Paragon Seeks More Healthcare Changes
Paragon Health Institute is riding a wave of success after many of its core healthcare proposals ended up in the recent budget reconciliation bill. It is busy defending the legislation but also pushing for more reforms in a possible second budget bill. Paragon is now pushing the following for inclusion:
- Site neutral payments
- Exchange cost-sharing reduction reform
- Reducing the 90% federal match rate for Medicaid expansion
- 340B drug discount program reform
- Medicare Advantage (MA) reform, including rate benchmark changes, ending additive quality bonus payments, and risk adjustment reform
#healthcare #healthcarereform #medicare #medicaid #medicareadvantage #exchanges
Aetna To Contract In MA Again
After contracting products in MA dramatically in 2025, Aetna has announced it will end nearly 90 MA plans across 34 states in 2026. Preferred Provider Organization (PPO) products are being targeted.
Further, health systems that sponsor Medicare Advantage (MA) plans are looking for opportunities to expand as big national plans reduce their enrollment by several million over the past few years and now into 2026. As was previously announced, UnitedHealthcare will shed as many as 600,000 lives in MA in 2026.
Additional article: https://www.beckerspayer.com/payer/medicare-advantage/as-payers-stumble-hospitals-eye-their-medicare-advantage-members/
(Some articles may require a subscription.)
#hospitals #healthplans #aetna #unitedhealthcare
https://www.modernhealthcare.com/insurance/mh-aetna-medicare-advantage-plans-2026
UHG Cleared To Buy Home Health Entity
UnitedHealth Group and home health provider Amedisys reached a settlement with the federal government to proceed with Amedisys’ sale to United for $3.3 billion. The two companies agreed to divest 164 home health and hospice locations in 19 states.
In other news, Democratic senators are seeking more answers on United’s alleged scheme that it paid off nursing homes to keep patients out of the hospital.
Additional articles: https://www.modernhealthcare.com/insurance/mh-unitedhealth-group-i-snp-senate-democrats/ and https://www.fiercehealthcare.com/payers/unitedhealth-amedisys-sell-facilities-settlement-doj and https://www.beckerspayer.com/m-and-a/unitedhealth-reaches-deal-with-justice-department-to-move-amedisys-deal-forward/ and https://www.healthcaredive.com/news/unitedhealth-amedisys-doj-settlement-merger/757086/ and https://thehill.com/homenews/senate/5439793-unitedhealth-group-nursing-homes/
(Some articles may require a subscription.)
#unitedhealthcare #manda #acquisitions #healthcare
https://www.modernhealthcare.com/post-acute-care/mh-unitedhealth-amedisys-merger-settlement-doj
Trump Drug Tariffs Will Have Major Fallout
Both sides of the aisle are critical of Donald Trump’s threat to levy major tariffs on drug imports, arguing it puts affordability and access at risk. Generic availability is especially a concern. The tariffs will start low but eventually hit as high as 250%. Trump argues it will lead to onshoring of drug manufacturing.
In other news, three federal judges recently ruled against drug company interests in challenges to the Medicare Drug Price Negotiation Program.
#drugpricing #tariffs
https://www.medpagetoday.com/publichealthpolicy/healthpolicy/116891
— Marc S. Ryan
