An actuarial view of $569 million in ACA marketplace SUD spending Today, August 31, 2026, is International Overdose Awareness Day—a time to remember the lives lost to overdose, to support people affected by substance use, and to advance action that saves lives. In recognition of this day, Sober Sidekick and Wakely Consulting Group, an HMA … Read More
CMS’s Proposed Provider Tax Rule Could Reshape Medicaid Financing
August 20, 2026
The Centers for Medicare & Medicaid Services (CMS) has proposed significant changes to how Medicaid provider taxes are structured, reported, and monitored. Issued in response to the Working Families Tax Cut Act (WFTCA), the proposed rule would affect provider tax grandfathering, hold harmless thresholds, reporting requirements, and permissible tax classes, with important implications for states, … Read More
CMS Proposed Rule (CMS-2452-P) Could Reshape State Health Insurer Assessments—and Put Marketplace and Reinsurance Funding at Risk
August 4, 2026
What CMS-2452-P Means for State-Based Marketplaces, Section 1332 Reinsurance Programs, the individual market, and Medicaid Financing On July 14, 2026, the Centers for Medicare & Medicaid Services (CMS) released the Amending the Indirect Hold Harmless Threshold of Health Care-Related Taxes Proposed Rule (CMS-2452-P) to implement Section 71115 of the 2025 budget reconciliation legislation, P.L. 119-21, … Read More
How States Are Implementing Medicaid Section 1115 Justice-Involved Reentry Demonstrations
July 20, 2026
Medicaid Section 1115 Justice-Involved Reentry Demonstrations allow states to provide selected Medicaid-covered services before an individual is released from incarceration. This report highlights the operational, governance, technology, and care coordination strategies needed for successful implementation across multiple jurisdictions. HMA’s new report, Lessons Learned from Implementing 1115 Justice-Involved Reentry Initiatives: Strategic Planning and Operational Considerations, shares … Read More
Community Health Workers as Trusted Messengers: Strengthening the Community Health Information Ecosystem
July 16, 2026
Learning What Works to Foster Trusted and Effective Communication Channels Community health workers (CHWs) are among the most trusted sources of health information, yet they often lack reliable systems for receiving, validating, and sharing timely guidance. This report examines how health information flows to, through, and from CHWs in Cook County, Illinois, and identifies strategies … Read More
Final 2027 Notice of Benefit and Payment Parameters Notice: What States and Issuers Need to Know
June 8, 2026
What are the changes in the payment notice for 2027? On May 15, 2026, the Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) released the final Notice of Benefit and Payment Parameters (NBPP) for 2027, setting key rules for the individual and small group health insurance markets. … Read More
Medicaid Community Engagement Interim Final Rule: Key Implications for States, Payers, and Providers
June 5, 2026
HMA’s issue brief on the Medicaid Community Engagement Interim Final Rule provides a clear, actionable summary of new Medicaid work requirements and community engagement requirements for states, Medicaid health plans, providers, community-based organizations, and technology vendors. The report explains key policy changes issued by CMS on June 1, 2026, including exemptions such as medical frailty, … Read More
Ground Ambulance Payment Landscape: Challenges and Policy Options
June 2, 2026
Ground ambulance transport is a critical piece of the US healthcare infrastructure and is currently facing several challenges, which may result in the loss of patient access to care. These life-saving services play a vital role in the patient care continuum and significantly impact acute care and long-term recovery. Often, at critical and tense moments … Read More
Proposed Changes to Medicaid State Directed Payments and Targeted Practitioner Payments
May 28, 2026
On May 20, 2026, the Centers for Medicare & Medicaid Services (CMS) released the Medicaid Managed Care State Directed Payments and Medicaid Fee-For-Service Targeted Medicaid Practitioner Payments Proposed Rule. This proposed regulation outlines critical updates to Medicaid provider reimbursement, directly addressing federal mandates from the One Big Beautiful Bill Act (the Working Families Tax Cut … Read More
Treatment-Resistant Depression: Costs, Caregiving, and Gaps in Care
May 27, 2026
HMA’s report examines the clinical, economic, and caregiving burden of treatment-resistant depression (TRD), a condition affecting nearly one in three individuals with major depressive disorder. Drawing on a comprehensive literature review and analysis of Medicare data, the report highlights the substantial costs associated with TRD, including higher rates of hospitalization, increased healthcare utilization, and approximately … Read More