This week’s policy signals for health systems:
Congress resumes with coverage funding at center stage. Lawmakers are back with limited time to resolve government funding ahead of the January 30 CR deadline. Enhanced ACA premium tax credits expired at year-end, creating immediate affordability pressure for marketplace enrollees and elevating coverage stability as a near-term policy risk for health systems—particularly in markets sensitive to payer mix shifts. Read more: NPR, Politico, Reuters, and Politico Pro.
CMS advances Rural Health Transformation (RHT) funding. CMS approved RHT Program awards for all 50 states, distributing $10B annually to support rural access and system sustainability. Award sizes vary by state, signaling meaningful opportunities—and competitive expectations—for systems to align transformation plans with CMS priorities. Read more: Fierce Healthcare | Inside Health Policy.
AI payment policy moves from concept to mechanics. New Health Affairs analyses outline paths to pay for AI within Medicare, including coverage frameworks, RVU reform considerations, and cost-effectiveness standards. While reimbursement remains unsettled, the direction of travel reinforces the need for governance, transparency, and outcome accountability as adoption accelerates.
Read more: Health Affairs (Longyear, Berenson) and Health Affairs (Neprash).