Healthcare Cost Projected To Soar
PwC says health plans expect commercial healthcare costs to climb 9% in 2027. Payers say increased use of artificial intelligence tools by health systems, hospitals and medical practices are in part to blame. AI is documenting greater specificity and reimbursable severity without proportionate increases in care intensity. Further, there is the growing use of expensive drugs, proliferation of mental health issues, and higher reimbursement demands.
A survey by Mercer says U.S. companies plan to charge more for employee health plans next year.
Additional articles: https://www.fiercehealthcare.com/payers/healthcare-costs-poised-jump-9-2027-health-plans-blame-ai-adoption-drug-prices and https://www.modernhealthcare.com/insurance/mh-health-insurance-costs-mercer-survey/
(Some articles may require a subscription.)
#employercoverage #healthcare #costs
https://www.modernhealthcare.com/providers/mh-healthcare-costs-2027-pwc-report
Hospitals Don’t Like Rate Hike Or Joint Model
Hospital groups want the Centers for Medicare and Medicaid Services’ (CMS) proposed annual pay rate increase of 2.4% for inpatient care to be increased. Further, it wants the agency to reconsider a mandatory bundled-payment joint replacement model.
#hospitals #margins #medicare
States Worried About Medicaid Cuts
Governors and state legislatures are concerned that the funding reductions at the federal level for Medicaid will saddle their states with higher healthcare costs. Rating agency S&P says the cuts could put significant pressure on state budgets.
(Article may require a subscription.)
#states #medicaid #obbba
https://www.modernhealthcare.com/politics-regulation/mh-states-budget-medicaid-cuts-hr-1
Medicare Insolvency Sooner
Medicare trustees report that the hospital Insurance trust fund will run dry in Q2 of 2033, a quarter earlier than the last report. This will happen because recent reconciliation legislation permanently cut taxes that supported Medicare.
#medicare #solvency
https://www.healthcaredive.com/news/medicare-insolvency-date-hi-fund-obbb-trustees-report/822499
CMS To Strengthen 1115 Budget Neutrality
The Centers for Medicare and Medicaid Services (CMS) announced plans to strengthen budget neutrality standards for 1115 Medicaid waivers. It says nearly one-third of all federal Medicaid dollars flow through demonstration projects. A new rule will:
- Require an independent certification of a demonstration’s budget neutrality by the CMS Chief Actuary.
- Ensure states clearly demonstrate how proposals will be budget neutral through improved beneficiary health outcomes.
#medicaid #cms #waivers
— Marc S. Ryan
