The Centers for Medicare & Medicaid Services’ annual pay rate proposal for outpatient and ambulatory surgical centers (ASCs) includes a step toward site-neutral payments, a broader list of services eligible for outpatient reimbursement, updates to hospital price transparency rules and several quality rating methodology updates.
Rural emergency model emerging as lifeline for shuttered hospitals
Forty-one hospitals have converted to rural emergency status since the designation took effect in 2023. Under the designation, hospitals end inpatient services and instead offer emergency, observation and other outpatient services. While providing an opportunity to preserve critical healthcare services in rural communities, it is also offering a path to revive hospitals that have closed.
Survey: Hospitals Brace for Proposed Pharmaceutical Tariffs
On July 9, the market research firm Black Book Research released report findings on a recent quick survey about how hospitals are reacting to the proposed 200 percent tariffs on pharmaceutical imports. The findings show that health systems are preparing themselves. “Hospital leaders are rapidly deploying mitigation strategies to address what could become one of the most disruptive cost shocks in recent healthcare history.”
CMS’ proposed rule for the 2026 Medicare Physician Fee Schedule comprises key updates to the Medicare Shared Savings Program, according to a July 14 news release from the agency. The proposals aim to increase accountable care organization participation flexibility, improve program operations and encourage faster two-sided risk transitions. Proposed rule public comments are due Sept. 12.
While major pharmacy benefit management reform was stripped out of the Big Beautiful Bill, a bipartisan group of representatives has introduced legislation that takes aim at the industry. The PBM Reform Act, led by Republican Rep. Buddy Carter of Georgia, seeks to ban spread-pricing models in Medicaid and instead move to a more "transparent" system that the legislators say will more fairly reimburse pharmacies for the services they provide.
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