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Thursday, September 17 · 3 stories
- Industry
Health Systems Lease SNF Beds to Address Patient Boarding and Discharge Delays
Hospitals are leasing skilled nursing facility beds to reduce emergency department boarding and expedite patient discharges as SNF capacity tightens. Four health systems report success using bed leasing arrangements that include value alignment with SNF partners, transparent patient selection criteria, and regular operational check-ins. The approach addresses growing pressure from an aging population and declining overall SNF bed supply. Systems largely exited the SNF business years ago but are now contracting for guaranteed bed access.
- Industry
FTC Tightens Failing Firm Defense Standards for Hospital Acquisitions
The Federal Trade Commission is applying stricter standards to the failing firm defense in hospital merger reviews, even as rural and critical access hospitals face documented financial pressures from low reimbursements, high Medicaid and Medicare volumes, uninsured patient populations, and expired pandemic relief funding. Hospitals seeking acquisition approval must now meet heightened thresholds to demonstrate they cannot remain independent or find alternative purchasers. The guidance affects health systems pursuing distressed hospital acquisitions, including those serving significant Medicaid populations.
- Industry
FDA Faces Staff Shortage That Hampers Agency's Ability to Expand Workforce
The Food and Drug Administration is experiencing a hiring bottleneck due to insufficient staffing resources to recruit and onboard new employees. This operational constraint affects the agency's ability to scale up its workforce even when funding and positions are authorized. The staffing limitation comes as FDA faces increasing regulatory responsibilities across drug approvals, medical device oversight, and food safety. While not directly a Medicaid story, this affects the broader regulatory environment in which Medicaid operates, particularly for drug approvals and medical device reviews that impact Medicaid coverage and spending decisions.
Wednesday, September 16 · 3 stories
- Industry
ASHP Advocates for Medicare Pharmacist Coverage, 340B Protections in Congressional Meetings
The American Society of Health-System Pharmacists (ASHP) is conducting Capitol Hill meetings on September 16 to advocate for three pharmacy priorities: expanded Medicare coverage of pharmacist-provided care, protections for the 340B Drug Pricing Program, and pharmacy residency training support. The advocacy day reflects organized pharmacy's push for provider status recognition and safeguarding discount drug programs. ASHP announced the legislative agenda in a September 15 news release ahead of member meetings with congressional offices.
- Industry
Addus HomeCare to Acquire AccentCare Personal Care Division for $275 Million
Addus HomeCare Corporation announced a $275 million acquisition of AccentCare's personal care division, expected to close in Q1 2027 at the earliest. The transaction is part of Addus's broader expansion strategy and will provide the company entry into new geographic markets. The deal represents strategic alignment as both companies focus on their core business lines. Addus executives have indicated additional large acquisitions are in the pipeline.
- Industry · VT
Dartmouth Health and UVM Health Network Announce Over 600 Job Cuts
Dartmouth Health is eliminating 420 positions and UVM Health Network is laying off 199 staff, effective Oct. 1, 2026. Dartmouth is closing its Tele-ICU and Tele-ED services, the New England Alliance for Health collaborative, and an employee training program while consolidating executive roles. UVM Health is closing two patient care units and cutting positions across its six-hospital network in Vermont and New York. Both networks cite rising costs for drugs, supplies, and salaries combined with declining patient volumes and payment rates. The cuts are expected to save UVM Health $16.8 million annually.
Tuesday, September 15 · 6 stories
- Industry
Hospital Margins Fall to 1.4% in July Amid Rising Bad Debt and Charity Care
Hospital operating margins declined to 1.4% in July 2026, with bad debt and charity care rising significantly, according to Kaufman Hall's National Hospital Flash Report analyzing data from over 1,300 hospitals. The increases in uncompensated care suggest deteriorating payer mix, meaning fewer patients with commercial insurance and more with Medicaid or no coverage. The trend pressures hospital financial sustainability and may affect provider participation in Medicaid managed care networks as hospitals reassess contracting strategies. Kaufman Hall warns hospitals may need to redesign financial and operational strategies to remain viable.
- Industry
Hospital Physician Advisor Overturns 78% of Payer Denials Across 11-Hospital System
Dr. Maliha Iqbal, physician advisor at Beacon Health System, completed 5,118 utilization reviews in 2025 as the sole physician advisor across 11 hospitals, overturning 78% of peer-to-peer denials. The workload doubled following a health system merger. The article profiles operational practices for managing high-volume utilization review and payer denial appeals at scale. This reflects ongoing provider strategies to combat managed care prior authorization and medical necessity denials.
- Industry
KFF Survey Finds Adults With Complex Health Conditions Face Access and Cost Barriers
A KFF survey of over 25,000 adults found that individuals with multiple or complex health conditions face significant challenges affording medical care and accessing services and medications, with uninsured adults experiencing the most severe barriers. The survey highlights systemic gaps in the healthcare system's ability to serve chronically ill populations. KFF President Drew Altman stated the findings suggest the healthcare system is failing to meet its primary obligation to care for the sick, particularly those who are both chronically ill and uninsured.
- Industry
Hospitals Lease SNF Beds to Reduce ED Boarding Amid Post-Acute Capacity Crunch
Hospital systems are leasing skilled nursing facility beds to address emergency department boarding driven by post-acute discharge bottlenecks. The strategy responds to reduced overall SNF capacity, an aging population, and persistent throughput challenges despite testing other post-acute alternatives. Systems previously exited the SNF business but are now returning to secure discharge capacity. Implementation timelines and specific health system participation were not detailed in the available excerpt.
- Industry
Latent Adds Seven Health Systems for AI-Driven Specialty Pharmacy Platform
Latent, an enterprise pharmacy intelligence platform, announced partnerships with seven health systems including Cleveland Clinic and AdventHealth, bringing its total partner count to 60. The company is deploying autonomous AI agents designed to address specialty drug access bottlenecks by automating pharmacy operations rather than simply flagging issues for human review. The expansion reflects growing health system interest in automation tools to manage complex specialty pharmacy workflows as the specialty drug pipeline continues to expand faster than traditional operational infrastructure can support.
- Industry
AHA, Kaufman Hall Report Calls for Broader M&A Review Beyond Commercial Pricing
A new Kaufman Hall report prepared for the American Hospital Association argues that hospital merger reviews should assess impacts on Medicare and Medicaid beneficiaries, who account for nearly 60% of hospital patient days, not just commercial insurance pricing. The report finds that hospitals seeking mergers often serve vulnerable communities and face financial pressures, and that blocked transactions can lead to deterioration threatening services and access. The authors call for merger analysis that considers consequences if deals do not proceed and evaluates effects on government-payer populations.
Monday, September 14 · 5 stories
- Industry
Johnson & Johnson Requires Claims Data Sharing for 340B Discounts
Johnson & Johnson is requiring 340B-covered entities to share claims data as a condition of receiving 340B drug discounts. The company joins other pharmaceutical manufacturers implementing reporting requirements, citing concerns about duplicate discounts. The policy affects safety-net providers that rely on 340B pricing, including federally qualified health centers and disproportionate share hospitals that serve Medicaid populations. The requirement takes effect immediately for providers seeking to maintain access to J&J's discounted pricing under the 340B program.
- Industry
Addus HomeCare to Acquire AccentCare Personal Care Division for $275 Million
Addus HomeCare Corporation will acquire AccentCare's personal care division outside New York for approximately $275 million. The transaction covers operations in 10 states serving approximately 13,700 clients daily and expands Addus into six new states: Colorado, Georgia, Minnesota, Pennsylvania, Tennessee, and Washington. The acquisition consolidates personal care market share among home and community-based services providers serving Medicaid beneficiaries, particularly in long-term services and supports programs. Financial and regulatory closing terms were not disclosed in the announcement.
- Industry
CMS Health Technology Ecosystem Falls Short on Interoperability Promise
President Trump's 2025 pledge to eliminate redundant patient paperwork through CMS's Health Technology Ecosystem has not been fully realized. Healthcare providers still face significant barriers to seamless record exchange across appointments and care settings. The initiative aimed to reduce administrative burden through improved data interoperability, but implementation challenges persist. For Medicaid managed care organizations and providers, gaps in health information exchange continue to drive care coordination inefficiencies and administrative costs.
- Industry
Kaufman Hall Report Examines Financial Effects of Blocked Hospital Mergers
A new Kaufman Hall report argues that antitrust review of hospital mergers focuses too narrowly on commercial insurance pricing impacts and overlooks effects on Medicare and Medicaid patients, who represent nearly 60% of acute-care hospital patient days. The report finds that among 88 canceled hospital transactions, potential acquirees experienced a median 50% reduction in operating profit margin and 38% reduction in days cash on hand in the following year. The analysis shows hospitals seeking acquisition serve communities with higher vulnerability and higher Medicare/Medicaid patient shares than their prospective acquirers, and that facility closures or service reductions following blocked mergers may disproportionately affect Medicare and Medicaid beneficiaries whose access to care is at risk even though government-set rates would not change.
- Industry
Rural Hospitals Form Clinically Integrated Networks Across Eight States
Over 150 independent rural hospitals across eight states have formed clinically integrated networks in the past three years to maintain independence and negotiate with payers. The most recent is Missouri's Show-Me High Value Network, comprising 23 hospitals. These networks aim to achieve scale, share data, and strengthen contract negotiations while avoiding acquisition by larger health systems or managed care organizations. The trend reflects rural providers' strategy to remain viable amid industry consolidation.
Friday, September 11 · 4 stories
- Industry
UnitedHealth Group Drops Prior Authorization for 1,700 Services, Faces Maryland Lawsuit
UnitedHealth Group has announced plans to eliminate prior authorization requirements for 1,700 services, a significant operational change affecting providers and patients. The company also faces a lawsuit from Maryland's attorney general, though specific allegations were not detailed in the brief. Additional updates include the appointment of Ujjwal Ratan as chief AI officer at Optum Insight. These developments span regulatory compliance, clinical operations, and corporate leadership at the nation's largest health insurer.
- Industry
NASHP Releases Hospital Cost Tool to Calculate Commercial Payment Breakeven Rates
The National Academy for State Health Policy (NASHP) has released a hospital cost tool that allows state payers to calculate commercial payment breakeven rates. The tool helps states and other payers analyze hospital pricing by determining the minimum commercial rates needed to cover costs when considering Medicare and Medicaid payments. This analysis is relevant for states evaluating hospital payment adequacy and negotiating commercial rates, which indirectly affects Medicaid programs through cross-subsidization dynamics and hospital financial viability. The tool is available now for state use.
- Industry
Foley Partner to Speak on Medicare and Medicaid Administrative Enforcement Trends
Foley & Lardner partner Judy Waltz will present on Medicare and Medicaid administrative enforcement trends at the California Society for Healthcare Attorneys Fall Seminar. The session will address emerging enforcement patterns affecting healthcare providers and plans. No specific date or enforcement details are provided in the announcement.