Wakely Wire

August 14, 2025

New Insights

Events & More

Newsworthy Findings

Bonus Article

Just for Fun

New Insights

Whitepapers, briefs, press releases and more

By Michael Cohen

Week in Washington 08/14/25

Congress Executive Branch

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Events & More

Wakely Webinar- From Insight to Impact: Measuring What Matters in Care Management

Tuesday, August 26, 2025
2:00 p.m. ET

With care management programs and point solutions continuing to expand across Medicare, Medicaid, and Commercial lines of business, the need for rigorous, data-driven evaluation has never been more urgent. Join us for a practical session on how payers and partners can design and execute credible studies to measure both the financial and member experience impact of their investments.

We’ll cover where to start (hint: it begins with your data), introduce analytical frameworks for assessing direct and indirect outcomes, and share lessons from a recent case study—blinded for objectivity. Whether you’re considering how to pursue new opportunities, understanding the landscape, building your first evaluation or refining an existing one, this session offers strategic and tactical guidance for turning good intentions into actionable insights.

Learn more and register

Newsworthy Findings

ACA Plans Want to Hike Premiums by Median of 18% Next Year: KFF

It’s the largest increase that ACA insurers have asked for in more than five years as payers brace for membership turmoil.

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Editor's Note

According to a new analysis from preliminary ACA rate filings by the KFF, the largest midpoint increase the industry has asked for since 2018 is being seen for projected 2026 premiums. This could be due to elevated medical costs, and utilization as well as the expiration of federal subsidies for ACA plans. Insurers are submitting multiple rate filings to cover different policy scenarios, trimming their plans and even fleeing the ACA exchanges entirely.

Physicians Are Working More but Reimbursement Isn’t Keeping Pace

Physicians are working harder now than in past years, but they’re getting less for that work, according to new research from Kaufman Hall.

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Editor's Note

According to a report from Kaufman Hall, the amount of work that goes into providing a physician service has increased by 11% over the past two years. This is an issue as Kaufman Hall also found that patient revenue per each work relative value unit dropped 7% over the same time period, leading provider compensation per work relative value unit fell 2%. A recent CMS rule includes a Medicare base rate hike of 2.5% for doctors next year. But, its impact on reimbursement will vary wildly based on a physician’s specialty and site of practice.

Hospitals Prepare For $149B Cut to Medicaid State-Directed Payments

New limits to the program could force hospitals to slash capital spending while bracing for millions of newly uninsured patients.

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Editor's Note

With state-directed Medicaid payments facing sharp cuts, hospitals will be hit from two sides: reduced funding and a projected surge of 10 million newly uninsured people between 2025 and 2034. This will drive up uncompensated care costs, as patients will still seek treatment but be unable to pay. States have few alternatives to replace the lost dollars, as tight budgets may force them to cut provider payment rates, scale back benefits, or narrow Medicaid eligibility.

Hospitals Prepare For $149B Cut to Medicaid State-Directed Payments

New limits to the program could force hospitals to slash capital spending while bracing for millions of newly uninsured patients.

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Editor's Note

Depressed Volumes Hounded for-Profit Providers in Q2

Executives at major for-profit hospital chains gave conflicting explanations for the softer volumes in the second quarter, from flagging consumer confidence to lower Medicaid admissions.

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Editor's Note

In addition to the softer volumes, recent legislation cutting healthcare services is expected to cause further losses starting in 2027.

Bonus Article

Blowing in a Conch Shell Helps Treat Dangerous Snoring Symptoms for Folks With Sleep Apnea, Says Study

Patients who took part in the ancient practice regularly for six months experienced a significant reduction in their symptoms of obstructive sleep apnea (OSA), a common sleep disorder where breathing stops repeatedly during the night due to a blocked airway.

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Just for Fun

Math Joke:

Who’s in charge in a pencil case?

Prior Week

Q: Did you hear about what happened to the statistician?

A: Probably!

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