The Paragon Health Institute, a conservative think tank led by first-term Trump health official Brian Blase, has called for changes to federal financing for hospitals. The think tank argues that federal policy overpays hospitals, gives them an edge in competition and promotes consolidation. It also disputes the industry's claim that facilities lose money treating Medicare and Medicaid patients, an argument often used to justify charging commercially insured patients more for services. The report also calls for greater scrutiny of "direct subsidy programs" like provider taxes, state-directed payments, and certain Medicare andMedicare payments. It suggests that Congress should tie nonprofit hospitals' tax-exempt status to "measurable and actual charity care" rather than vague defined "community benefit".