中文

Latest news

报告:医疗人力短缺重创农村社区,2030年前形势持续严峻

根据AMN Healthcare发布的报告,美国持续存在的医生短缺预计将持续到2030年,受人口老龄化、临床医生倦怠率高企及慢性病患者增多等因素驱动。农村社区将承受最严重冲击:2025年农村地区注册护士岗位填补率仅为城市的三分之一。报告还警告,特朗普总统签署的《一项大而美的法案》对Medicare和Medicaid的大幅削减可能加剧问题,导致更多农村医院和诊所关闭。

Hospitals
Fifth Circuit Overturns No Surprises Act QPA Methodology, Favoring Providers in Arbitration Disputes

The 5th U.S. Circuit Court of Appeals ruled on Tuesday that the federal methodology for calculating qualifying payment amounts (QPA) under the No Surprises Act is partly unlawful. The court sided with the Texas Medical Association and other plaintiffs on two of three challenges, finding that insurers improperly included 'ghost rates' and excluded bonus and incentive payments. The ruling is expected to raise provider payouts in arbitration, while the court allowed existing QPAs to remain temporarily to avoid disruption.

Payer
CHAI 组建工作组应对前沿 AI 模型网络安全风险

健康 AI 联盟(CHAI)于周三宣布成立工作组,汇集近 100 名医疗系统、支付方和行业领袖,共同应对前沿 AI 模型带来的网络安全风险。该工作组将每两周召开一次会议,目标在 2026 年底前发布健康 AI 网络安全指南,包括 AI 网络风险评估工具和攻防策略手册。CHAI 表示,Anthropic 今年春季发布的高级 Mythos 和 Fable AI 模型“根本性地改变了”医疗保健领域的网络威胁格局,成为推动成立该工作组的催化剂。

Health IT
Fitch Warns Nonprofit Hospital Recovery May Have Reached Its Peak

According to a Fitch Ratings report based on audited fiscal 2025 data, nonprofit hospitals and health systems improved their operating margins for a third consecutive year, with the median margin rising to 1.5%. However, Fitch cautions that this recovery may be uneven and could peak in 2025, as Medicaid funding reductions and other policy changes are expected to strain hospital revenues more significantly in 2027, particularly for financially weaker and Medicaid-dependent providers.

Hospitals
Brookings analysts: CMS work-rule impact estimates built on 'invented evidence'

A Brookings Institution analysis contends that the CMS rule implementing Medicaid work requirements rests on 'complete random assumptions' with no empirical justification. The report challenges the agency's estimates that 29% of affected beneficiaries will find work, that only 3.1-3.3 million will lose coverage over a decade, and that the policy will save $350.3 billion — figures that diverge sharply from CBO forecasts and prior studies.

Payer
Is Congress finally ready to stop subsidizing hospital consolidation?

MedPAC recently urged Congress to adopt site-neutral payment reforms to eliminate Medicare reimbursement differences between hospitals and independent physician clinics. The bipartisan Same Price, Lower Cost Act is expected to reduce costs for patients and taxpayers and slow the trend of hospital consolidation.

Opinion
Insurers want to hike small businesses’ premiums by 14% next year: KFF

A new analysis released by the health policy research organization KFF shows that insurers plan to increase median health insurance premiums in the small business group market by 14% in 2027. Amid soaring healthcare costs, surging demand for GLP-1 drugs, and the impact of the No Surprises Act, most insurers have requested increases ranging from 10% to 20%, with some even exceeding 30%.

Finances
Hinge Health expands into gastrointestinal care with $105M acquisition

Digital musculoskeletal care company Hinge Health announced on Tuesday that it has signed a definitive agreement to acquire virtual digestive care company Cylinder Health for $105 million in cash to expand gastrointestinal care services. The transaction is expected to close in the third quarter of this year, after which Hinge plans to incorporate integrated GI care into its existing MSK and migraine care programs.

Finances
Complete Health to pay $14M to settle Medicare Advantage fraud allegations

Complete Health has agreed to pay $14.1 million to settle a whistleblower lawsuit accusing it of inflating Medicare Advantage reimbursements through false diagnosis codes from 2020 to 2023. The U.S. Department of Justice stated that the settlement underscores regulators' commitment to combating profiteering in the MA program.

Finances

Our partners