Healthcare providers express cash flow concerns under new 340B rebate model
Editor's Note Healthcare providers could experience significant cash flow and operational changes under a new voluntary pilot program that fundamentally alters how the nation's second-largest drug payment program operates, according to an August 11 article in Modern Healthcare. As detailed in the article, The Health Resources and Services Administration announced…
CMS’s newly finalized TEAM payment model holds hospitals accountable for entire surgical episodes
Editor's Note As part of the Centers for Medicare and Medicaid Services (CMS) newly issued 2026 Final Rule, the Transforming Episode Accountability Model (TEAM) will hold hospitals and health systems accountable for the entire episode of care for major surgeries, from admission through 30 days post-discharge. HIT Consultant reported the…
Providers call for deeper reform despite CMS proposing payment hikes in 2026
Editor's Note CMS is boosting 2026 Medicare outpatient payments by 2.4%, but provider groups warn the increase barely scratches the surface of mounting financial strain. Alongside the payment bump, the agency is proposing a two-track physician reimbursement model that ties rates to value-based care participation. While some see these moves…
CMS proposes 2026 Medicare pay bump, targets wasteful spending
Editor's Note The Centers for Medicare & Medicaid Services (CMS) has proposed a 3.62% increase to the 2026 Medicare physician fee schedule, according to a July 14 article in Fierce Healthcare. The proposed rule sets the conversion factor at $33.42, up from $32.35 in 2025. The increase reflects a 2.5%…
Hospital M&A climbs as rural, outpatient shifts reshape care strategies
Editor's Note Hospital mergers and acquisitions saw a slight increase in Q2 2025, but broader shifts in healthcare affiliations and delivery models continue to gather momentum, according to a July 10 Kaufman Hall analysis of M&A activity for the second quarter of 2025. The report recorded eight hospital and health…
Children’s hospitals warn of care limits as Medicaid changes take hold
Editor's Note Children’s hospitals are warning that newly enacted federal healthcare cuts will force them to scale back essential services and programs, jeopardizing care for the very populations Medicaid was designed to protect. The law, signed by former President Donald Trump and detailed in a July 9 article in Modern…
ASCs deliver lower costs but face uphill payment, regulatory challenges
Editor's Note Ambulatory surgery centers (ASCs) continue to offer significant cost savings over hospital outpatient departments (HOPDs), but payment inequities, regulatory constraints, and growing competitive pressures are straining operations and growth prospects. Recent data show wide cost differentials between settings, Becker’s ASC Review June 20 reports. A Blue Health Intelligence…
Major insurers pledge prior authorization reform
Editor's Note Nearly 50 major US health insurers—including UnitedHealthcare, Aetna, Cigna, Elevance, and Humana—have pledged to reform prior authorization practices, with the goal of easing administrative burdens and improving access to care, according to a June 23 article in Healthcare Dive. As detailed in the article, the announcement came from…
Bad debt climbs as patient defaults, denials impact hospital revenue growth
Editor's Note Bad debt—payments hospitals expected to collect but ultimately had to write off—is increasing across hospitals as patients struggle to pay their share of healthcare costs and insurers raise the rate of claim denials, Modern Healthcare reported June 19. Citing a Kaufman Hall analysis of data from about 700…
Tariffs stir uncertainty in hospital supply chains, health insurance premiums
Editor's Note Recent reporting from Axios reveals hospitals and health insurers are reporting new concerns about rising tariffs and trade policy uncertainty, with the former delaying purchasing decisions and the latter planning premium increases as a result. In the first article, published June 18, the outlet reports that health system…
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