HealthEdge survey: 85% of payer execs say regulatory pressures impacting margins

Health plans are feeling the pressure in a complex policy environment, with most executives polled in a new survey saying it's impacting costs and margins. HealthEdge released the results from itsannual surveyof health insurance executives, and 85% of the 550 polled leaders said that the policy pressures are making themselves felt financially. This year's survey marks a...

When the hospital leaves town

CMS issues guidance on Medicaid provider tax overhaul

All U.S. states except for Alaskause provider taxes to finance some of their share of Medicaid spending, most commonly taxes on nursing facilities and hospitals, according to health policy research group the KFF. The tax arrangements are largely supported by providers, as they result in higher Medicaid reimbursements. However, opponents of the policies argue the arrangements allow states to shift more...

CMS finalizes increased pay rates for physicians in 2026, but hospital docs could lose out

The Centers for Medicare & Medicaid Services (CMS) released its annual physician pay rule for 2026 on Friday night, which increases physician reimbursement by 3.77% for qualifying providers in advanced alternative payment models and 3.26% for other providers. The bulk of the positive payment adjustment, 2.5%, comes from President Donald Trump's One Big Beautiful Bill...

Insurers most often blamed for medical debt, but providers trusted to protect patient interests

U.S. consumers across the political spectrum are largely in favor of new legal protections against medical debt, and the majority are laying blame at the feet of the insurance industry rather than other healthcare players like hospitals or drugmakers, according to a new national survey. The poll of 1,319 2024 general election voters, fielded between Aug. 21 and...

New health equity framework lays out steps to identify health disparities

A new evidence-based framework aims to establish a U.S. industry standard for measuring health equity efforts. Put out by the Institute for Healthcare Improvement (IHI), the white paperhas been in the works for two years. It offers a four-step approach to help healthcare teams across settings identify health disparities. Advancing health equity is defined in the paper as reducing and...

Hospital at home providers navigate complexities during government shutdown

When the government entered a partial shutdown Oct. 1, hospitals across the country faced a major task: discharging, relocating or shifting care programs for the thousands of patients in hospital at home programs. With Congress at a standoff over healthcare cuts and Affordable Care Act premium tax subsidies, the body failed to reauthorize the Centers for Medicare & Medicaid...

Nine VA medical centers to implement Oracle Health EHR in 2026

The Department of Veterans Affairs will expand its Oracle Health EHR system to nine additional medical centers and their associated clinics in 2026. These additions bring the total number of facilities scheduled to adopt the federal EHR system in 2026 to 13, including four Michigan sitesannouncedin December 2024. The VA expects full implementation across all its facilities as early as 2031.

KFF study: A look at growing enrollment in Medicare Advantage special needs plans

Enrollment in Medicare Advantage (MA) has climbed steadily over the past decade, and of late a key area of focus in this market has been around special needs plans, or SNPs. Anew reportfrom KFF finds that these SNPs now account for 21% of all MA enrollees, up from 13% in 2018, the year they became a permanent part of the MA program. Enrollment in SNPs has grown from 2.6...

Here's how Medicaid work requirement disenrollments will dent hospital operating margins

A new Commonwealth Fund analysis estimates U.S. hospitals’ annual operating margins will drop by 12.5% to 14.2% in 2027 should mandatory Medicaid work requirements take effect. Compared to current law, Medicaid expansion state hospitals’ collective 3.6% operating margin would drop between 0.4 percentage points and 0.5 percentage points with the change. That reflects a...