The Fundamentals of Budget Reconciliation | |
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President-elect Trump has indicated that he will move quickly to achieve an ambitious policy agenda in his second term. He and his transition team have promised to "seal the border" immediately following his inauguration and to extend the tax cuts in the Tax Cuts and Jobs Act within the first hundred days of his administration.
While many of Trump's policy objectives can be pursued through executive orders, significant components of his economic agenda will require legislative action. Newly re-elected House Speaker Mike Johnson (R-LA) has said there is "no daylight" between Trump's priorities and those of Congressional Republicans.
However, with narrow majorities in both the House and Senate, Republicans do not have the votes to overcome a Senate filibuster. Instead, they have committed to the use of budget reconciliation—a procedural mechanism that allows certain fiscal initiatives to pass with a simple majority in the Senate—to pursue Trump’s economic agenda.
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Federal Workforce Reform: Revisiting Schedule F | |
Preparation for the second Trump administration has brought renewed attention to the organization and operations of the federal workforce. Statements from the Trump transition team and remarks from Elon Musk and Vivek Ramaswamy, who are set to lead the advisory Department of Government Efficiency, have fueled speculation about an imminent restructuring of civil service roles. Central to this discussion is the possible reinstatement of Schedule F, an executive order originally issued by President Trump in 2020 and more recently emphasized as a key component of the Heritage Foundation’s Project 2025. | |
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Coming January 29:
NVHPF's Reporter Panel Looks Ahead to
Health Policy in 2025
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Join us for the Northern Virginia Health Policy Forum at noon ET on Wednesday, January 29, as seasoned Washington reporters share their perspectives on the future of health policy in Congress and the White House in 2025. | |
NVHPF's December Webinar:
Policy Pathways for Healthcare Under a New Administration
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The Northern Virginia Health Policy Forum closed out 2024 by welcoming two DC lobbyists who shared insider perspectives on what to expect under the incoming administration. Bret Baker from the Nickles Group and Diane Major from the D. Major Group joined Applied Policy President and CEO Jim Scott for a conversation that ranged from the confirmation prospects for President-elect Trump's appointees to the future of telehealth.
A recording of the event is available below. A summary of the conversation is available for download here.
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Applied Policy Welcomes Sampat Nidadavolu | |
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Sampat Nidadavolu,
Health Policy Manager
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Sampat Nidadavolu, M.S., MBA, has joined Applied Policy as a Health Policy Manager, specializing in medical devices.
Nidadavolu most recently worked at Palmetto GBA where he supported the review of applications for Healthcare Common Procedure Coding System (HCPCS) code assignment and conducted research and analysis for the Centers for Medicare & Medicaid Services. During his five-year tenure, he analyzed emerging technologies such as digital scanning and 3D printing, contributing to the development of precise coding guidelines. He also previously served as an Application Support Engineer at Siemens.
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In welcoming Nidadavolu, Applied Policy COO John Voorhees stated, "Sampat brings a wealth of experience in biomedical engineering and healthcare policy. He also has a proven track record in analyzing emerging technologies and supporting policy decision-making. His background in engineering and extensive experience in medical device coding and analysis will be invaluable to our clients."
Read Nidadavolu's full bio here.
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Visa Programs and Physician Shortages | |
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According to the Association of American Medical Colleges (AAMC), the United States faces a shortage of between 37,800 and 124,000 physicians by 2036. This shortfall, described as an “urgent crisis” by the president of the American Medical Association (AMA), is expected to disproportionately affect rural areas, where access to healthcare is already limited.
Both the AAMC and AMA have identified immigration policy as a critical strategy for strengthening the physician workforce and mitigating the impact of the physician shortage on the nation’s health. The J-1 and H-1B visa programs, which help to attract international physicians to fill gaps in primary care and specialty services, are central to these efforts.
As the incoming administration brings a renewed focus on immigration policy, we explore the visa programs that make it possible for foreign-national physicians to work in the United States.
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Annie Tuttle Advances to Health Policy Associate | |
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Annie Tuttle
Health Policy Associate
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Applied Policy is pleased to announce that Annie Tuttle, who joined the company as an intern in April 2024, has been hired as a full-time associate.
COO John Voorhees observed that Tuttle made exceptional contributions during her internship. “In addition to excelling in her research and support roles, Annie has been instrumental in the continued success of the Northern Virginia Health Policy Forum webinars,” Voorhees said. “We are delighted to welcome her as a full-time member of the team and look forward to her continued contributions.”
Read Tuttle's full bio here.
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Updates on Federal Rulemaking | |
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For 2026, CMS Proposes Changes Resulting in a 4.33 Percent Increase in Plan Payments and Implements Inflation Reduction Act Provisions on Part D Redesign
By Caitlyn Bernard
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On January 10, 2025, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2026 Advance Notice of Methodological Changes for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies, which makes proposals to update program policies for Medicare Advantage (MA) and Part D beginning in 2026. CMS also issued its Draft CY 2026 Part D Redesign Program Instructions, which center on implementing provisions of the Inflation Reduction Act of 2022 (IRA) related to the Part D benefit for 2026.
CMS proposes:
- Changes to the Effective Growth Rate and benchmark rate for MA payments
- Changes related to implementing the IRA Part D benefit redesign for 2026
- Completion of the three-year phase-in of the 2024 CMS-HCC risk adjustment model
- Beginning to transition to the 2024 CMS-HCC risk adjustment model for Program of All-Inclusive Care for the Elderly (PACE) Organizations
- To continue the Part D risk adjustment model with plans for 2026 IRA-related changes
- To continue the End Stage Renal Disease risk adjustment model
- To continue the frailty adjustment for Fully Integrated Dually Eligible (FIDE) Special Needs Plans (SNPs) and changes to adjustments for PACE
- To continue the adjustments to Fee-for-Service (FFS) per capita costs in Puerto Rico
The agency also solicits feedback on MA star ratings measure concepts for future years.
If these proposals are finalized, CMS anticipates a 4.33 percent, or over $21 billion, increase in MA plan payments from 2025 to 2026.
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MACPAC Discusses MCO Accountability
By Emma Hammer
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On December 12 and 13, 2024, the Medicaid and CHIP Payment and Access Commission held a virtual public meeting, which included the following sessions:
- State and Federal Tools for Ensuring Accountability of Medicaid Managed Care Organizations
- Potential Areas for Comment on CMS Proposed Rule on MA for CY 2026
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MEDPAC Recommends Updating Physician Payments
By Emma Hammer
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On December 12 and 13, 2024, the Medicare Payment Advisory Commission held a virtual public meeting. By law, the Commission reviews Medicare’s fee-for-service payment policies each year and makes payment update recommendations.
The meeting included sessions on MedPAC’s assessment of payment adequacy and draft recommendations for updating payments for the following:
- Physician and other health professional services
- Hospital inpatient and outpatient services and mandated report on rural emergency hospitals
- Skilled nursing facility services
- Inpatient rehabilitation facility services
- Home health care services
- Hospice services
- Outpatient dialysis services
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Celebrating a Year of Collaboration and Innovation | |
In December, Applied Policy gathered to reflect on a year of achievement and growth. Our team celebrated the collective effort behind last year’s successes—from advancing key client initiatives to driving innovation in health policy solutions. We connected with colleagues, both old and new, and found particular joy in giving back to the community through our holiday toy drive. As we begin 2025, Applied Policy remains committed to delivering continued value to our clients and Improving Lives. | |
Highlights from our year-end gathering in Alexandria, featuring teamwork, giving back, and time with valued friends. | |
On the Docket/Under Review | |
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Applied Policy is following these rules under review at the Office of Management and Budget:
- Occupational Exposure to COVID-19 in Healthcare Settings
- Healthcare System Resiliency and Modernization
- Telemedicine Prescribing of Controlled Substances When the Practitioner and the Patient Have not had a Prior In-Person Medical Evaluation
- Amendments to Rules Governing Organ Procurement Organizations
- Advance Notice of Methodological Changes for CY 2026 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies + Draft CY 2026 Part D Redesign Program Instructions
See all rules under OMB review here.
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Insight Joke of the Month for January | |
When does February come before January? | |
Questions, comments, or concerns? Please contact us at news@appliedpolicy.com | | |
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Applied Policy, L.L.C., is a health policy and reimbursement consulting firm strategically located minutes from Washington, D.C.
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