Literature Review

Tracking the Medicare Provisions in the 2025 Reconciliation Bill | KFF KFF; updated 7/8/25 Similar to the chart for Medicaid provisions in the 2025 Reconciliation Bill, KFF also provides details on the changes for Medicare. Topics include eligibility policies, physician payment, prescription drugs, rules for Pharmacy Benefit Managers (PBMs), nursing homes – including the prohibition of implementation, administration, or enforcement of the minimum staffing levels requirement until October 1, 2034, and funding for HHS to “contract with AI contractors and data scientists to identify and reduce Medicare improper payments and recoup overpayments.Guest Editor’s Note, Judi Lund Person: The chart of Medicare provisions confirms that implementation of the Medicare eligibility and enrollment final rule will be delayed until October 1, 2034, except for those provisions that have already taken effect. The Senate version enacted into law also has a temporary one-year increase of 2.5% in the Physician Fee Schedule conversion factor for all services furnished between January 1, 2026 and January 1, 2027 and a delay of the nursing home staffing final rule until October 1, 2034. It is helpful to have the chart in a usable form for reference on the final bill enacted into law.

KFF publishes summaries of Health Provisions in the 2025 Federal Budget Reconciliation BillKFF; updated 7/8/25 On July 3, the House passed the same version of the budget reconciliation bill passed by the Senate on July 1. On July 4, President Trump signed the legislation into law . KFF published this summary to describe the health care provisions in the law (described as the Senate-passed bill) in four categories: Medicaid, the Affordable Care Act, Medicare and Health Savings Accounts (HSAs). It also compares the provisions to a earlier draft of the bill passed by the House on May 22. Guest Editor’s Note, Judi Lund Person:  KFF was formerly known as the Kaiser Family Foundation but since KFF is not a foundation and has no connection to Kaiser Permanente, they are now called simply KFF. They state “As a one-of-a-kind information organization, we bring together substantial capabilities in policy research, polling, and journalism in one organization to meet the need for a trusted, independent source of information on national health issues—one with the scope and reach to be a counterweight to health care’s vested interests and a voice for people.”

Global adoption of value-based health care initiatives within health systems-A scoping reviewJAMA Health Forum; Ayooluwa O. Douglas, MD, MPH; Senthujan Senkaiahliyan, MHSc; Caroline A. Bulstra, DVM, MHSc, PhD; Carol Mita, MS; Che L. Reddy, MBChB, MPH; Rifat Atun, MBBS, MBA; 5/25The value-based health care (VBHC) framework was introduced in the US in 2006 to combat rising health care expenditures that failed to produce improvements in patient quality, safety, and outcomes over the past decades. The framework focuses on 6 elements: (1) organizing care around medical conditions, (2) measuring outcomes and costs for every patient, (3) aligning reimbursement with value through bundled payments, (4) integrating care systems regionally, (5) establishing national centers of excellence for complex care, and (6) using information technology systems to support these elements. This scoping review of 50 initiatives found that the implementation of VBHC globally is still in its early stages, with published scientific literature pointing to small-scale institutional-level implementation within individual departments and hospitals. Large-scale implementation designed to develop high-value health systems is limited.

HHS faces $31B cuts in proposed FY ’26 budget: 6 notes Becker's Hospital Review; by Madeline Ashley; 6/2/25 President Donald Trump’s proposed fiscal 2026 budget slashes funding for the National Institutes of Health by $18 billion to $27.5 billion as part of a sweeping overhaul to realign federal healthcare spending.  The NIH received $46.4 billion in program level funding in 2024 and just over $46 billion in 2025, according to the budget proposal. [Continue reading for this article's lists of (1) consolidated institutes and centers; and (2) "six things to know."]

HHS wants input on how to improve digital health tech for Medicare patients Fierce Healthcare; by Heather Landi; 5/14/25 The Department of Health and Human Services (HHS) wants feedback on how it can develop better digital health tools for Medicare beneficiaries and drive adoption. The Centers for Medicare & Medicaid Services (CMS), in partnership with HHS' health IT arm, now called the Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology (ASTP/ONC), is seeking public input on how best to "advance a seamless, secure, and patient-centered digital health infrastructure."

States sue HHS over layoffs, restructuring: 5 updates Becker's Hospital Review; by Madeline Ashley and Mackenzie Bean; 5/5/25 Nineteen states and the District of Columbia filed a lawsuit against the federal government May 5 aiming to block the Trump administration’s large-scale restructuring of HHS. In the lawsuit, New York Attorney General Letitia James and 19 other AGs argue the restructuring is an “unconstitutional and illegal dismantling of the department.” They contend the government has violated hundreds of laws and bypassed congressional authority by enacting the plan, which has erased decades of public health progress and left HHS unable to execute many vital functions.

RFK Jr. is gutting minority health offices across HHS that are key to reducing health disparities NBC New York 4, in partnership with CNBC; by Annika Kim Constantino; 4/30/25 

Administration to close HHS Civil Rights office Newsmax; by Brian Freeman; 4/28/25 As part of massive cutbacks at the Department of Health and Human Services, the Centers for Medicare & Medicaid Services will shut down their civil rights office in June, according to an email sent to staff on Monday and viewed by Politico. HHS has already been reduced by some 20% as part of overall downsizing, with Secretary Robert F. Kennedy Jr. and President Donald Trump focusing on eliminating those programs and agencies they say promote diversity, equity, and inclusion. ... Complaints that are nearing completion connected to workplace harassment and discrimination will be closed out in the coming weeks, and remaining complaints will be "transferred to an appropriate entity," the email stated.Editor's note: Data from the 2024 NHPCO Facts and Figures Report states: "In CY 2022, 51.6% of White Medicare decedents used the Medicare Hospice Benefit. 38.1% of Asian American Medicare decedents and 37.4% of Black Medicare decedents enrolled in hospice. 38.3% of Hispanic and 37.1% of North American Native Medicare decedents used hospice in 2022." The discrepancies between white and non-white decedents demonstrate double-digit differences. Extensive evidence-based research validates wide gaps in hospice/healthcare for persons whom the HHS Civil Rights office is charged with protecting. For more, visit Office of Civi Rights Home | HHS.gov and Office of Civil Rights About Us. 

HHS cuts funding for NIH-based Women's Health Initiative threatening decades-long study The American Journal of Managed Care (AJMC); by Giuliana Grossi; 4/23/25 HHS is defunding the regional research centers that have been conducting a long-term national health study focusing on preventive strategies for women's health since 1991, the largest study investigating women’s health in US history. The Women’s Health Initiative (WHI) regional centers will close by September 2025, at the end of the fiscal year, according to an announcement from the NIH-based initiative. Investigators at the WHI were informed by HHS earlier this week, although formal written notice from HHS is still pending.  

CMS to withdraw federal Medicaid match for workforce, social needs, and infrastructure: What states, health care providers and community organizations need to know Mondaq; by Sheppard Mullin Richter & Hampton; 4/22/25 In a move signaling a major shift in federal priorities, the Centers for Medicare & Medicaid Services ("CMS") recently announced it will limit federal funding for state Medicaid initiatives that support services beyond direct medical care. New policy guidance indicates that CMS intends to narrow the scope of the federal-state Medicaid partnership, refocusing matching funds on core healthcare services delivered to Medicaid beneficiaries. ... On April 10, CMS notified states that it will no longer approve new, or renew existing, state proposals for Section 1115(a) Demonstration Project expenditure authority to provide federal matching funds for state expenditures for designated state health programs ("DSHP") and designated state investment programs ("DSIP").

HHS proposal slashes Medicare SHIP funds MSN; by Mary Helen Gillespie; 4/22/25 The Trump administration is proposing federal budget cuts to Medicare State Health Insurance Assistance Programs (SHIP) and seven additional elder health care safety net programs that assist older Americans. ... SHIP programs have been under the umbrella of the Health and Human Services agency Administration for Community Living. The pre-decisional budget lists funds for seven other ACL programs that would be eliminated are:

Cybersecurity contracts at risk as HHS cuts 150 IT workers: Report Becker's Health IT; by Naomi Diaz; 4/15/25 The Department of Health and Human Services could face a critical breakdown in its IT and cybersecurity systems after a sweeping reduction in force that eliminated key staff and leadership, Wired reported April 14, citing four current and former agency employees. More than 150 workers in HHS’ Office of the Chief Information Officer were among hundreds of administrative staff laid off April 1, according to the report. These employees were responsible for contract renewals and cybersecurity licenses and oversaw operations at the department’s Computer Security Incident Response Center — the hub for detecting and responding to cyberthreats across the department. Sources told Wired the cuts left no one in place to renew critical cybersecurity contracts, some of which are set to expire as soon as June.