Newsletters

10.31.24

How States Support Safety Net Hospitals through Innovative Funding Approaches

Safety net hospitals are critical institutions for advancing health equity in marginalized communities. They provide important services – including behavioral health and trauma services – that would otherwise be unavailable in their neighborhoods.


08.20.24

The End of Provider Pooling? What Providers and States Need to Know about CMS’ Recent Regulations

CMS recently reinforced its commitment to prohibiting pooling arrangements. Given CMS’s position, provider groups with pooling arrangements will want to consider alternative approaches.


07.31.24

Do Providers That Serve Historically Marginalized Populations Get Paid Less? New Manatt Study

Our analysis found that hospitals disproportionately serving historically marginalized populations (HMPs) faced financial payment disparities not experienced by other hospitals, a result of both greater reliance on Medicaid reimbursements and less favorable commercial payment rates.


07.25.24

How States Can Ensure Safety Net Hospitals Benefit from the New Medicaid Access Rule

Safety net hospitals play a vital role in serving marginalized communities, however, their efforts to advance health equity are undermined because in many states Medicaid payment rates do not cover costs.


07.17.24

North Carolina’s New Plan to Relieve Medical Debt

On July 1, North Carolina announced a new plan to relieve past medical debt for low- and middle-income consumers and mitigate the impact of medical debt going forward.


07.01.24

Designing a Medicaid Hospital Global Budget Under CMS’ AHEAD Model

In September 2023, the Centers for Medicare and Medicaid Services (CMS) announced the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model, and this week CMS is expected to make a first set of announcements about states set to join the model.


06.20.24

Key Takeaways for States, Providers and Plans on State Directed Payments and Separate Payment Terms

The Centers for Medicare & Medicaid Services (CMS) made sweeping changes to the regulatory landscape for Medicaid and the Children's Health Insurance Program in its recent set of final Medicaid access regulations (here and here), including significant changes to CMS’ oversight of ...


03.28.24

Understanding CMS’ AHEAD Model: Medicare Hospital Global Budget Design and Implications

The Center for Medicare and Medicaid Innovation at the Centers for Medicare & Medicaid Services (CMS) recently released initial specifications for its Medicare Hospital Global Budget methodology under the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model.


10.02.23

North Carolina Expands Medicaid

On December 1, 2023, North Carolina will become the 40th state to implement Medicaid expansion under the Affordable Care Act (ACA), extending Medicaid eligibility to more than 600,000 adults with incomes up to 138% of the federal poverty level (FPL).


09.20.23

State-Directed Payments: Overview, Trends and Proposed Changes

In 2020, Medicaid spent $220.8 billion on hospital care. Hospital care accounted for 33% of Medicaid spending.