{"id":89105,"date":"2025-07-24T16:49:10","date_gmt":"2025-07-24T16:49:10","guid":{"rendered":"https:\/\/www.europesays.com\/us\/89105\/"},"modified":"2025-07-24T16:49:10","modified_gmt":"2025-07-24T16:49:10","slug":"health-care-data-ceo-gets-real-about-wearables","status":"publish","type":"post","link":"https:\/\/www.europesays.com\/us\/89105\/","title":{"rendered":"Health Care Data CEO Gets Real About Wearables"},"content":{"rendered":"

This is a preview of Access Health\u2014Tap here to get this newsletter delivered straight to your inbox<\/a>.<\/strong><\/p>\n

Good morning. Moody’s released its quarterly health care report<\/strong> on Tuesday. Let’s take a look at the highlights.<\/p>\n

Moody’s quarterly paints a sobering picture for hospitals and health systems. The biggest headline, unsurprisingly, is that Medicaid cuts are coming\u2014and they’re steep.<\/p>\n

The newly enacted federal budget reconciliation law is projected to slash Medicaid spending by $1.1 trillion through 2034<\/strong>, compared to previous projections from the Congressional Budget Office. This could leave hospitals with more uninsured patients and fewer reimbursement dollars, especially safety-net and rural providers.<\/p>\n

Congress’ next moves will determine the exact conditions of this new normal<\/strong>. If lawmakers do not extend expanded premium tax credits for the Affordable Care Act by the end of the year, the CBO estimates that the number of uninsured Americans would increase by at least 4.2 million. Republicans<\/a> are not keen on this measure, but it’s still possible that they could compromise with Democrats<\/a> to get other key GOP health care policies passed.<\/p>\n

One of those key policies is pharmacy benefit manager (PBM) reform, something that, historically, has garnered bipartisan support. They’ve been criticized by lawmakers on both sides of the aisle for overcharging for medications. Cigna, CVS Health and UnitedHealth\u2014which together own 80 percent of the PBM market\u2014face a credit risk if the government does crack down<\/strong>, according to Moody’s. For more on the Congressional health care standoff, read on to the next section.<\/p>\n

Insurers’ finances are also in a precarious position. On the bright side, CMS’ Medicare Advantage reimbursement rate is rising to 5.1 percent in 2026. This is likely to float the industry to more typical earnings and margins after a period of weak performance, Moody’s projects. But its analysts aren’t sure how long it will take to regulate. For now, they gave health insurers a “negative” outlook due to higher-than-expected spending, particularly on weight-loss drugs and behavioral health care.<\/strong><\/p>\n

I’ll end on a positive note. Moody’s analyzed CMS data, which suggests that the independent dispute resolution (IDR) process is becoming more efficient. The No Surprises Act (NSA) has been a headache for many providers since it was enacted in 2022, but the process is finally hitting its stride, <\/strong>per the numbers. New IDR claims continued to increase throughout 2024, but the number of resolved claims began to surpass new claims starting in the third quarter.<\/p>\n

“This, along with a consistently high provider win rate in disputes, suggests a decline in NSA-related accounts receivable and an easing of liquidity stress,” Moody’s analysts said in the report.<\/p>\n

How are you feeling about your organization’s financial situation as we head into the latter half of 2025? Let me know at a.kayser@newsweek.com<\/a>.<\/p>\n

In Other News<\/strong><\/p>\n

Major health care headlines from the week<\/strong><\/p>\n