The Hertel Report

1 week ago | thehertelreport.com | Melanie MacEachern

Last week, the U.S. House of Representatives passed a reconciliation package with significant changes for Medicaid and the Affordable Care Act (ACA) Marketplace as part of President Donald Trump’s “big beautiful” spending vision for his second term in office. The Congressional Budget Office (CBO) estimates that the part of the legislation that passed the Energy and Commerce Committee would leave 8.6 million Americans uninsured through changes to the ACA and Medicaid programs.

1 month ago | thehertelreport.com | Melanie MacEachern

The skilled nursing industry was elated by the Centers for Medicare and Medicaid Services (CMS) proposed Skilled Nursing Facility Prospective Payment System (SNF PPS) proposed rule, which included a 2.8% pay bump for FY 2026. The rate hike falls far short of the 4.2% raise that SNFs received this year and the 4% increase the year prior, but the industry was thrilled with the announcement nonetheless.

1 month ago | thehertelreport.com | Melanie MacEachern

The Centers for Medicare and Medicaid Services announced its proposed Hospice Wage Index and Payment Rate Update proposed rule for FY 2026. The proposed reimbursement update will raise the base payment rate by 2.4%, lower than the 2025 increase of 2.9%. The increase represents $695 million rise in total hospital payments, Hospice News reports. CMS will also hold its 5% cap on any year-over-year wage increase. According to stakeholders, the increase falls far short of what is needed by the industry.

1 month ago | thehertelreport.com | Melanie MacEachern

The Centers for Medicare and Medicaid Services (CMS) has proposed a rule under the Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) and the IRF Quality Reporting Program (QRP) for Fiscal Year (FY) 2026. The agency proposes updating the payment rates by 2.6% based on the IRF market baskey update of 3.4%, minus 0.8% for a productivity adjustment.

1 month ago | thehertelreport.com | Melanie MacEachern

The Centers for Medicare and Medicaid Services issued a proposed rule for the Medicare inpatient prospective payment system (IPPS) for fiscal year (FY) 2026. The rule includes a proposed pay bump of 2.4% for hospitals. CMS said that the rate reflects a 3.2% projected hospital market basket increase with a 0.8% productivity adjustment due to anticipated improvements in efficiency, Healthcare Finance News reports.