Reimbursement
CMS also proposes to update the outlier threshold so that estimated outlier payments remain at 2% of total payments.
This translates to an estimated increase of $695 million in payments from fiscal year 2025, CMS says.
The American Hospital Association voiced concern over that rate and a 2.6% increase for long-term care hospitals.
Adjustments are estimated to total $196.5 million in 2026, CMS says.
Declining physician payments and rising operational costs place emergency medicine at financial risk, RAND finds.
This translates to $25 billion for MA insurers in 2026.
CMS declined to cover obesity drugs, as proposed under the Biden administration.
Cuts in Medicaid would likely mean that many beneficiaries would lose coverage, leading to more uncompensated care for hospitals.
Hospitals that are already struggling will lose funding, say the Democratic state treasurers of Republican-proposed cuts.
Members are frustrated by not finding accurate information online, by being unable to get a live agent or by lack of preventative care options, says Rita Sharma, chief product officer at Pager Health.