红领巾瓜报

OKEMOS, Mich., July 8, 2026 鈥� 红领巾瓜报 (红领巾瓜报), a national leader in health and human services consulting, today announced Arda Ural will serve as the firm鈥檚 chief operating officer (COO), effective July 6.

Ural is an accomplished and innovative healthcare executive with over 30 years of leadership experience. His operational expertise has led to profitable growth across the professional services and life sciences industries.

鈥淎rda is an internationally recognized expert in the life sciences sector and has an exceptional track record of leading growth and innovation at every step of his career,鈥� said Chuck Milligan, 红领巾瓜报鈥檚 chief executive officer. 鈥淲e are excited to welcome Arda to 红领巾瓜报. I am confident his strong leadership and significant operational experience will help propel our company and our clients to solve the toughest challenges in healthcare and human services.鈥�

鈥淚 am excited to help drive 红领巾瓜报鈥檚 unique mission to improve lives by helping our clients make health and human services more accessible, effective, and sustainable,鈥� said Arda Ural, PhD.

Prior to joining 红领巾瓜报, Ural was the Americas Life Sciences leader at EY, accountable for strategy, consulting, M&A, technology, tax, and assurance businesses 鈥� driving significant revenue growth. Ural previously served as Accenture鈥檚 managing director of the life sciences M&A practice and before that was vice president of strategic marketing at Becton Dickinson, where he also led the Fortune 500 medtech company鈥檚 business unit. At Eyetech Pharmaceuticals Ural served as senior vice president of marketing and sales, building commercial capabilities for the biotechnology company through its initial public offering which led to its acquisition. During his 10 years in leadership roles at Pfizer he led the multi-billion dollar global launch of Viagra and managed the U.S. Celebrex franchise.

Ural will be based in 红领巾瓜报鈥檚 New York City office.

About 红领巾瓜报 (红领巾瓜报)
红领巾瓜报 is an independent, national research and consulting firm specializing in publicly funded healthcare and human services policy, programs, financing, and evaluation. We serve government, public and private providers, health systems, health plans, community-based organizations, institutional investors, foundations, and associations. With multidisciplinary consultants coast to coast, 红领巾瓜报’s expertise, services, and team are always within client reach.

The Centers for Medicare & Medicaid Services (CMS) released the听 proposed rule (CMS-1850-P), July 2, outlining policies that would take effect, if finalized, January 1, 2027. Although the proposed rule includes annual payment updates, it also offers insights into the agency鈥檚 broader policy agenda.听

CMS continues to advance several long-term priorities, including site-neutral payment reform, elimination of the inpatient only list to migrate services to lower-cost settings, and efforts to align reimbursement more closely with acquisition costs for pharmaceuticals purchased through the 340B Drug Pricing Program. CMS is refining its policies that encountered operational or legal challenges, most notably in the case of its 340B payment proposals.听

The听rule also signals how听CMS is preparing听Medicare听for the next generation of healthcare delivery. As software-based therapies, artificial intelligence, and other听health听technology听become increasingly integrated into care delivery,听the agency is听laying听the groundwork for payment policies that reflect evolving care models and emerging medical innovation.听听听

This article听highlights five听proposals听that may have significant financial, operational, and strategic implications across the healthcare听system.听听

Highlights听of Key听Changes in the听OPPS听Proposed听Rule听

1. CMS Intends to Cut to Reimbursement for Drugs Acquired Under the 340B Program听

Based on findings from a survey of hospital acquisition costs, CMS proposes reducing reimbursement for drugs acquired through the 340B Drug Pricing Program from Average Sales Price (ASP) plus 6 percent to ASP minus 33.4 percent beginning in CY 2027. CMS estimates the policy could reduce Medicare fee-for-service (FFS) drug spending by $4.55 billion in its first year, which would be redistributed to non-drug service payments under OPPS鈥檚 budget neutrality rules.听

The proposal would similarly reduce payment rates for 340B drugs paid under alternative methodologies, including those reimbursed using Wholesale Acquisition Cost (WAC). Vaccines, pass-through drugs, and certain non-opioid pain management products would remain exempt, as would Children’s Hospitals, Sole Community Hospitals, and PPS-exempt听cancer听hospitals.听

CMS also proposes applying the policy to 340B drugs administered in non-excepted off-campus provider-based departments while leaving reimbursement for non-340B drugs unchanged.听

红领巾瓜报 (红领巾瓜报)听Analysis:听CMS is effectively continuing a policy听discussion听that has been听ongoing听for听nearly a听decade.听Although听prior litigation altered the agency’s听approach, the proposal听demonstrates听CMS’s continued interest in aligning Medicare reimbursement more closely with acquisition costs for 340B drugs. The financial implications will vary significantly across hospitals depending on their reliance on 340B savings. At the same time, providers with limited 340B exposure may听benefit听from the budget-neutral redistribution of savings elsewhere in the OPPS payment system.听

2. Because of the 340B Payment Cuts, Hospitals Will See an Increase in the Conversion Factor Used to Set Payments for Most Non-Drug Items and Services 听

CMS proposes an overall听2.4 percent payment听increase in OPPS payments for CY 2027, but听payment levels will vary under the rule based on major policy changes.听The proposed 340B payment reduction, for instance, would trigger an 8.44听percent听increase听in听the conversion factor听for non-drug services.听CMS is also proposing听a听conversion factor reduction of 3 percent听intended听to recover听increased payments听hospitals received听for non-drug items and services听as a result of听CMS鈥檚 remedy related to听prior 340B reimbursement听cuts.i听

红领巾瓜报 Analysis:听The proposed payment updates听illustrate how interconnected Medicare payment policies have become. Organizations should look beyond the headline听increase听and evaluate how individual provisions interact. The proposed reduction in 340B reimbursement serves as a budget-neutral offset that increases the OPPS conversion factor, creating winners and losers across provider categories.听Separately, the proposal would accelerate the pace and听magnitude听of听legal-remedy-related rate reductions originating from the听termination of an earlier iteration of the 340B payment reduction policy.听Understanding this redistribution effect will be critical for forecasting organization-specific financial听effects.听

3. More Proceduresare Moving to the Outpatient Setting听

CMS proposes removing 638听procedures from the Medicare Inpatient听Only (IPO) list in CY 2027,听representing听nearly half听of the remaining procedures听designated听as听such.听The proposed removals focus on less complex services across several clinical听areas, including digestive, endocrine, respiratory, urinary, maternity, and other procedural categories.听

红领巾瓜报 Analysis: This proposal continues CMS’s long-term strategy of shifting appropriate services to outpatient settings. As the IPO list continues to shrink, hospitals will have greater flexibility to conduct procedures in the outpatient setting than in the past. At the same time, hospitals billing for certain previously IPO-listed services in inpatient settings could encounter greater scrutiny and pressure to migrate towards outpatient sites. Because many commercial coverage policies and听utilization听management approaches have historically relied on Medicare’s IPO framework, the proposal may accelerate broader market movement toward outpatient care, creating operational, capacity, and revenue implications for providers.听

4. Site-Neutral Payment Reform Remains a Long-Term CMS Priority

CMS proposes extending site-neutral payment policies to imaging services without contrast provided in excepted off-campus provider-based departments (PBDs). The agency notes substantial growth in the听utilization听and spending associated with these services over the past decade and views the proposal as a continuation of broader efforts to reduce听payment听differentials across sites of care.听This proposal follows CMS’s recent expansion of site-neutral payment policies for drug administration services.听

红领巾瓜报 Analysis:听The proposal reinforces that site-neutral payment reform听remains听a priority for CMS.听Although听the immediate policy targets imaging services without contrast, stakeholders should view the proposal within the context of a broader and continuing effort to reduce payment differentials between hospital outpatient departments and physician office settings. Hospitals with significant outpatient imaging capacity鈥攑articularly in off-campus PBDs鈥攕hould evaluate the potential听financial impact听and consider how future site-neutral policies could affect other service lines.听Hospitals should also听anticipate听incremental additions to this framework听in the future, as CMS continues to scrutinize听site-of-care allocations for听services.听听

5. A Future Framework for AI and Digital Health is in the Works, While Maintaining Existing Policies in the Short Term听听

Recognizing the growing role of software and AI-enabled technologies in healthcare delivery, CMS proposes using CY 2027 as a bridge year while it develops a longer-term payment approach for technologies categorized as Software as a Medical Service (SaMS).听Under the proposal, technologies currently assigned to听New Technology听Ambulatory Payment Classifications (NT-APCs)听would听generally maintain听their payment assignments during CY 2027.听

红领巾瓜报 Analysis:听Although the proposal preserves near-term payment stability, it may be one of the most consequential signals in the rule for manufacturers, digital health companies, investors, and providers adopting听new technologies. CMS is exploring how software-based interventions, AI-enabled tools, and algorithm-driven services generate value and how that value should be reflected in Medicare payment policy. Future reimbursement methodologies听will听likely place听greater emphasis on听demonstrated听clinical outcomes, efficiency gains, and measurable impacts on healthcare听utilization. Organizations developing or deploying these technologies should view CY 2027 as an opportunity to prepare for a more mature reimbursement framework in the years ahead听and to engage with CMS on preferred policy approaches.听

Looking Ahead听

The CY 2027 OPPS proposed rule provides insight into the direction of Medicare reimbursement policy,听changes in Hospital Conditions of Participation (CoP)听for听obstetrical services, and planned revisions to the exceptions to the 鈥渇our walls鈥� requirement under the Medicaid clinic benefit for Indian Health Services/Tribal clinics, behavioral health clinics, and clinics听located in rural areas.听For hospitals, health systems, manufacturers, life sciences companies, digital health organizations, and investors, now is the time to assess potential impacts and evaluate strategic responses before policies are听finalized.听Comments on听the听proposed rule are due August 31, 2026.听

红领巾瓜报 is helping organizations understand the financial, operational, and market implications of the proposed rule through:听

• Customized听financial impact听modeling听
• 340B reimbursement and redistribution analyses听
• Site-neutral payment impact听analyses听
• Clinical service line and specialty-specific analyses听
• Medicare听and Medicaid听policy scenario planning and forecasting听
• Regulatory comment strategy development听

As CMS continues to听pull听the thread on several long-term policy priorities, organizations that begin planning now will be better positioned to navigate the changes ahead. Contact 红领巾瓜报’s Medicare experts to discuss how these proposals may affect your organization and explore potential strategic responses before the final rule is released.