Spending on Medicaid State Directed Payments Before New Limits Take Effect
This issue brief analyzes Medicaid spending by state on SDPs that require prior CMS approval…
Spending on Medicaid State Directed Payments Before New Limits Take Effect
This issue brief analyzes Medicaid spending by state on SDPs that require prior CMS approval to better understand the use of SDPs before new limits in the reconciliation law take effect.
Forthcoming Policy Changes to Medicaid State Directed Payments
The 2025 reconciliation law reduced federal Medicaid spending by an estimated $911 billion from 2025 through 2034, some of which stems from new restrictions on Medicaid state directed payments (SDPs) for hospital and other health care services. This issue brief describes SDPs and forthcoming policy changes stemming from the 2025 reconciliation law and the proposed…
Federal Medicaid Spending Through State Directed Payments Nears $100 Billion Annually Across 41 States, With New Limits Set to Reduce Funding to States
Forty states and DC currently receive $93 billion in annual federal Medicaid spending through state directed payments (SDPs) and may be at risk due to forthcoming limits on these payments, according to new KFF estimates. Annual federal spending on SDPs is highest in California (an estimated $10.6 billion)—followed by Texas ($6.3 billion), North Carolina ($5.2…
Why One in Four Americans Is Walking Away from Healthcare
The healthcare affordability crisis in the U.S. has quietly become a trust crisis, with a growing share of Americans walking away from care altogether. Industry leaders say the fix requires something the system has never really done: starting with the patient. The post Why One in Four Americans Is Walking Away from Healthcare appeared first…
They’re Uninsured After Obamacare Became Too Costly. And They’re Far From Alone.
SUGAR GROVE, N.C. — Year after year, Ross and Rebecca Tobiassen saw their healthcare costs rise, having relied on the Affordable Care Act for federally subsidized health insurance since its start in 2014. Year after year, the couple in western North Carolina kept their coverage, believing the peace of mind was worth the cost. But…
Long-Awaited Rule Aims To Boost ACA Choices While Embracing Higher Deductibles
The Affordable Care Act seems to always be in a policy tug-of-war as its backers and critics spar over how it should work and who can qualify for coverage. This year is no different, with the Trump administration embracing standards it says will reduce fraud as well as steps that could further erode national enrollment….
Paul Markovich’s 4 Ideas to Reduce Healthcare Costs
Paul Markovich, president and CEO of Ascendiun, shared his ideas for bringing down healthcare costs, including digital health records and changing how healthcare is paid for. The post Paul Markovich’s 4 Ideas to Reduce Healthcare Costs appeared first on MedCity News.
Rocket Pharma Reaps $180M From Sale of FDA Drug Review Fast Pass
Rocket Pharmaceuticals received the rare pediatric disease priority review voucher with the accelerated FDA approval for Kresladi in March. The non-dilutive capital from the voucher’s sale will support a pipeline that includes a gene therapy in pivotal clinical testing for the rare genetic disorder Danon disease. The post Rocket Pharma Reaps $180M From Sale of…
In the Age of AI, Interoperability Isn’t Enough: Why Healthcare Needs Shared Understanding, Not Just Shared Data
The industry needs a framework that can translate clinical nuance into a consistent, trusted representation across systems and use cases. The post In the Age of AI, Interoperability Isn’t Enough: Why Healthcare Needs Shared Understanding, Not Just Shared Data appeared first on MedCity News.
The Myth of Insurance Networks
How America’s outdated insurance model is failing at its most important job The post The Myth of Insurance Networks appeared first on MedCity News.
