- CMS: Medicare and Medicaid Programs: CY 2026 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program
- Public Inspection: CMS: Medicare and Medicaid Programs: CY 2026 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare Prescription Drug Inflation Rebate Program
- CMS: Medicare Program; Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model
- Public Inspection: CMS: Medicare Program: Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction Model
- CMS: Secretarial Comments on the CBE's (Battelle Memorial Institute) 2024 Activities: Report to Congress and the Secretary of the Department of Health and Human Services
- HHS: Patient Protection and Affordable Care Act: Marketplace Integrity and Affordability
- Public Inspection: HHS: Patient Protection and Affordable Care Act: Marketplace Integrity and Affordability
- Increased Risk of Cyber Threats Against Healthcare and Public Health Sector
- HRSA Announces Action to Lower Out-of-Pocket Costs for Life-Saving Medications at Health Centers Nationwide
- Announcing the 2030 Census Disclosure Avoidance Research Program
- Eight Hospitals Selected for First Cohort of Rural Hospital Stabilization Program
- CMS: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2026 Rates; Requirements for Quality Programs; and Other Policy Changes; Correction
- CMS: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2026 Rates; Requirements for Quality Programs; and Other Policy Changes; Correction
- CMS: Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly; Correction
- CMS: Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly; Correction
Financial Analysis of General Acute Care Hospitals in Pennsylvania Shows Significant Changes in Margins
The Pennsylvania Health Care Cost Containment Council (PHC4) released Financial Analysis – Volume One, the first volume of a three-part series of financial reports published annually by PHC4. Volume One displays financial information from general acute care (GAC) hospitals licensed in Pennsylvania during fiscal year 2024 (FY24).
“While the data shows many Pennsylvania hospitals experienced relatively healthy margins in fiscal year 2024, 37% lost money on operations and 32% lost money overall,” said Barry D. Buckingham, executive director of PHC4. “Also, the continued growth of uncompensated care remains a major concern for Pennsylvania hospitals.”
This report includes insight into the 153 GAC hospitals licensed in the Commonwealth that operated during at least some portion of FY24. Within Volume One the statewide average operating margin increased from 2.26% in FY23 to 6.80% in FY24. The data shows in FY24:
- 37% of PA GAC hospitals posted a negative operating margin
- 14% of PA GAC hospitals posted an operating margin between 0% and 4%
- 49% of PA GAC hospitals posted an operating margin higher than 4%
Volume One also reports that 32% of Pennsylvania’s GAC hospitals posted a negative total margin, 10% posted a total margin between 0% and 4%, and the remaining 58% posted a total margin higher than 4%. Regarding the margins observed in this report, Buckingham said, “The reasons for the significant increases identified in this year’s report are currently unclear. While the data reflects an upward trend, the underlying factors driving these changes have not been fully identified or analyzed. Further investigation is needed to pinpoint the specific contributors to this growth.”
PHC4 is an independent council formed under Pennsylvania statute (Act 89 of 1986, as amended by Act 15 of 2020) in order to address rapidly growing health care costs. PHC4 continues to produce comparative information about the most efficient and effective health care to individual consumers and group purchasers of health services. In addition, PHC4 produces information used to identify opportunities to contain costs and improve the quality of care delivered.
For more information, visit phc4.org or review the full report here.
Registration to Open August 7 for Appalachian Commission Annual Conference
Join your fellow economic development leaders at our 2025 annual conference, Appalachian Places. Registration opens August 7 at 3 p.m ET.
We’ll gather in Frostburg, Maryland, October 6-7, and share insights on growing place-based economies. Attendees will hear from Appalachian leaders on a variety of programming tracks:
👣 Creating paths for future success
⛲ Leveraging local assets
🤖 Training workers for shifting economies
💡 Igniting innovation and entrepreneurship
🍎 Fostering community well-being
Spaces fill up quickly, so mark your calendars: August 7, 3 p.m. ET, Appalachian Places registration!
CMS Announces Calendar Year 2026 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center Proposed Rule
The Centers for Medicare & Medicaid Services (CMS) today issued the Calendar Year (CY) 2026 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule (CMS-1834-P), introducing a series of patient-focused reforms that would modernize payments, expand access to care, and enhance hospital accountability.
Calendar Year 2026 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center Proposed Rule Materials:
CMS Publishes Calendar Year (CY) 2026 Physician Fee Schedule (PFS) Proposed Rule
The Centers for Medicare and Medicaid Services (CMS) issued the Calendar Year (CY) 2026 Physician Fee Schedule (PFS) proposed rule (CMS-1832-P). This annual proposed rule establishes revised payment policies under the Medicare PFS and makes other policy changes to payment under Medicare Part B. These changes will apply to services furnished beginning January 1, 2026.
The final rule must be displayed at the Federal Register by November 1, 2025.
Click here for the press release.
Click here for the Physician Fee Schedule for Calendar Year 2026.
Click here for the Medicare Shared Savings Plan Fact Sheet for Calendar Year 2026.
Report Shows Decline in Rural Obstetric Care
With support from the Federal Office of Rural Health Policy, a team of researchers from the University of Minnesota, Harvard University, and the University of Pennsylvania found widespread loss of obstetric services across states, especially among rural hospitals, during the 12-year period studied. By 2022, eight states had more than two-thirds of rural hospitals without obstetric services.
Read the report: Obstetric Care Access Declined in Rural and Urban Hospitals Across US States, 2010–22.
Study Focuses on Expanding Dental Care in Safety Net
A new study conducted by the Oral Health Workforce Research Center examined critical factors influencing the delivery of oral health services at federally qualified health centers (FQHCs). The study evaluated trends in oral health services at 1,000 FQHCs nationwide and the results were recently published in the Journal of Public Health Dentistry.
Introducing the New Institute for Dental Safety and Science
The Association for Dental Safety (ADS) launched a new organization to provide clinical guidelines and best practices after the CDC’s oral health division was eliminated in a round of federal layoffs. The ADS previously oversaw dental infection prevention and patient safety initiatives in partnership with the CDC. Now, the new ADS Institute for Dental Safety and Science will work to continue developing guidelines and best practices. One of the first tasks the new group will undertake is appointing an advisory committee that will oversee updates to the CDC’s infection control guidelines for dental healthcare settings, which was last updated in 2003.
2025 Compendium of Rural Oral Health Best Practices Released
The National Rural Health Association released the 2025 Compendium of Best Practices in Rural Oral Health. This collection contains best practices in programs, models, and policies aimed at enhancing access to quality rural oral health care.
Fluoride Resources Provided by the American Dental Association
The American Dental Association (ADA) Health Policy Institute (HPI) recently published a brief,
“State-Level Costs of Removing Fluoride from Community Water Systems.” Nationally, they estimate that the total five-year increase in dental care costs due to removing fluoride from community water systems is $45.9 billion dollars. For Pennsylvania, the estimated cost is over $1.1 billion dollars.
The ADA also released a series of resources to help combat fluoride misinformation. “Fluoridation Facts” highlights 80 years of research and practical experience to support water fluoridation. See below for several other helpful fluoridation resources from the ADA.
Click here to view the Fluoridation Facts Executive Summary.
Click here to view the full version of Fluoridation Facts.
Click here to view All About Fluoridation.
Click here to view How to Take Action on Water Fluoridation.
Click here to view Fluoride Facts for Water Operators.
Pennsylvania Broadband Authority Receives 2025 Governor’s Award
The Pennsylvania Broadband Development Authority (PBDA) team has been selected as recipients of the 2025 Governor’s Awards for Excellence — one of the highest honors in state government.
The PBDA team received the honor for securing a historic $1.16 billion in federal funding and launching multiple competitive grant programs to bridge the digital divide.
Congratulations to the Team!