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Healthcare Services: Key Considerations for Healthcare Services Ahead of the 2026 Midterm Elections
研报英文原文证据摘录
Healthcare Services: Key Considerations for Healthcare Services Ahead of the 2026 Midterm Elections
olicy-setting
framework. As a result, we see the most important decisions (e.g., 2028 MA rates, policy
changes around stars) as less impacted by changes in Congress, with minimal changes to
the bureaucratic apparatus. For this key reason, while we acknowledge that there could
be noise around the headlines from Congress, we still see the most influential policy
makers as unchanged and expect to see a continued focus from CMS on prior
authorization, risk coding (particularly in MA), fraud, and AI, consistent with what we
heard from them at AHIP earlier this year.
• For healthcare facilities, policy priorities tend to focus on hospital pricing and
consolidation, protecting financially distressed facilities, and tightening oversight
of ownership and business practices. While we believe that the hospitals maintain
mainstream bipartisan support and sizable lobbying influence (particularly at the local
level), the size and growth of hospital spending in recent years (and subsequent pay-for
potential from reforms) has led to renewed interest in reining in spending growth,
typically under arguments revolving around potential budgetary or profiteering
concerns. This has included dialogue regarding the downstream impact to coverage and
rural/safety net facilities following changes to Medicaid under the OBBBA and coverage
and collections volatility tied to ACA Exchange enrollment shifts, as well as prospective
discussions regarding changes to Medicare payment and delivery-site reform (e.g., site-
neutral, 340B), heightened oversight of market conduct, and use of AI within utilization
management (e.g., WISeR Model). Should nothing change, we think the most concrete,
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