joe, Author at DeBrunner & Associates

PRICE TRANSPARENCY NOT LIVING UP TO OBJECTIVE – YET

The requirement that hospitals post transparent information about their prices is not yet leading consumers to do more price shopping before obtaining care. Instead, to the degree that hospitals are fulfilling the requirement at all, the data they share is mostly used by other hospitals and insurers to aid in their negotiations with one another. Even when hospitals post the required data – many still do not – that data often is not presented in a way that is useful, or even comprehensible, for consumers. In addition, it can be difficult for consumers to make apples-to-apples comparisons between providers because [...]

joe2026-02-25T08:05:53-05:00February 25, 2026|hospitals|

Medicare Advantage Musical Chairs Continues

Even as the number of seniors enrolling in Medicare Advantage plans rises every year, the program’s stability is threatened by the withdrawal of those plans from the program. According to a new JAMA Network analysis, after years of just one percent of Medicare Advantage participants being forced to find new plans because their plan left the program, the rate of participants who need to find new plans for that reason rose to 6.5 percent in 2025 and to ten percent in 2026. This is occurring, moreover, even though the number of plans participating in Medicare Advantage continues to increase. The [...]

joe2026-02-24T14:21:56-05:00February 24, 2026|Medicare|

Rate of Timely Prenatal Care Declines

The rate at which pregnant women start receiving prenatal care during their first trimester declined between 2021 and 2024, as did the rate of pregnant women who received late or no care. Meanwhile, the rate at which pregnant women initiated prenatal care during their second trimester rate rose. These figures come from a new data brief from the Centers for Disease Control and Prevention’s National Center for Health Statistics. Highlights from the CDC’s findings, taken directly from the report, include: After increasing from 2016 (77.1%) to 2021 (78.3%), prenatal care beginning in the first trimester decreased to 75.5% in 2024. [...]

joe2026-02-19T16:28:49-05:00February 23, 2026|Uncategorized|

Federal Health Policy Update for February 19

The following is the latest health policy news from the federal government for February 13-19. Some of the language used below is taken directly from government documents. Congress Congress is not in session this week and will return on Monday, February 23. The House Ways and Means Committee will hold a hearing titled “Next Generation of Health Care Workforce” on Tuesday, February 24. View a livestream of the hearing here. The Courts A federal court has vacated the Federal Trade Commission’s (FTC) 2024 overhaul of the Hart-Scott-Rodino Premerger Notification Rule. That rule expanded disclosure requirements, requiring filings for transactions valued [...]

joe2026-02-19T15:40:16-05:00February 19, 2026|340b, Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Medicaid, Medicare, Medicare regulations|

Feds Taking Another Shot at 340B Changes

Only a week after a federal court rejected for a second time its attempt to introduce a new approach to administering the 340B Drug Pricing Program, the Health Resources and Services Administration is going back to the drawing board and trying again to launch the model. In its first step, HRSA has issued a Request for Information (RFI) to gather input from interested parties on whether the agency should implement a rebate model under the 340B program and how best to implement such a model. The RFI notes that in 2024, HRSA began receiving inquiries from drug companies seeking to [...]

joe2026-02-18T10:37:51-05:00February 18, 2026|340b|

ACA Premium Subsidy Talks Over?

Negotiations seeking to strike a compromise in the elimination of enhanced subsidies for lower-income purchasers of health plans sold on Affordable Care Act insurance exchanges appear to have died a quiet death. Talks between Democratic and Republican negotiators focused on a one- or two-year extension of those subsidies, but once the subsidies ended at the close of 2025 and then Congress enacted an FY 2026 funding bill for the Department of Health and Human Services, those talks appeared to collapse. Learn more about the issues that negotiators stumbled over and how those talks faltered and ultimately failed from the Wall [...]

joe2026-02-12T14:39:00-05:00February 13, 2026|Affordable Care Act|

Federal Health Policy Update for February 12

The following is the latest health policy news from the federal government for February 6-12. Some of the language used below is taken directly from government documents. The White House The White House announced the launch of TrumpRx, a service that will enable consumers to purchase a limited number of discounted prescription drugs directly from the manufacturers of those drugs and in some cases from pharmacies without the benefit of health or prescription drug insurance. Learn more about TrumpRx and its launch from this White House announcement, an accompanying fact sheet, and the TrumpRx web site. Congress Following passage of [...]

joe2026-02-12T16:12:39-05:00February 12, 2026|340b, Affordable Care Act, Centers for Medicare & Medicaid Services, Congress, hospitals, Medicaid, Medicare, Medicare reimbursement policy|

CMS Proposes Major Changes in Exchange Plans

The Centers for Medicare & Medicaid Services has proposed sweeping changes in the health plans offered by Affordable Care Act marketplace exchanges. The changes, revealed in CMS’s proposed Notice of Benefit and Payment Parameters for 2027, affect both the regulations governing the types of health plans that can be offered on exchanges and how potential buyers of those plans are deemed eligible for those plans. The major changes include: Permitting insurers to offer catastrophic plans with terms of either one year or multiple consecutive years, up to ten years. Repealing standardized plan options and related limit requirements. Permitting low-deductible plans [...]

joe2026-02-11T12:46:23-05:00February 12, 2026|Affordable Care Act, Centers for Medicare & Medicaid Services|

CMS Axes 340B Model

Following two defeats in federal court, the Centers for Medicare & Medicaid Services has ended its 2025 attempt to launch its 340B Rebate Model Pilot Program. The program, which would have introduced a new approach to the 340B prescription drug discount program under which a limited number of pharmaceutical companies would pay rebates to 340B-eligible entities after they purchase drugs instead of offering discounts for the purchase of those same drugs, as has been the practice since the 340B program’s launch in 1992. Late last year a federal court ruled against the imminent introduction of the model, doing so largely [...]

joe2026-02-11T08:22:39-05:00February 11, 2026|340b|

Docs Not Always Caring for Medicaid Patients

More than a quarter of all doctors enrolled to serve Medicaid patients in 2021 did not serve any Medicaid patients at all while another ten percent treated fewer than 10 Medicaid patients, according to a new Health Affairs study. Among different types of doctors, primary care physicians and cardiologists were most likely to care for higher numbers of Medicaid patients while Medicaid patients seeking the services of psychiatrists were mostly out of luck. Many of the doctors who care for Medicaid patients, and especially those who do not, cite reimbursement that is lower than – and often much lower than [...]

joe2026-02-05T16:51:38-05:00February 10, 2026|Medicaid|

joe

About joe