A ‘Barbaric’ Problem in American Hospitals Is Only Getting Bigger
Patients are getting stuck in the emergency department for days while waiting for a spot in an inpatient ward.
CMS
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Real Estate Investors Profit From Long-Term Care While Residents Languish
Real estate investment trusts are landlords for thousands of nursing homes, assisted living facilities, and hospitals. Some select the managers and keep close watch over their performance but deny responsibility for bad care.
By Jordan Rau -
New Federal Medicaid Rules Require One Month of Work. Some States Demand More.
Starting next year, about 18.5 million adults will be subject to new Medicaid work rules in 42 states and Washington, D.C. Applicants must show they’ve been working for at least a month before receiving benefits. Some Republican-controlled states want to triple the required work period.
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States Face Another Challenge With Medicaid Work Rules: Staffing Shortages
Some states already don’t have enough staff to quickly process Medicaid applications and answer enrollees’ phone calls. Researchers say they may not be prepared to handle new Medicaid work rules, predicting people will lose coverage as a result.
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Trump’s Hunt for Undocumented Medicaid Enrollees Yields Few Violators
Federal health officials have ordered states to reverify the immigration status of hundreds of thousands of Medicaid enrollees. After seven months, findings from five states show the reviews have uncovered few immigrants without legal status who are improperly receiving benefits.
A Headless CDC
Episode 439The Trump administration faces the challenge of naming a new director of the Centers for Disease Control and Prevention who can both satisfy the Make America Healthy Again movement and get confirmed by the Senate. Meanwhile, a new Senate bill to rescind the approval of the abortion pill mifepristone is again elevating the abortion debate, which some Republicans would prefer to stay on the back burner until after the midterms. Shefali Luthra of The 19th, Lizzy Lawrence of Stat, and Rachel Cohrs Zhang of Bloomberg News join KFF Health News’ Julie Rovner to discuss the news. Also this week, Rovner interviews Georgetown University Law Center’s Katie Keith about the state of the Affordable Care Act on its 16th anniversary.
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Oz Escalates Medicaid Fraud Claims Against States After Focus on Minnesota
The Trump administration’s unprecedented actions targeting Medicaid funding in Minnesota are part of what could become a playbook as officials turn pressure toward California, Florida, Maine, and New York.
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Oz Says California’s Not Fighting Health Care Fraud, but Data Shows It’s Part of a Larger Battle
Trump administration officials say the state allows rampant fraud and have promised to investigate, blaming the “Russian, Armenian mafia” in the hospice and home health care industry. But data shows hotbeds of health care fraud throughout the country, with California outperforming most other states in recovering fraud dollars.
By Don Thompson -
Medicare Advantage ‘Dark Money’ Group Attempts To Win Higher Payments for Insurance Companies
Medicare Advantage insurers say a proposal by the Trump administration to keep their payments nearly flat next year may lead to service cuts that harm seniors struggling to afford health care. A decision is due by early next month.
RFK Jr.’s Very Bad Week
Episode 437HHS Secretary Robert F. Kennedy Jr. had another tough week. In addition to Kennedy having rotator cuff surgery, the nomination of his ally to become surgeon general is teetering, the controversial head of the FDA's vaccine center is resigning next month, and a new survey shows Americans trust government health officials less than they do former Biden official Anthony Fauci. Anna Edney of Bloomberg News, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico Magazine, and Shefali Luthra of The 19th join KFF Health News’ Julie Rovner to discuss these stories and more.
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Lawmakers, Health Groups Resist Their States’ Rural Health Fund Plans
Some Republican state lawmakers and state health associations are pushing back against spending plans under the Trump administration’s $50 billion federal rural health fund. Federal administrators already approved states’ plans, but in many cases, state lawmakers must greenlight spending.
By Arielle Zionts and Sarah Jane Tribble -
Even Patients Are Shocked by the Prices Their Insurers Will Pay — And It Costs All of Us
Health care prices are on the rise, and patients are flummoxed that even insurance companies aren’t doing more to control costs.
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Wyoming Wants To Make Its Five-Year Federal Rural Health Funding Last ‘Forever’
State officials believe they’ve found a way to extend the life of federal Rural Health Transformation Program money Wyoming is receiving as part of last summer’s One Big Beautiful Bill Act — by investing most of it.
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Trump Required Hospitals To Post Their Prices for Patients. Mostly It’s the Industry Using the Data.
Politicians have pushed for price transparency in health care. But instead of patients shopping for services, it’s mostly health systems and insurers that are using the information, as fodder for negotiations over pay.
By Darius Tahir -
Clinics Sour on CMS After Agency Scraps 10-Year Primary Care Program Only Months In
A planned 10-year federal program called Making Care Primary was supposed to help primary care doctors by easing administrative burdens, allowing them to focus on improving patients’ health. A year after the Trump administration eliminated the program, federal officials created an alternative plan that favors companies.
By Andrew Jones -
With ICE Using Medicaid Data, Hospitals and States Are in a Bind Over Warning Immigrant Patients
The Trump administration’s move to give deportation officials access to Medicaid data is forcing hospitals and states to consider alerting immigrant patients that information from emergency medical coverage applications could be used in efforts to remove them from the country.
By Phil Galewitz and Amanda Seitz -
Sick of Fighting Insurers, Hospitals Offer Their Own Medicare Advantage Plans
Breakups between insurers and health systems, on top of plan cuts, left more than 3.7 million Medicare Advantage enrollees facing a tough choice last year: find new insurance or new doctors. But hospital systems say their Advantage plans can avert such upheaval, giving patients peace of mind.
By Susan Jaffe -
These 3 Policy Moves Are Likely To Change Health Care for Older People
Two Trump administration regulatory rollbacks affect nursing home staffing and home care workers, and a new AI experiment in Medicare has alarmed eldercare advocates and congressional Democrats.
By Paula Span -
Medicaid Tries New Approach With Sickle Cell: Companies Get Paid Only if Costly Gene Therapies Work
The government is using sickle cell treatments to test a new strategy: paying only if the therapies benefit patients. With more expensive treatments on the horizon, the program — created by the Biden administration and continued under President Trump — could help Medicaid save money and treat more patients.
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States Race To Launch Rural Health Transformation Plans
Every state will receive at least $100 million annually from the federal Rural Health Transformation fund, but some scored millions more based on how the Centers for Medicare & Medicaid Services judged the “quality” of their plans and willingness to pass policies embracing "Make America Healthy Again" initiatives.