financial and other harms the…
CMS distributes $10 billion for states to use to improve rural health
CMS awarded states $10 billion in rural health funding for 2026, implementing a widely anticipated provision of the legislation known as the One Big Beautiful Bill Act (OBBBA). The Rural Health Transformation Program (RHTP) funding is intended to help rural healthcare providers succeed amid the projected cutbacks in federal Medicaid funding over the next decade…