All stories
Jump to date
Monday, October 5 · 64 stories
- Industry
Report Details Community Health Center Patients, Services, Financing in 2024
A new research brief analyzes 2024 Uniform Data System figures showing community health centers served more than 32 million patients across medically underserved urban and rural areas. The brief covers who health centers serve, the range of services they provide, and how those services are financed, including the role of Medicaid as a key payer. It draws on national UDS data compiled for calendar year 2024. The report provides a baseline snapshot of health center capacity and reliance on public funding sources.
- State Policy · MI
Commentary: Michigan Medicaid Cuts Confuse Coverage Loss With Cost Savings
In a commentary piece, the author argues that federal Medicaid eligibility restrictions enacted under the 2025 reconciliation law will increase uninsurance and medical debt in Michigan rather than reduce healthcare costs. The author cites Michigan data showing Medicaid expansion covers more than 650,000 adults as of August 2026 and has reduced emergency room use, uncompensated care, and medical debt. The piece argues new federal requirements, work reporting, more frequent eligibility checks, and narrower immigrant eligibility, will cause eligible people to lose coverage while raising state administrative costs for caseworkers. The author contends these changes are framed as program integrity measures but actually undermine affordability and access to care.
- State Policy · MA
MA Governor Candidate Minogue Discusses Medicaid Cuts, Primary Care Mandate
On the Health or Consequences podcast, Massachusetts Republican gubernatorial candidate Mike Minogue discussed federal Medicaid cuts, a proposed primary care spending mandate, and health care workforce immigration issues. He voiced skepticism toward legislative proposals to raise insurer primary care spending from about 7-8 percent to 15 percent of premiums, arguing it merely shifts money rather than cutting waste and fraud, citing pharmacy benefit managers as a target. On federal Medicaid cuts projected by CBO to cause 326,000 Massachusetts residents to lose coverage and cost the state $2 billion annually in federal revenue, Minogue proposed administrative fixes like a hotline and multilingual website to help enrollees navigate new work requirements, without directly addressing the roughly 7,500 documented immigrants losing MassHealth coverage October 1. He also discussed mental health system strain, hospital consolidation, and a potential shared-savings arrangement with federal health officials.
- Industry
KFF Survey Details State Use of Medicaid Home Care Integrity Tools
KFF's issue brief presents findings from its most recent survey of state Medicaid home care programs, focusing on how states use program integrity tools such as electronic visit verification and other monitoring mechanisms. The brief covers the range of approaches states report using to detect and prevent improper payments in home and community-based services. It draws on survey responses collected across state Medicaid agencies rather than describing a single new policy action. The findings are relevant to states, managed care plans, and providers involved in administering or delivering home care services under Medicaid.
- Industry
KFF Survey Tracks Medicaid HCBS Waiting Lists From 2016 to 2026
KFF's latest survey of state Medicaid home care programs provides updated data on waiting lists for home- and community-based services (HCBS) spanning 2016 to 2026. The data note explains that waiting lists are an incomplete measure of unmet need, since states vary widely in how they manage, screen, and report individuals awaiting services. KFF cautions that figures are not necessarily comparable across states or over time, even after efforts to standardize the data collection. The note is aimed at helping policymakers and researchers interpret trends in access to long-term services and supports more cautiously.
- Legal
House GOP Releases Fraud Report, Unveils 13 Medicaid Bills
In a commentary piece, the author argues that the House Energy & Commerce Committee's Republican majority staff report on Medicare and Medicaid fraud, released September 29, is politically timed oversight published five weeks before the midterm elections. The same day, the Committee Chairman announced a package of 14 bills, 13 of which would amend the Medicaid statute to address program fraud. The piece characterizes the report and legislative package as "oversight done wrong," suggesting the timing and substance warrant scrutiny. The author's framing questions whether the report's findings and proposed legislative fixes are driven by genuine oversight concerns or electoral strategy.
- State Policy · IN
Indiana: 58,000 HIP Enrollees Not Yet Meeting New Work Rules
Indiana's Family and Social Services Administration released internal estimates showing 58,000 Healthy Indiana Plan (HIP) members, about 12% of current enrollees, are not yet compliant with federal Medicaid work requirements taking effect January 1, 2027. Enforcement will use a three-month look-back period, meaning anyone applying for or renewing coverage in January must demonstrate compliance starting this month. Members must show 80 hours per month of work, school, volunteering, or an apprenticeship, or earn at least $580 monthly, unless they qualify for an exemption such as caregiving, pregnancy, disability, or recent incarceration. The agency previously estimated up to 300,000 Hoosiers could be subject to the requirement after exemptions are applied, and is holding town halls statewide, including one Tuesday at Ivy Tech Valparaiso, to explain the change.
- Federal Policy
Grassley Urges Trump Administration to Finalize Kratom Rule
Sen. Chuck Grassley (R-Iowa) publicly pressed the Trump administration to finalize a proposed rule restricting sale of 7-hydroxymitragynine (7OH), a concentrated kratom compound, calling the substance deadly and demanding it be pulled from gas stations, vape shops, and other retail outlets. The statement does not specify a new regulatory action by the administration, but amplifies pressure on FDA/DEA to move from proposed to final rule status. No effective date is given, as the underlying rule remains unfinalized. The push concerns a substance regulated outside typical Medicaid pharmacy channels, though it intersects with broader opioid-use and behavioral health policy concerns.
- Industry
Hospital Revenue Cycle Leadership Shifts Toward VP-Level, Specialized Roles
In a roundup on revenue cycle leadership trends, Becker's Hospital Review reports that hospital revenue cycle executive roles are becoming more specialized and strategically central in 2026, even as fewer health systems create chief-level titles. Becker's tracked only two chief revenue officer and one chief revenue cycle officer appointment in 2026, down sharply from 2025, with most of 39 tracked moves occurring at the vice president or executive director level. New titles increasingly describe narrower functions (revenue realization, revenue integrity, net revenue management) or combine revenue cycle with finance or payer strategy. Leaders say automation of payer claims review, silent downcoding, and staff upskilling gaps are now core parts of the job, alongside succession planning.
- Industry
Becker's: Pharmacy Vacancy Costs Outweigh Visible Staffing Spend
In a Becker's Hospital Review commentary, the author argues that hospital pharmacy leaders focus too narrowly on visible staffing and contract labor costs while underestimating the larger financial toll of unfilled pharmacy and technician vacancies. The piece cites ASHP data showing technician turnover above 20%, vacancy rates up to 40% in some settings, turnover costs of $25,000-$35,000 per technician, and pharmacist burnout rates around 64%. It contends that unfilled roles push pharmacists into technician-level tasks, increase overtime and burnout, and trigger attrition cycles that cost more than strategic staffing investment. The author recommends evaluating vacancy cost alongside staffing cost rather than treating hourly rates as the primary savings lever.
- Industry
Hall Render Briefing Tracks Hospital Real Estate Deals, PE Oversight Laws
In its Weekly Hospital Real Estate Briefing, Hall Render compiles a range of recent developments: medical office building cap rates held steady at 6.7% through mid-2026 per Revista data, while per-square-foot prices rose; Phil and Penny Knight pledged $1.1B to Providence St. Vincent for a new women's hospital and cardiovascular expansion; EvergreenHealth received a $100M estate gift; Piedmont Healthcare and Sarasota Memorial announced major facility investments; and the University of Kansas Health System will acquire full ownership of Topeka's St. Francis Campus from Ardent Health by year-end 2026. The briefing also notes eight states enacted laws in 2026 expanding oversight of private equity health care transactions, and federal lawmakers introduced legislation to bar private equity and insurers from owning physician practices.
- Legal · SC
Stomagienics CEO Criticizes Medicare Ostomy Supply Bidding Plan
In a commentary published ahead of Ostomy Awareness Day, Theresa Johnson, CEO of South Carolina-based Stomagienics, argues that CMS's plan to apply competitive bidding to ostomy supplies will harm patients. She writes that beginning January 1, 2028, CMS will award contracts to just six suppliers nationwide, which she argues will reduce access to the specific, properly-fitting products beneficiaries need, since ostomy products are not interchangeable commodities. Johnson cites United Ostomy Associations of America estimates that 13,200 South Carolinians live with an ostomy, including 8,580 Medicare beneficiaries, and warns that a dozen South Carolina supply companies could be forced to reduce or eliminate ostomy offerings. She contends that lowering product costs through bidding risks raising overall care costs through leakage, skin damage, infections, and hospitalizations, and urges Congress to weigh real-world patient outcomes rather than price alone.
- Industry
KFF Health News Column Highlights Risks of Overmedicating Older Adults
In her "The New Old Age" column for The New York Times and KFF Health News, Paula Span discusses "deprescribing", the practice of reviewing and reducing unnecessary or harmful medications in older patients. Span, who also appeared on WAMU's Health Hub, cites geriatrician K. Eric De Jonge noting that patients on six or seven prescriptions face nearly a 100% chance of side effects or drug interactions. The piece flags benzodiazepines, antibiotics, and daily aspirin as commonly overused drugs among older adults, and urges patients and caregivers to proactively ask doctors whether long-standing prescriptions are still appropriate given evolving medical evidence.
- Industry
Commentary Argues Health Insurers Need Agentic AI Integration, Not More Tools
In an industry commentary, the author argues that health insurance companies do not need another standalone AI point solution but rather "connective tissue" that enables existing technology investments to work together through agentic AI. The piece contends that insurers, including Medicaid plans, have accumulated disparate systems and tools over years without achieving coordinated automation or intelligence across them. The author frames agentic AI's real value as orchestration and integration across an organization's existing stack rather than the introduction of new isolated capabilities. No specific product, vendor, or regulatory action is cited in the piece.
- Industry
KFF-AP Poll Finds Rural Voters Split on Immigration Crackdown Effects
A KFF-Associated Press survey of more than 2,000 rural voters conducted in August finds rural America divided on whether President Trump's immigration enforcement has helped or hurt their communities, with about a third saying it was positive, a third saying negative, and roughly three in ten reporting no impact. Despite this split, about 7 in 10 rural voters say immigrants with legal status and seasonal agricultural workers are important to their local economies. Rural voters are less likely than the general public to believe Trump has "gone too far" on immigration enforcement, with only about 4 in 10 saying so compared to 55% of U.S. adults overall. A Harvard health policy researcher cited in the poll noted that research shows immigrants use less healthcare than native-born Americans, countering claims that immigration strains the healthcare system.
- Industry
Hospital M&A Accelerates: Nine Deals Close or Launch in One Week
In its weekly hospital M&A roundup, Becker's Hospital Review reports nine health system transactions completed or announced during the week of Sept. 28. Highlights include HealthPartners and Essentia Health's plan to combine into a 22-hospital Minnesota system by January 2027, and UPMC's completed acquisition of Steubenville, Ohio-based Trinity Health System from CommonSpirit Health, marking UPMC's entry into Ohio. Other deals include WVU Health System's acquisition of Independence Health System's five hospitals with an $800 million modernization commitment, Orlando Health's acquisition of an Alabama hospital, and the University of Kansas Health System's move to take full ownership of a Topeka hospital from Ardent Health. Several deals took effect Oct. 1, while others remain pending regulatory approval.
- Federal Policy
CMS Issues FAQ on Medicare Improvement Fund Premium Rebate
CMS published a frequently-asked-questions fact sheet explaining the Medicare Improvement Fund Premium Rebate. The document addresses how the rebate works and who qualifies for it under Medicare, clarifying operational and eligibility questions for beneficiaries and stakeholders. No specific effective date or dollar figures are detailed beyond the FAQ format itself. The guidance is relevant primarily to Medicare administration rather than Medicaid.
- Industry · ME
MaineHealth Completes Acquisition of York Hospital
York (Maine) Hospital officially became MaineHealth's 10th hospital on Oct. 1, joining the system's Southern region after signing a letter of intent in October 2025. The 79-bed hospital cited rising labor and pharmaceutical costs, increasing payer denials, and its ineligibility for federal safety-net programs like critical access hospital designation and 340B drug pricing as reasons for seeking affiliation. MaineHealth and York Hospital plan to maintain inpatient services while strengthening primary care and expanding specialty access through the larger network. CEO Patrick Taylor said the deal preserves the hospital's community focus while adding system-level support.
- Industry
Rural Health Policy Leader Keith Mueller Dies at 73
Keith Mueller, PhD, longtime director of the Rural Policy Research Institute (RUPRI) at the University of Iowa, died September 26 following a brief illness. Over more than three decades, Mueller advised federal agencies including CMS, testified repeatedly before Congress, led the National Rural Health Association, and published over 220 scholarly works on rural health policy. Colleagues credit him with building RUPRI's reputation for nonpartisan, evidence-based analysis that lawmakers from both parties relied on consistently. He also served as interim dean of the University of Iowa College of Public Health and mentored generations of rural health researchers.
- Industry · GA
Children's Healthcare of Atlanta CEO Unveils 30-Minute Access Strategy
Patrick Frias, MD, who became CEO of Children's Healthcare of Atlanta in August after returning from Rady Children's Health in San Diego, is pursuing a strategy called "More Than Possible" to put pediatric services within 30 minutes of every family in metro Atlanta. The system has opened a new primary care office in Adamsville that has served 500 new patients since late June, purchased land in Sandy Springs for future growth, and is expanding into rural Georgia through a partnership with Mercer University School of Medicine including a scholarship program for medical students committing to rural pediatric practice. Mental health is a defined pillar of the strategy, with the system citing more than 300 care team members in what it calls the largest pediatric mental health workforce in Georgia. The strategy also includes research partnerships with Emory University and Georgia Tech and a cellular and gene therapy program.