April 28, 2026

Site Neutral Stunner On Capitol Hill

Health system CEOs faced a grilling on a range of hospital issues today on Capitol Hill, but in a stunning turn of events the executives said that they are willing to discuss reasonable changes to their long-standing opposition to site neural payments in Medicare.

Under site neutral, the same services at all locations are paid the same rate, which would drop hospital payments dramatically. What emerged was some consensus on moves to site neutral that would recognize hospital differences in some cases and changes that might be phased in so as not to undermine finances at health systems.

Lawmakers, mostly on the GOP side, otherwise accused health systems of driving high costs and reducing competition. Democrats focused on the cuts in the One Big Beautiful Bill (OBBBA).

The Trump administration finalized another small step on site neutrality, but Capitol Hill has always been stymied by a strong hospital lobby opposition. It was truly a watershed event.

Additional articles: https://www.fiercehealthcare.com/providers/capitol-hill-health-system-ceos-agree-rational-reworking-site-neutral-payments and https://thehill.com/homenews/house/5853987-gop-hearing-hospital-costs/

(Some articles may require a subscription.)

#hospitals #antitrust #mergers #acquisitions #siteneutral

https://www.modernhealthcare.com/politics-regulation/mh-congress-hca-commonspirit-new-york-presbyterian-ceos

Centene Hikes Outlook

Centene hiked its 2026 profit guidance after a good Q1. Centene brought in net profit of $1.5 billion in Q1, up 18% from the same period a year ago. 

Medicaid and overall medical loss ratio stabilized. The company’s Exchange membership fell sharply since Q1 2025, dropping to 3.6 million from 5.6 million a year ago. Centene says more and more people are choosing lower metal tier benefits.

In other news, Health Care Service Corp. recorded a net loss of more than $1.9 billion in 2025, a sharp reversal from the prior two years.

Additional articles: https://www.fiercehealthcare.com/payers/centene-raises-2026-guidance-strong-q1-revenue-earnings-results and https://www.beckerspayer.com/financial/centene-posts-1-5b-profit-in-q1-aca-membership-declines-by-2m/ and https://www.healthcaredive.com/news/centene-hikes-2026-profit-guidance-buoyant-q1/818581/ and https://www.beckerspayer.com/financial/health-care-service-corp-posts-1-9b-loss-in-2025/

(Some articles may require a subscription.)

#centene #healthplans #margins

https://www.modernhealthcare.com/insurance/mh-centene-earnings-aca-exchange-membership

FDA Announces Real-Time Clinical Trials

The Food and Drug Association (FDA) announced the launch of a new real-time clinical trial, with a second one coming. This is touted as allowing agency evaluators to see swift results. Both are cancer trials. The agency also is soliciting input for a larger pilot program.

#fda #clincialtrials #drugapprovals

https://www.medpagetoday.com/washington-watch/fdageneral/121006

Nebraska Becomes First New Medicaid Work Requirement State

Nebraska will become the first state to enforce work, volunteer or education requirements for new Medicaid applicants under the One Big Beautiful Bill Act (OBBBA), some eight months before the mandate. Advocates say the move is rushed and will impact recipients. The state says it is ready and is thoroughly educating workers, enrollees, and stakeholders.

#medicaid #workrequirements #obbba

https://thehill.com/homenews/state-watch/nebraska-medicaid-work-requirements/

— Marc S. Ryan

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