Today's News and Commentary

HealthcareInsights will resume on Monday, June 16.

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In other news:

NIH restores DEI prohibition for grant recipients within hours of rescinding it: On Monday, the National Institutes of Health rescinded a 7-week-old DEI directive, only to reinstate it hours later without explanation.
The maneuvering dates back to April, when the National Institutes of Health began requiring grantees to certify they did not have diversity, equity, and inclusion policies that ran afoul of anti-discrimination laws or boycotts of Israel in order to receive funding for research. The move made some universities worry about their ability to accept grant funding from the NIH without opening themselves up to litigation from the Trump administration. 

Dozens of states sue to block the sale of 23andMe personal genetic data without customer consent: Twenty-seven states and the District of Columbia on Monday filed a lawsuit in bankruptcy court seeking to block the sale of personal genetic data by 23andMe without customer consent. The lawsuit comes as a biotechnology company seeks the court’s approval to buy the struggling firm.
Biological samples, DNA data, health-related traits and medical records are too sensitive to be sold without each person’s express, informed consent, Oregon Attorney General Dan Rayfield said in a news release about the lawsuit. Customers should have the right to control such deeply personal information and it cannot be sold like ordinary property, it said.  

About health insurance/insurers

Moody’s downgrades UnitedHealth’s outlook to negative, affirms credit ratings: Moody’s Ratings has downgraded UnitedHealth Group’s outlook from stable to negative, citing “a number of adverse trends simultaneously.” 
The ratings agency also affirmed the company’s strong credit ratings, including its long-term issuer and senior unsecured debt ratings, as well as its short-term commercial paper rating. UnitedHealthcare’s financial strength rating was maintained as well.
Moody’s downgraded UnitedHealth because of the higher than expected medical cost trend within its Medicare Advantage business, increased leverage post-cyberattack on Change Healthcare, a decline in the company’s risk-based capital level, reduced interest coverage, and potential credit risk from reported Justice Department investigations into its MA billing practices. 

About hospitals and healthcare systems

15 profitable health systems in Q1 FYI

About pharma

Amazon Can’t Shed Supplement Label Deception Consumer Class Suit: Amazon.com Services LLC failed to shake off a proposed class action alleging the e-commerce marketplace misled consumers into thinking supplements they bought on the site had therapeutic value and that the marketing claims were reviewed by the Food and Drug Administration. 

About healthcare IT

Joint Commission to create guidelines on AI’s use in healthcare: The Joint Commission has partnered with the Coalition for Health AI to establish and implement evidence-based guidance on the use of artificial intelligence in healthcare operations.
The first set of guidelines and best practices is slated to be released in the fall… 

About healthcare personnel

Relocation Post-Dobbs Among Clinicians Providing Abortions: This survey study found that after Dobbs, 42% of survey respondents who provided abortions in states banning abortion relocated to another state. Almost all clinicians who relocated from any policy context relocated to states not banning abortion. We document practice relocation rates vastly exceeding those of obstetrician-gynecologists from 2005 to 2015, and among obstetrician-gynecologists post-Dobbs…Given that most study respondents provided both abortion and nonabortion health care, these accelerated relocations have implications for abortion access and for the broader maternal health workforce, exacerbating health care deserts and outcome disparities.

53% of benefit managers know their wellness programs are failing employees: Ultimately, well-being initiatives will only have an impact when they are employee-centered, culturally supported and strategically integrated into the broader benefits ecosystem. As companies grapple with rising healthcare costs and evolving employee expectations, it's no longer enough to offer wellness as an add-on. It must be a pillar of the employee experience. 
Comment: The entire article is worth reading. Implementing employee heath programs without understanding what is being addressed and how individuals will adopt them is bound to fail.

Today's News and Commentary

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In other news:

Strata Performance Trends Report- Market Insights from Q1 2025: The following report combines financial, operational, and claims data from hospitals, health systems, and other healthcare organizations across the country. Key findings include:
—Medical supply and drug expenses saw steady growth over the past two years, and that growth could accelerate due to the impacts of tariffs on imports.
—U.S. health systems saw growth in charity and bad debt deductions in recent years, including a more than 20% increase in charity deductions from Q1 2023 to Q1 2025.
—Medicaid accounts for more than 12% of revenue for most hospitals nationwide, with percentages ranging from 11.1% for hospitals in the Midwest to 14.4% for those in the West.
—Operating margins for U.S. health systems narrowed slightly to 0.9% in March, falling below 1% for the first time in 15 months after holding steady at 1% for both January and February.
—Patient demand was up nationwide across most metrics in March, following decreases in February, as growth in outpatient visits outpaced inpatient admissions. 

About pharma

Polypill Approved for Hypertension, Including as Initial Therapy: The FDA approved a polypill containing telmisartan, amlodipine, and indapamide, known as Widaplik, for the treatment of hypertension in adults, including as initial treatment.
This marks the first time that a triple combination medication has been indicated for initial therapy in patients who are likely to need multiple drugs to achieve blood pressure goals, manufacturer George Medicines noted in their announcement of the approvalopens in a new tab or window.
Initial monotherapy has historically been the default for hypertension. However, this often leads to suboptimal results, due to treatment inertia. 
Comment: PBMs typically do not approve such combinations as first or second line therapies. Physicians who want to use this pill will face push-back. 

About the public’s health

Firearm Laws and Pediatric Mortality in the US: Excess mortality analysis found that a group of states with the most permissive firearm laws after 2010 experienced more than 6029 firearm deaths in children and adolescents aged 0 to 17 years between 2011 and 2023 and 1424 excess firearm deaths in a group of states with permissive laws. In the most permissive states, the largest increase occurred in the non-Hispanic Black pediatric population; among all states, 4 states had statistical decreases in pediatric firearm mortality during the study period, all of which were in states with strict firearm policies. 

About healthcare personnel

New Oregon law sets nation’s strictest limits on corporate control of medical practices: State law mandates that physicians hold at least a 51% stake in most medical practices, but supporters of the new legislation say that companies have taken advantage of a loophole by employing their own physicians and putting their names down as clinic owners, according to the report. 
The legislation limits the control companies can have in a clinic’s operations and also bans noncompete agreements that prohibit physicians from taking a position at a different practice, the report said. The bill does not take effect immediately and has a three-year adjustment period for facilities to comply with the new restrictions. 
Hospitals, tribal health facilities, behavioral health programs and crisis lines are exempted from the legislation, according to the report. 

States ranked by share of healthcare workers FYI

Today's News and Commentary

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RFK Jr. fires all 17 members of CDC's vaccine committee: Health and Human Services Secretary Robert F. Kennedy Jr. on Monday fired the 17 sitting members of the Centers for Disease Control and Prevention's Advisory Committee for Immunization Practices (ACIP), claiming that removing all doctors and public health experts on the panel will restore public trust. 
According to Kennedy, each member was appointed by the Biden administration as part of a "concerted effort to lock in public health ideology" and to limit the Trump administration from taking "the proper actions to restore public trust in vaccines."
ACIP members usually serve four-year terms. Because 13 appointees took their seats in 2024, without the complete ouster, the committee would not have had a Kennedy-selected majority until 2028. 
"A clean sweep is necessary to reestablish public confidence in vaccine science," Kennedy said in the HHS release. 

RFK Jr.’s chronic disease agency would eliminate or reduce funding for some prevention programs: Budget documents released by the Trump administration Friday provide the first clear indication of the priorities of a proposed new agency focused on preventing chronic disease. 
The Administration for a Healthy America would absorb multiple federal agencies and existing programs, but the documents indicate that numerous initiatives axed from the Centers for Disease Control and Prevention through a reduction in force (RIF) in April will be resurrected with reduced funding — or not at all. 

NIH walks back ban on new grants for universities with DEI programs or Israel boycotts: The National Institutes of Health has, for now, walked back a policy requiring universities and other research institutes to certify that they do not have unlawful diversity, equity, and inclusion programs or boycotts of Israel in order to receive research dollars. 
The rule, which was initially posted in April, was seen as the next stage of using research funds as leverage against private universities and efforts to increase diversity in the sciences. It is unclear what prompted the rescission of the policy, which is effective immediately. But the notice published on Monday says, “NIH is awaiting further Federal-wide guidance and will provide a future update to the extramural community.”  

About health insurance/insurers

Medicare Advantage Plan Disenrollment: Beneficiaries Cite Access, Cost, And Quality Among Reasons For Leaving: Enrollees’ self-reported inability to access and receive high-quality care, more than perceived burdens of out-of-pocket costs, was associated with MA plan disenrollment, as was an objective measure of plan generosity. Difficulty accessing needed medical care was more strongly associated with MA-to–traditional Medicare exits than MA-to-MA plan switching. Dissatisfaction with access, cost, and quality was much more common for enrollees in poor health. These findings renew concerns about access to high-quality care for high-risk and other MA enrollees. 

Medicare Advantage Denies 17 Percent Of Initial Claims; Most Denials Are Reversed, But Provider Payouts Dip 7 Percent:Employing medical claims data from multiple MA plans, covering 30 percent of the entire MA market in 2019, our study found claim denial rates of 17 percent as a share of initial claim submissions. We also found that 57 percent of all claim denials were ultimately overturned. We calculated that denials resulted in a 7 percent net reduction in provider MA revenue, based on the dollar-weighted share of claim denials that were not overturned. However, the indirect impact of denials could be even greater than this direct effect that we measured.

Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Coventry Health and Life Insurance Company [from the HHS OIG]:
-For the 10 high-risk groups covered by our audit, most of Coventry’s submissions of the selected diagnosis codes to CMS for use in CMS’s risk adjustment program did not comply with Federal requirements.
- For 249 of 300 sampled enrollee-years, the diagnosis codes that Coventry submitted to CMS were not supported by medical records and resulted in $752,587 in net overpayments. On the basis of our sample results, we estimated that Coventry received at least $6.9 million in net overpayments for 2018 and 2019.
-As demonstrated by the errors we identified, Coventry’s policies and procedures to prevent, detect, and correct noncompliance with CMS’s program requirements, as mandated by Federal regulations, could be improved.
Recommendations are in the report.

About hospitals and healthcare systems

National Hospital Flash Report: April 2025 Data Key Takeaways
1. Hospital financial performance improved between January and April. On a year-to-date basis, hospital performance in the first four months of 2025 compared favorably to the same time period in 2024.
2. Average length of stay decreased and adjusted discharges per calendar day increased compared to the prior year period. This reflects improved patient throughput and a higher demand for hospital services.
3. Measures of patient volume showed improvement. Inpatient revenue, discharges, ED visits and operating room minutes all increased compared to the prior year period.  

About pharma

FDA Approved — And Ineffective: This investigation found that from 2013 through 2022:

• Seventy-three percent of drugs approved by the FDA did not meet the agency’s four foundational standards required to show they work as expected. 

• More than half of drug approvals were based on preliminary data rather than sound evidence that patients had fewer symptoms, improved function, or lived longer. 

• Fifty-five of the 429 drugs approved met only one of the four standards needed to show that a drug is safe and effective; 39 drugs met none of them.

Merck & Co.'s oral PCSK9 inhibitor succeeds in dual Phase III trials:Merck & Co. is a step closer to bringing the first oral PCSK9 inhibitor to market. On Monday, the company announced that its experimental pill, enlicitide decanoate (formerly MK-0616), hit its main goals in two Phase III trials, significantly lowering LDL cholesterol with a safety profile comparable to placebo and existing oral treatments. 
Comment: This oral form could significantly lower ther price for patients who need this drug. Among other cost-lowering factors is saving a physician visit with a facility fee.

Today's News and Commentary

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In other news: The Disappearing Funds for Vaccine Research A really interesting article with an interactive graphic. 

Today's News and Commentary

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In other news:

HHS budget proposal cuts NCI funding by 37%: The Trump administration has proposed allocating $4.53 billion for the National Cancer Institute in fiscal year 2026, marking a 37.2% decrease from the $7.22 billion the NCI received in fiscal 2025. 
Cancer research organizations and advocacy groups have expressed concern over the budget proposal, citing the link federal funding has to breakthroughs in cancer research and treatment.   

About health insurance/insurers

Medicare negotiations underway to lower prices for next batch of drugs: Medicare is negotiating the prices of 15 drugs, including Novo Nordisk's Ozempic. The government has until Nov. 30 to announce the agreed-upon Medicare prices. The lower prices would go into effect in January 2027.

CEO of healthcare software company convicted for role in $1B fraud scheme: The CEO of a healthcare software company was convicted by a federal jury for his role in operating a platform that generated fraudulent physicians’ orders to defraud Medicare and other payers out of more than $1 billion.
Gary Cox, 79, of Maricopa County, Ariz., was the CEO of Power Mobility Doctor Rx (DMERx), an internet-based platform that generated fraudulent orders for unnecessary orthotic braces, pain creams and other items, according to a June 3 Justice Department news release.

UnitedHealth Retail Traders Turn Bearish After Leaked Memo Shows Investor-Appeasing Steps Ahead Of Shareholder Meeting: Retail sentiment around UnitedHealth Group turned cautious after the company reportedly prepared a confidential internal memo ahead of its June 2 shareholder meeting, to coordinate responses aimed at allaying shareholder concerns about its business practices and reassure them about a return to growth and profitability, according to STAT…
The document appears to respond to a lawsuit alleging the company hid anticonsumer practices, including unethical claims denials that boosted profits.

About pharma

Lilly expands Welldoc partnership with new app for Zepbound and Mounjaro users: Lilly is deepening its partnership with digital health company Welldoc to launch a new app aimed at supporting patients taking its dual GIP/GLP-1 agonist, tirzepatide, in managing their cardiometabolic health.
The app includes features such as reminders, device integration, health data tracking and medication logging for the drug, which is marketed as Zepbound for weight-loss and Mounjaro to treat diabetes.  

About the public’s health

Vaccines could slash antibiotic use by 2.5B doses annually: Report: Vaccines have the potential to reduce global antibiotic use by 2.5 billion doses a year, according to a report from Wellcome Trust, which underscores their role in curbing antimicrobial resistance.  

Alcohol: Is Any Amount Safe for Health?: Although some studies have suggested such a benefit, those that better accounted for confounders have not

.Lead, arsenic found in popular rice brands: Study: A study conducted by Healthy Babies, Bright Future found that out of 145 rice samples nationwide, 100% of them contained arsenic. According to the organization, more than one in four exceeded the FDA’s action level for infant cereal…
Overall, the report found four toxic metals in these rice products: Arsenic, cadmium, lead and mercury.

About healthcare IT

Artificial intelligence vs human clinicians: a comparative analysis of complex medical query handling across the USA and Australia: The results show that AI-generated responses were generally more accurate and professional than human responses, suggesting potential benefits like increased efficiency, lower costs and enhanced patient satisfaction. However, significant concerns such as AI’s lack of emotional depth, data bias and the risk of displacing human clinicians must be addressed to fully utilize AI in clinical settings.  

About healthcare finance

23andMe to restart auction after former CEO wins challenge to Regeneron bid: 23andMe will hold another auction for its assets after former chief executive officer Anne Wojcicki successfully challenged the outcome of an earlier bidding round that was won by Regeneron Pharmaceuticals. The auction comes after the human genetics firm filed for Chapter 11 bankruptcy protection in March amid a downturn in its fortunes, including a previous hacking incident that has led to a class-action lawsuit.

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In other news:

Trump Administration Revokes Federal Guidance Protecting Emergency Abortions: The Trump administration announced on Tuesday that it would revoke guidance to the nation's hospitals that directed them to provide emergency abortions to women when they are necessary to stabilize their medical condition.  

About health insurance/insurers

10.9 million projected to lose insurance in 2034 from ‘big, beautiful’ bill: The Congressional Budget Office estimates 10.9 million people will lose health insurance under President Donald Trump‘s One Big Beautiful Bill Act, including 1.4 million who are in the country without legal status in state-funded programs.
The office’s analysis also found that the bill cuts taxes by $3.75 trillion but increase federal deficits by $2.4 trillion over the next decade.

Medicare Plan Switching Among Beneficiaries With and Without a History of Cancer: In this cohort study of 2852 older adults, 31.52% without a history of cancer and 29.61% with a history of cancer switched Medicare coverage in the 2 years following initial plan selection. Initial choice of Medicare Advantage or traditional Medicare plus supplemental coverage was associated with a low likelihood of plan switching among respondents with and without a history of cancer. 

About the public’s health

The role of masks and respirators in preventing respiratory infections in healthcare and community settings: In summary, extensive evidence generated during the covid-19 pandemic confirms the superiority of respirators and supports the use of masks and respirators in the community during periods of high epidemic activity. Some gaps in research remain, including economic analyses, research in special population groups for whom masking is challenging, and research on countering disinformation.

Single Shot Against Both Influenza and COVID-19 Shows Promise in Phase 3 Trial: A novel multicomponent messenger RNA (mRNA) vaccine, mRNA-1083, demonstrated noninferiority to standard influenza and COVID-19 vaccines in adults aged 50 years or older, eliciting higher immune responses against most influenza strains (A/H1N1, A/H3N2, B/Victoria, and B/Yamagata) and SARS-CoV-2 (Omicron XBB.1.5), according to a pivotal phase 3 study.
Comment: The problem is that HHS pulled funding from Moderna to create such a vaccine. 

Hypertension, Diabetes, and High Cholesterol Awareness Among US Adults: The proportion of US adults who were unaware of having hypertension increased significantly over the study period, particularly in young adults and women, while diabetes and high cholesterol level unawareness remained stable. By the 2021 to 2023 cycle, approximately 1 in 6 adults with hypertension and 3 in 10 with diabetes were unaware of their condition.

Study Supports Lowering Colon Cancer Screening Age: Key Takeaways

• A single-center study supported recommendations to lower the colorectal cancer screening age from 50 to 45.

• Screening colonoscopy outcomes were slightly less frequent in people ages 45-49 versus 50-54.

• Only the risk of any adenoma was significantly lower in the younger age group.

About health technology

FDA will not appeal court decision striking down lab-developed test rule: The FDA has opted to not appeal a federal court decision that struck down the agency’s rule to regulate laboratory-developed tests as medical devices.

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2025 Milliman Medical Index: Healthcare costs for the average person increased 6.7%, from $7,378 in 2024 to $7,871 in 2025. Outpatient facility care and pharmacy are the primary drivers of this increase, with pharmacy costs rising 9.7% and outpatient facility care costs rising 8.5%. Together, these service categories contributed to 69% of the year-over-year cost increase for the average person.  

About Covid-19

CDC tweaks — but does not remove — COVID-19 vaccine recommendation for kids: Rather than recommending routine COVID-19 vaccination for healthy children aged 6 months to 17 years, the CDC’s website now says that patients in this age group “may receive COVID-19 vaccination, informed by the clinical judgment of a health care provider and personal preference and circumstances.” A note at the top of the relevant page indicates that the update was made May 29. 

About the public’s health

Dietary Sugar Intake and Incident Type 2 Diabetes [T2D] Risk: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies: These findings suggest that dietary sugar consumed as a beverage (SSB [non-diet sugar-sweetened beverages] and fruit juice) is associated with incident T2D risk. The results do not support the common assumption that dietary sugar (i.e., total sugar and sucrose), irrespective of type and amount, is consistently associated with increased T2D risk.

About healthcare IT

HHS names new national coordinator for health IT: Thomas Keane, MD, has been appointed assistant secretary for technology policy and the ninth national coordinator for health information technology at the Department of Health and Human Services.
This role, according to Politico, is responsible for drafting regulations for EHRs and helps shape the department’s data, technology and AI strategies.
Dr. Keane, according to HHS’ website, previously served within the Office of the Assistant Secretary for Technology Policy and was a senior advisor to the deputy secretary of HHS. 

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23andMe founder says Fortune 500 company backs new buyout offer: The founder of 23andMe has asked a federal bankruptcy court judge to reopen an auction for the genetic testing company, saying she has the fresh financial backing of a Fortune 500 company. Anne Wojcicki said in court filings on Saturday that she has secured the support of a “Fortune 500 company with a current market capitalisation of more than $400bn and $17bn of cash on hand”.  Last month, 23andMe announced that the upstate New York-based biotech company Regeneron had won the bidding for the company with a $256mn all-cash deal. In her court papers, Wojcicki alleged that the debtor and its advisers had unfairly tilted the auction to Regeneron, a claim the company denied in its own court filings. 

HHS faces $31B cuts in proposed FY ’26 budget: 6 notes A good review of the proposed changes. Hint: most have nothing to do with withdrawal of DEI activities.

About Covid-19

RFK Jr. Says Healthy Pregnant Women Don’t Need Covid Boosters. What the Science Says. Read this article! Despite what the governmental “experts” are saying, the actual science contradicts them.

FDA approves Moderna’s new lower-dose COVID-19 vaccine: The U.S. approved a new COVID-19 vaccine made by Moderna late Friday but with limits on who can use it — not a replacement for the company’s existing shot, but a second option.
The new vaccine, mNexspike, is a step toward next-generation coronavirus vaccines. It’s made in a way that allows for a lower dose — a fifth of the dose of its current COVID-19 vaccine, Spikevax — by refining its immune target. 

About health insurance/insurers

Medicare Advantage Plan Disenrollment: Beneficiaries Cite Access, Cost, And Quality Among Reasons For Leaving: Enrollees’ self-reported inability to access and receive high-quality care, more than perceived burdens of out-of-pocket costs, was associated with MA plan disenrollment, as was an objective measure of plan generosity. Difficulty accessing needed medical care was more strongly associated with MA-to–traditional Medicare exits than MA-to-MA plan switching. Dissatisfaction with access, cost, and quality was much more common for enrollees in poor health. These findings renew concerns about access to high-quality care for high-risk and other MA enrollees.

Medicare Advantage Denies 17 Percent Of Initial Claims; Most Denials Are Reversed, But Provider Payouts Dip 7 Percent:[Using data from] 2019, our study found claim denial rates of 17 percent as a share of initial claim submissions. We also found that 57 percent of all claim denials were ultimately overturned. We calculated that denials resulted in a 7 percent net reduction in provider MA revenue, based on the dollar-weighted share of claim denials that were not overturned. However, the indirect impact of denials could be even greater than this direct effect that we measured. This article points to the important role that claim denials play in reducing MA spending and in driving outcome differences between MA and traditional Medicare. However, our analysis did not weigh the cost-saving benefits of claim denials against potential downsides.

Blue Shield of California posts $103M profit in 2024: Blue Shield of California reported a net income of $103 million in 2024, down more than 20% from $130 million in 2023.
In 2024, the company’s total revenue was $27.4 billion, up 8.2% year over year.
The company’s operating expenses rose more than 8% to $27.3 billion in 2024.

Exclusive: HHS watchdog finds more than $16B in health savings: The report was sent to Congress late Friday.
By the numbers:
—The HHS Office of Inspector General identified $16.6 billion in real and potential savings from October 2024 through March of this year.
—The office's investigations identified $3.5 billion in funds due back to the federal government, and its audits found another $451 million that the government will recoup.
—More than $12 billion in potential cost savings were identified if HHS makes recommended policy changes. The office issued 165 recommendations over the six months. 

About hospitals and healthcare systems

Advocate Health’s operating income up 217% in Q1: Charlotte, N.C.-based Advocate Health recorded an operating income of $329.1 million (3.6% operating margin) in the first quarter of 2025, up from $103.7 million (1.3% margin) during the same period last year, according to its May 30 financial report. 

About pharma

Sanofi to buy Blueprint Medicines in deal worth more than $9 billion: Sanofi said Monday it plans to buy Blueprint Medicines in a deal worth more than $9 billion, as the French pharma firm expands its immunology pipeline, a key focus for the company. 

FDA Launches Agency-Wide AI Tool to Optimize Performance for the American People [An FDA release]: Built within a high-security GovCloud environment, Elsa offers a secure platform for FDA employees to access internal documents while ensuring all information remains within the agency. The models do not train on data submitted by regulated industry, safeguarding the sensitive research and data handled by FDA staff.

Trends In Authorized Generic Drug Launches And Their Effects On Competition In Oral-Solid Drug Markets In The US, 2016–23: With data on 146 oral-solid drugs experiencing first generic entry during the period 2016–23, we found evidence for both positive and negative effects of authorized generics on competition. On-invoice prices that pharmacies paid for new generics were 13–18 percent lower when an authorized generic was available. However, authorized generic launches, which were once common, declined markedly in more recent years, which may be partly explained by no-authorized-generic agreements in brand-generic patent litigation settlements. Curtailing these agreements could greatly benefit drug purchasers. 

About health technology

Clinical Validation of a Circulating Tumor DNA–Based Blood Test to Screen for Colorectal Cancer: This prospective, population-based, observational study enrolled 48 995 participants aged 45 to 85 years at average risk of colorectal cancer. In a cohort of 27 010 evaluable participants, the blood test demonstrated 79.2% sensitivity for colorectal cancer and 91.5% specificity for advanced colorectal neoplasia using colonoscopy as the reference standard.
Comment: This test is not yet available but is getting a lot of attention in the public press. Please see the editorial comment below:
Blood-Based Colorectal Cancer ScreeningThe Illusion of Simplicity and the Cancer Prevention Paradox: …However, the illusion of simplicity is deceptive: the new test may paradoxically result in inferior outcomes if substituted for currently recommended tests or if follow-up colonoscopy is not completed in those with abnormal results. A blood test could be very effective if detection of early-stage cancer and advanced cancer precursors can be improved, and if individuals with an abnormal test finding are successfully navigated to colonoscopy. We believe that these should be the goals for future blood tests. But until such time, clinicians should educate their patients about the effectiveness of colonoscopy and stool-based screening, and should reserve offers of cell-free DNA blood tests for those who clearly refuse these strategies.

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White House to fix ‘formatting errors’ in RFK Jr. ‘MAHA Report’: The White House on Thursday said it will fix errors in its “Make America Healthy Again,” or MAHA, report after a news outlet’s investigation found that it cited sources that don’t exist. The report, released last week to much fanfare by the administration, cited hundreds of studies to purportedly find the root causes of chronic diseases. Health and Human Services Secretary Robert F. Kennedy Jr. called the report a “milestone.”
But an examination by the news organization NOTUS found that some of those studies did not actually exist.  

About Covid-19

Contradicting RFK Jr., CDC keeps recommending covid vaccine for kids: Coronavirus vaccines are still recommended for healthy children if their doctors approve, according to updated immunization schedules published late Thursday by the Centers for Disease Control and Prevention, contradicting Health and Human Services Secretary Robert F. Kennedy Jr.’s announcement earlier this week. 

Prior COVID vaccination produces immune response against new SARS-CoV-2 strains, study finds: The findings are promising and suggest that, despite a drop in antibodies for mutated parts of the virus, vaccination offers ongoing protection from severe disease.

About health insurance/insurers

EMPLOYER HEALTH PLAN PERFORMANCE GAP EXPANDS, SAYS J.D. POWER:  KEY TAKEAWAYS:
The latest results from J.D. Power show a growing gap between high- and low- performing health plans in the U.S.
The best performers — regional, Blue Cross Blue Shield, and provider-sponsored plans — are getting better while the worst performers — the large national carriers — are getting worse.
Member experience has become a competitive differentiator — something for all carriers to keep in mind as employers make benefit decisions. 

About hospitals and healthcare systems

13 health systems with credit rating upgrades FYI

4 new health systems launched in 2025 FYI

About the public’s health

Projected Outcomes of Removing Fluoride From US Public Water Systems:This cost-effectiveness analysis using data for 8484 children (mean age, 9.6 years) from the US National Health and Nutrition Examination Survey for 2013 to 2016 found that elimination of fluoride would be associated with an increase in tooth decay of 7.5 percentage points and cost approximately $9.8 billion over 5 years.  

About healthcare personnel

Physician Practice Benchmark Survey Among the findings: Forty-two percent of physicians were in private practice in 2024, an 18 percentage point drop since 2012 (our first year of the Benchmark Survey)…An additional 7.7 percent of physicians (data not shown) indicated that they or another physician had an ownership stake in their practice but identified their practice as owned by a hospital, private equity group, or insurer…

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About Covid-19

A new variant of COVID-19 may be driving up cases in some parts of the world, WHO says: COVID-19 cases are rising again as a new variant begins to circulate in some parts of the world. The World Health Organization said Wednesday the rise in cases is primarily in the eastern Mediterranean, Southeast Asia and western Pacific regions.
Airport screening in the United States has detected the new variant in travelers arriving from those regions to destinations in California, Washington state, Virginia and New York.
The new variant is called NB.1.8.1. It arrives as the United States’ official stance on COVID-19 vaccination is changing. On Tuesday, Health Secretary Robert F. Kennedy Jr. announced that COVID-19 shots are no longer recommended for healthy children and pregnant women — a move immediately questioned by several public health experts.

About health insurance/insurers

States providing Medicaid coverage to undocumented immigrants could face $92B in penalties: States that extend Medicaid coverage to individuals without legal status will receive fewer federal Medicaid dollars if budget legislation passed by the House of Representatives is finalized, according to KFF. 
The legislation would reduce federal Medicaid funding matches to 80% instead of 90% for states that extend coverage to individuals regardless of immigration status. Currently, 14 states and the District of Columbia provide Medicaid coverage to undocumented children, and seven states extend coverage to undocumented adults. 

The top-ranked commercial health plans for member experience | 2025 FYI

Healthcare billing fraud: 10 recent cases  Note not only the type of fraud but that they involved federal programs.

About pharma

7 top pharmas posted revenue declines in Q1. The common thread? All are US firms FYI

About the public’s health

Moderna reports early immunogenicity data for bird flu jab as HHS pulls funding: Moderna is facing another setback from the vaccine-sceptical Trump administration, with the company disclosing Wednesday that the Department of Health and Human Services (HHS) has cancelled over $760 million in funding to develop vaccines for pre-pandemic influenzas — including bird flu. 
"After a rigorous review, we concluded that continued investment in Moderna’s H5N1 mRNA vaccine was not scientifically or ethically justifiable," remarked HHS Communications Director Andrew Nixon. "The reality is that mRNA technology remains under-tested, and we are not going to spend taxpayer dollars repeating the mistakes of the last administration, which concealed legitimate safety concerns from the public."
The announcement came in conjunction with an interim data readout from Moderna's 300-person Phase I/II trial of its H5 avian influenza vaccine, mRNA-1018. 
More than 97% of participants who received two doses of the experimental vaccine had haemagglutination inhibition (HAI) antibody titres ≥1:40 — the level considered to be protective — at three weeks after the second vaccination. About 2% of individuals had protective levels of HAI antibodies at baseline. 
In addition, mRNA-1018 was generally well-tolerated, with most adverse reactions being either Grade 1 or 2, and no dose-limiting tolerability concerns. Moderna plans to present additional data at an upcoming scientific meeting.   
Comment: Another HHS political pronouncement masquerading as scientifically reasoned.

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RFK Jr. threatens to bar government scientists from publishing in leading medical journals: HHS Secretary Robert F. Kennedy Jr. threatened to stop government scientists from publishing their work in major medical journals on a podcast Tuesday as part of his escalating war on institutions he says are influenced by pharmaceutical companies.
Speaking on the “Ultimate Human” podcast, Kennedy said the New England Journal of Medicine, the Journal of the American Medical Association and The Lancet, three of the most influential medical journals in the world, were “corrupt” and publish studies funded and approved by pharmaceutical companies. 
“Unless those journals change dramatically, we are going to stop NIH scientists from publishing in them and we’re going to create our own journals in-house,” he said, referring to the National Institutes of Health, an HHS agency that is the world’s largest funder of health research.
Comment: While these Journals have very rigorous peer review and conflict-of-interest vetting processes, I wonder if the articles in RFK, Jr’s proposed journal would have the same scrutiny. My prediction: Academic articles derived from federally funded research will be prohibited from publishing in any but Kennedy’s journal. Watch for First Amendment lawsuits.

About health insurance/insurers

Blue Cross Blue Shield plans reverse course on GLP-1 coverage: Several Blue Cross Blue Shield (BCBS) plans are reversing their course on covering GLP-1 medications, particularly for weight loss, citing high costs and the novelty of these drugs. Some plans, like Blue Cross Blue Shield of Michigan and Blue Cross and Blue Shield of Massachusetts, are discontinuing coverage for GLP-1s used solely for weight loss, starting in 2026. However, they will continue to cover these medications when prescribed for Type 2 diabetes or other approved medical conditions. 

About hospitals and healthcare systems

61 health systems ranked by total assets FYI

About pharma

Lilly snaps up non-opioid pain startup SiteOne for up to $1B: Eyeing an expansion of its pain portfolio, Eli Lilly entered the sodium channel inhibitor space on Tuesday through the acquisition of SiteOne Therapeutics. While the upfront amount was not disclosed, the total deal is valued at up to $1 billion, including regulatory and commercial milestones. 
The takeout comes on the heels of a megaround for SiteOne — and the first FDA approval for a non-opioid pain medication in more than two decades.
 

About the public’s health

HHS cancels nearly $600 million Moderna contract on vaccines for flu pandemics: The Department of Health and Human Services has notified Moderna that it is canceling a nearly $600 million contract with the company to develop, test, and license vaccines for flu strains that could trigger future pandemics, including the dangerous H5N1 bird flu virus. 

Time to Treatment Initiation [TTI] for the 30 Most Prevalent Cancer Types: Trends and Predictors of Change: The proportion of patients diagnosed with new stage I disease increased by 52.2% from 2004 (28.4%, n = 78,732) to 2015 (43.2%, n = 256,150). All other stages decreased in percent incidence. There was a 100.0% increase in median TTI for stage I patients from 2004 to 2015 (14-28 days). Cancer stage was the most important predictor of change in TTI for 16 cancer types (P < .001 for all 16).

About healthcare personnel

New Survey Shows Physician Appointment Wait Times Surge: 19% Since 2022, 48% Since 2004: The time required to schedule a physician appointment in 15 major metropolitan areas has increased by 19% since 2022 and by 48% since 2004…
 The 2025 Survey of Physician Appointment Wait Times reveals that it now takes an average of 31 days to schedule a physician appointment in 15 of the largest metropolitan areas in the United States. This is an increase from 26 days in 2022, the last year the survey was conducted, and from 21 days in 2004, the first year the survey was conducted.
"Average physician appointment wait times are the longest they have been since we began conducting the survey in 2004," said Leah Grant, president of AMN Healthcare's Physician Solutions division (formerly known as Merritt Hawkins). "Longer physician appointment wait times are a significant indicator that the nation is experiencing a growing shortage of physicians." 
Comment: See the article for specialty-specific data.

About health technology

GTCR sells Antylia Scientific for $1.34 billion:  Private equity’s GTCR is selling Vernon Hills-based Antylia Scientific, a maker of molecular diagnostic reagents, specialty chemicals, and water- and air-quality testing equipment, to Brookfield Asset Management and CDPQ in a $1.34 billion deal.
The sale marks the second deal of more than $1 billion for one of GTCR’s portfolio companies this month, following its similar-sized saleof insurance technology firm Itel.  

Gene therapy trial reports patient death, FDA enacts clinical hold: Rocket Pharmaceuticals said the patient experienced “clinical complications related to a capillary leak syndrome,” a rare disorder in which fluids escape blood vessels and enter surrounding tissue. The company voluntarily paused further dosing in the 12-person trial before the FDA placed a clinical hold on May 23.
Since then, the patient died after an acute systemic infection, according to a May 27 news release from the company.

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About Covid-19

Why are more than 300 people in the US still dying from COVID every week?: The experts said there are a few reasons why people might still be dying from the virus, including low vaccination uptake, waning immunity and not enough people accessing treatments.
In a related story, check out this post from HHS stating the latest vaccination policy.  

About hospitals and healthcare systems

The only 24 hospitals to earn Magnet’s top honor  FYI

About pharma

Prices for new US drugs doubled in 4 years as focus on rare disease grows: U.S. prices for newly-launched pharmaceuticals more than doubled last year compared to 2021, as companies leveraged scientific advances to develop more therapies for rare diseases, which typically command high prices, a Reuters analysis found.
The median annual list price for a new drug was over $370,000 in 2024, according to the Reuters survey of 45 medicines.
In 2021, the median price was $180,000 for the 30 drugs first marketed through mid-July, according to a study published in JAMA based on the same criteria. The median launch price was $300,000 in 2023 and $222,000 in 2022. 

Assessing US Food and Drug Administration Guidance Practices in Drug Development FYI

About the public’s health

PATIENT ACCESS TRENDS: INSIGHTS FROM EXPERIAN’S RECENT RCM SURVEY: There is some discrepancy between providers and patients when it comes to patient access, according to a new report from Experian Health. And that could impact revenue cycle management.
Just over one-third of providers surveyed said patient access has improved, but only 16% of patients agreed. Conversely, only 15% of patient respondents said that patient access was worse in 2024 – the lowest amount since Experian began asking the question in 2022. 

About healthcare IT

OpenAI’s $6.5 Billion Hardware Acquisition And HealthBench Work Will Accelerate Healthcare AI Capabilities: OpenAI, the famed company behind ChatGPT, released HealthBench, a new standard to measure AI outputs specifically for healthcare use cases. The company indicates that creation of the standard involved the partnership of 262 physicians across 60 countries to develop 5,000 conversations with customized “rubrics” for each to determine the efficacy and quality of responses from models. 

Today's News and Commentary

HealthcareInsights.MD will resume on Tuesday, May 27 in consideration of Memorial Day.

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White House unveils ‘MAHA’ report: 10 takeaways:The White House’s Make America Healthy Again Commission published its anticipated report on childhood chronic disease May 22. 
Comment: Some true statements and some false (like vaccine skepticism). The report did not have any recommendations, which supposedly are forthcoming.

Proposed cuts to SAMHSA, AHRQ could further stress primary care system: The specific cuts to some of the major, more easily recognizable agencies include:

• $17.965 billion cut to the NIH;

• $3.588 billion cut to the CDC;

• $1.732 billion cut to the Health Resources and Services Administration (HRSA); and

• $674 million cut to CMS.

About health insurance/insurers

UnitedHealth’s former CEO resigns from board of directors: UnitedHealth Group’s former CEO Andrew Witty has resigned from the company’s board of directors, effective immediately. 
Mr. Witty will not stand for re-election as a director during the company’s annual shareholder meeting scheduled for June 2, the company said in regulatory documents filed May 21.

Claim denials grew as prior authorization rejections fell in 2024: Health insurance companies initially declined to pay more than one dollar for every $10 providers submitted in claims last year, an increase from 2023. 

About hospitals and healthcare systems

CMS updates hospital price transparency guidance following executive order: In the updated guidance, CMS said hospitals must display payer-specific standard charges as dollar amounts in their machine-readable files (MRFs) whenever calculable. This includes the amount negotiated for the item or service, the base rate negotiated for a service package and a dollar amount if the standard charge is based on a percentage of a known fee schedule.
CMS also said hospitals should discontinue encoding “999999999” (nine 9s) in the estimated allowed amount data element within the MRF, and instead encode an actual dollar amount. 

About pharma

Unlike CVS, Walgreens Interested In Rite Aid Patient Files, Not Stores: Walgreens confirmed its only buying prescription files and not brick and mortar stores among the pharmacy assets being sold across the U.S. by Rite Aid.
A U.S. Bankruptcy Court in New Jersey approved the sale of pharmacy assets from more than 800 Rite Aid stores to CVS Health, Walgreens as well as grocery store chains including Kroger and Albertsons.
But CVS appears to be the only major drugstore chain interested in brick-and-mortar stores, confirming plans to buy 64 Rite Aid stores in the pacific northwest U.S. CVS is also purchasing prescription files of 625 Rite Aid pharmacies across 15 states in markets already served by CVS pharmacies, the company said. 

About the public’s health

‘World-first’ gonorrhoea vaccine to be rolled out in England and Wales: A vaccine for gonorrhoea will be rolled out in England and Wales as part of a world-first programme, officials have announced.
The move, hailed as a “landmark moment for sexual health”, will aim to tackle rising levels of the sexually transmitted infection (STI).

FDA vaccine panel recommends retaining JN.1 COVID-19 variant for new season jabs: The FDA’s vaccine advisory panel unanimously recommended maintaining JN.1 lineage variants for the forthcoming respiratory virus season's COVID-19 vaccines.
The agency’s Vaccines and Related Biological Products Advisory Committee (VRBPAC), which convened on Thursday, delivered its recommendation following an assessment of current variant circulation patterns and nonclinical vaccine performance data.  

Priority Health Conditions and Global Life Expectancy Disparities: This cross-sectional study suggests that a limited number of causes account for most life expectancy disparities. Together with current information on risk factors, interventions, and morbidity not yet reflected in life expectancy, the varying contributions of these causes to gaps in life expectancy can help focus health policy and guide interventions to reduce risk factors and treat conditions.
Comment: See the graphics for more detailed information. Conditions’ importance vary by region.

Hold My Beer: The Linkage between Municipal Water and Brewing Location on PFAS in Popular Beverages: PFAS were detected in most beers, particularly from smaller scale breweries located near drinking water sources with known PFAS. Perfluorosulfonic acids, particularly PFOS, were frequently detected, with PFOA or PFOS above U.S. EPA’s Maximum Contaminant Limits in some beers. There was also a county–level correlation between the total PFAS, PFOA, and PFBS concentrations in drinking water and beers. Given that approximately 18% of U.S. breweries are located within zip codes with detectable PFAS in municipal drinking water, our findings, which link PFAS in beer to the brewery water source, are intended to help inform data-driven policies on PFAS in beverages for governmental agencies, provide insights for brewers and water utilities on treatment needs, and support informed decision-making for consumers.
Comment: Read the article for assessments of where these contaminants are high.

About healthcare IT

Health system kickback scheme involves Epic EHR: An alleged kickback scheme that a California health system settled for $31.5 million involved steering physicians to use its Epic EHR. 

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House passes Trump’s agenda bill: 6 things to know  A good summary of the Bill’s health provisions.

GOP budget bill would slash Medicare funding by $490B: CBO: According to a May 20 report from the nonpartisan Congressional Budget Office, the legislation is projected to add $2.3 trillion to the national debt, triggering automatic budget cuts under federal law.
The CBO estimates that an average annual increase of $230 billion in the deficit will occur each year under the legislation, resulting in a need to reduce spending by that amount annually. The first round of sequestration could take place in 2026.
Medicare spending is limited to a 4% reduction each year, which would amount to $45 billion in cuts for fiscal year 2026. Although Medicare is capped at these 4% reductions, the rest of the federal budget would face even larger cuts. Some programs, such as Social Security and low-income assistance programs, are exempt from sequestration, leaving other federal programs to shoulder the remaining cuts. 

About health insurance/insurers

CMS plans ‘aggressive’ Medicare Advantage audits: MS will audit every Medicare Advantage plan for potential overpayments annually, in what the agency called an “aggressive” plan to step up oversight. According to a May 21 news release, the agency plans to audit each of the more than 500 MA plans each year. Currently, the agency audits around 60 plans each year. 

About pharma

Moderna 'voluntarily' pulls FDA application for combo flu/COVID-19 vaccine: Moderna said Wednesday that it has voluntarily withdrawn an application with the FDA seeking approval of its combination influenza/COVID-19 vaccine mRNA-1083 for adults aged 50 years and older. While the submission had a target review date in November, the company recently pushed back the mRNA-based jab's timeline after the FDA said that it required Phase III flu efficacy data.

Judge approves Rite Aid assets sale: On May 21, a federal judge approved Rite Aid’s bankruptcy plan to close stores and sell most of its pharmacy assets to other national chains, according to court documents reviewed by Becker’s. 
CVS, Walgreens, and grocery store chains Albertsons, Kroger, Giant Eagle and others have entered into separate transactions to buy Rite Aid’s assets, including prescription services and 810 of its 1,240 pharmacy locations.  

GoodRx to directly contract with independent pharmacies: In June, GoodRx will provide a cost-plus model offering to independent community pharmacies through direct contracts, the company said May 22. 
Dubbed GoodRx Community Link, it will allow locally owned and operated pharmacies to contract with its integrated savings program. The program compares a medication’s copay with GoodRx’s discount price to offer the lowest available price.

2025 Prescription Drug Expenditure Projections for Health System Leaders: The overall prescription drug spending in the United States in 2025 is predicted to rise between 9% and 11% higher than 2024 spending, which totaled $806 billion, according to a recently published paper on national trends in prescription drug expenditures and projections for 2025 in the American Journal of Health-System Pharmacy.
Drug spending at clinics in 2025, the paper predicts, will likely be higher than spending at hospitals, with an 11.0% to 13.0% increase. Lead author Eric Tichy, Pharm.D., M.B.A., vice chair of pharmacy formulary at Mayo Clinic Health System, explained there has been an effort to move more care into the outpatient setting. Additionally, innovation is allowing more drugs to be approved that can be administered in the ambulatory setting.

About the public’s health

Nutritional Content of Ready-to-Eat Breakfast Cereals Marketed to Children: Analysis of newly launched children’s RTE cereals from 2010 to 2023 revealed concerning nutritional shifts: notable increases in fat, sodium, and sugar alongside decreases in protein and fiber. Children’s cereals contain high levels of added sugar, with a single serving exceeding 45% of the American Heart Association’s daily recommended limit for children. These trends suggest a potential prioritization of taste over nutritional quality in product development, contributing to childhood obesity and long-term cardiovascular health risks.

U.S. Global Health Country-Level Funding TrackerA very interesting chart of where the U.S. spends its global health dollars (by country) and on what programs.

Exclusive: Opioid use disorder costs almost $700K per case: State of play:
Opioid use disorder — defined as frequent opioid use and unsuccessful efforts to quit — is estimated to affect more than 6 million people in the United States.

• The cumulative economic burden on patients, including years of life lost and reduced quality of life, exceeded $3 trillion in 2024, Avalere estimated.

• Private businesses absorbed more than $467 billion in costs from lost productivity and health insurance costs while the federal government bore about $118 billion in Medicare and other federal insurance costs, lost taxes and criminal justice expenses.

• It cost state and local governments more than $94 billion, with about $42 billion of that going toward criminal justice costs.

• The Trump administration in March released its own analysis that estimated illicit opioids cost the U.S. about $2.7 trillion in 2023.  

About healthcare IT

In lawsuit over teen’s death, judge rejects arguments that AI chatbots have free speech rights: A federal judge on Wednesday rejected arguments made by an artificial intelligence company that its chatbots are protected by the First Amendment — at least for now. The developers behind Character.AI are seeking to dismiss a lawsuit alleging the company’s chatbots pushed a teenage boy to kill himself.
The judge’s order will allow the wrongful death lawsuit to proceed, in what legal experts say is among the latest constitutional tests of artificial intelligence.

About healthcare personnel

61% of nurses plan job change within 1 year: Report: Within the next 12 months, 61% of more than 12,000 nurses surveyed by AMN Healthcare said they plan to leave their current employer, switch departments, retire, return to school, or work part-time, per diem or in a virtual role. 
High levels of burnout, stress and dissatisfaction continue to foment workforce instability. The National Council of State Boards of Nursing’s biennial 2024 National Workforce Study, which surveyed more than 800,000 U.S. nurses, found that 40% of RNs plan to exit the field by 2029. 

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In a significant change, House GOP tax cut bill would start Medicaid work requirements next year: The latest draft of the House tax cut bill calls for starting Medicaid work requirements next year, up from 2029, according to Rep. Chip Roy (R-Texas).
Roy is among the members of the far-right House Freedom Caucus who fought for starting the requirements sooner. He’s also a member of the House Rules Committee, which started debating the budget reconciliation bill at 1 a.m. At publication time, committee members were still working through the 537 amendments that were submitted. The Rules Committee is the last stop before a House vote, and Speaker Mike Johnson (R-La.) aims to pass the bill before the end of the week. 
Ans in a related story:
‘Don’t ‘f— with Medicaid,’ Trump tells GOP lawmakers: Several Republican lawmakers had pushed for deeper cuts to Medicaid, which has become a key sticking point in negotiations as fiscal conservatives seek cuts to help offset the bill’s tax provisions, according to the report. The bill also faces pushback from centrist Republicans in high-tax states like New York and California, who are advocating for changes to the $30,000 cap on state and local tax deductions.
“I think it was a meeting of love,” President Trump said, according to the report. “And there were a couple of things we talked about specifically where some people felt a little bit one way or the other. Not a big deal.” 

About the public’s health

Diseases are spreading. The CDC isn't warning the public like it was months ago: Many of the CDC's newsletters have stopped being distributed, workers at the CDC say. Health alerts about disease outbreaks, previously sent to health professionals subscribed to the CDC's Health Alert Network, haven't been dispatched since March. The agency's main social media channels have come under new ownership of the Department of Health and Human Services, emails reviewed by NPR show, and most have gone more than a month without posting their own new content. 

Poll: 83% of Americans say benefits of MMR vaccines outweigh risks: A new Annenberg Poll shows that 87% of Americans say the benefit of childhood measles, mumps, and rubella (MMR) vaccination outweighs the risk, and 67% say they know that MMR vaccines don't cause autism.

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Massive Medicaid cuts would ripple through nonprofit sector, too Great summary of the topic, including the effect on Easter Seals.

Veterans' VA Referrals to Private Medical Care Will No Longer Require Additional Doctor Review: The Department of Veterans Affairs has changed its process for veterans to get medical care from non-VA providers, removing a requirement that a referral to community care be reviewed by another VA doctor.
The VA announced Monday that it is enacting a provision of the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act that will help ease veterans' access to medical services from private providers. 

About pharma

HHS sets ‘pricing targets’ to lower US drug costs: HHS is taking “immediate steps” to implement President Donald Trump’s executive order, Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients — a key initiative aimed at reducing healthcare costs…
Under the executive order, HHS has until June 11 to develop and communicate drug pricing reduction goals with pharmaceutical manufacturers. If meaningful progress is not made, the department is instructed to begin the rulemaking process to enforce most-favored-nation pricing. However, the order does not outline a clear legal mechanism for mandating lower drug prices, and it remains uncertain how the directive would intersect with ongoing Medicare drug price negotiation efforts under the Inflation Reduction Act. 

Pfizer pays $1.25B upfront for rights to PD-1/VEGF bispecific from China's 3SBio: Top Story: Pfizer signed a licensing deal potentially worth over $6 billion with 3SBio, securing ex-China rights to the latter’s PD-1/VEGF-targeting bispecific antibody SSGJ-707 in oncology indications. The agreement — which includes an upfront payment of $1.25 billion — marks Pfizer's second recent move into the PD-1/VEGF bispecific antibody space.

About the public’s health

Kennedy’s placebo requirement for vaccine testing could cost lives:Robert F. Kennedy Jr. in his hearing before Congress last week doubled down on his plans to revamp the vaccine approval process. The health and human services secretary claimed that no vaccines other than the coronavirus shots had been tested against a placebo, which he vowed to “remedy.” An HHS spokesperson previously characterized conducting placebo-controlled trials as “a radical departure from past practices.”
These statements are flat-out wrong. Many vaccines are, in fact, tested against placebos. Those that aren’t always have a specific ethical and scientific rationale. Changing existing practice won’t make immunizations safer, but it will delay access and impede disease prevention.
Other related articles:
An Evidence-Based Approach to Covid-19 Vaccination and
FDA will limit Covid vaccines to people over 65 or at high risk of serious illness, leaders say

Nebraska to ban soda and energy drinks from SNAP under first USDA waiver: Nebraska is the first state to receive a federal waiver to ban the purchase of soda and energy drinks under the benefit program for low-income Americans long known as food stamps.
The move, announced Monday by U.S. Agriculture Secretary Brooke Rollins, would affect about 152,000 people in Nebraska enrolled in the Supplemental Nutrition Assistance Program, or SNAP, which helps families pay for groceries.
“There’s absolutely zero reason for taxpayers to be subsidizing purchases of soda and energy drinks,” Nebraska Gov. Jim Pillen said in a statement. “SNAP is about helping families in need get healthy food into their diets, but there’s nothing nutritious about the junk we’re removing with today’s waiver.”
Six other states — Arkansas, Colorado, Kansas, Indiana, Iowa and West Virginia — have also submitted requests for waivers banning certain foods and drinks or, in some cases, expanding access to hot foods for participants, according to the USDA.

World Health Assembly adopts historic Pandemic Agreement to make the world more equitable and safer from future pandemics: The WHO Pandemic Agreement sets out the principles, approaches and tools for better international coordination across a range of areas, in order to strengthen the global health architecture for pandemic prevention, preparedness and response. This includes through the equitable and timely access to vaccines, therapeutics and diagnostics. 

About healthcare personnel

Private funder HHMI pauses postdoc fellowship : The Hanna Gray fellowship, created by the Howard Hughes Medical Institute, supports postdoctoral researchers from diverse backgrounds in their transition to heading their own labs. During normal times, the opportunity was transformative, but in an era of cuts to research funding and uncertainty at universities, some saw it as a lifeline to an academic career…
HHMI, the largest private funder of biomedical research, announced it would no longer be considering applications for the upcoming cycle. It’s the latest retrenchment by HHMI, which had become a leader in efforts to make the science workforce more diverse, amid the Trump administration’s attacks on diversity, equity, and inclusion programs. 

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America’s sickness economy An excellent review with useful charts.

Survey Highlights Progress, Persistent Barriers on Value-Based Care Journey: NAACOS, the National Association of ACOs, and Innovaccer, a company that has developed an interoperability platform for value-based care (VBC), have released a survey of healthcare professionals about their progress on value-based care transformation.
Here are some bullet-point highlights: 
• 30% of organizations reported that 25% or more of their revenue is tied to VBC contracts.
• More than 60% of organizations have increased their participation in VBC programs.
• Nearly 20% of organizations report that over half of their revenue comes from fully capitated or downside risk contracts.
• Barriers to adoption cited by respondents include financial risk, provider resistance, lack of data interoperability and the cost of technology to facilitate VBC.
• Those surveyed cited greater financial support, improved data sharing capabilities with payers and clearer regulatory guidelines as factors that would greatly support VBC adoption.

Trump’s DOJ Accuses Medicare Advantage Insurers of Paying ‘Kickbacks’ for Primo Customers I wrote about this suit before but this article is a nice summary of the issue.

As Congress Debates Cutting Medicaid, a Major Study Shows It Saves Lives: Poor adults who gained Medicaid coverage after the Affordable Care Act expanded access were 21 percent less likely to die during a given year than those not enrolled, the research shows. By analyzing federal records on 37 million Americans, two economists found that deaths fell not only among older enrollees but also among those in their 20s and 30s — a group often assumed to have few medical needs, and who would have been far less likely to qualify for Medicaid before the expansion.
The findings were published this month in a National Bureau of Economic Research working paper…

About health insurance/insurers

Study suggests upcoding practices are fairly common across outpatient care: The report, compiled by researchers at Trilliant Health, found that the share of visits that were coded at higher intensities grew in emergency care, urgent care and physician office visits between 2018 and 2023. For example, the number of emergency department visits coded as 99284, or level four of five total, grew from 32.5% to 39.6% in the study window. 

About pharma

GLP-1s may cut risk of obesity-related cancers: 3 study notes: A new study has found GLP-1s may reduce the risk of developing obesity-related cancers by 41% compared to bariatric surgery — a benefit researchers believe could be tied to the drugs’ ability to reduce inflammation.  

White House, Cost Plus Drugs’ new drug manufacturing alliance: 5 notes: The White House has launched a new program focused on leveraging technology and private sector partnerships to find new ways to quickly produce key pharmaceutical ingredients and finished drugs at the point-of-care. 
The initiative, called Equip-A-Pharma, involves collaborations with Mark Cuban’s Cost Plus Drugs and three other healthcare partners. 

Regeneron to buy 23andMe out of bankruptcy for $256 million: Regeneron Pharmaceuticals said Monday it had entered into an agreement to buy the consumer genetics firm 23andMe out of bankruptcy for $256 million. The deal is subject to bankruptcy court and regulatory approvals.
The Tarrytown, N.Y.-based biotech said it would continue 23andMe’s consumer business and use the data the company has collected for drug development.

CVS, Walgreens bid for Rite Aid pharmacy assets: CVS Health Corp. is trying to buy stores and patient data from Rite Aid Corp., the beleaguered pharmacy chain that is going out of business after filing for bankruptcy a second time earlier this month….
Rite Aid has also received multiple bids on some of its pharmacy assets, such as patient data and inventory, from Walgreens Boots Alliance Inc., Albertsons Cos., Kroger Co., Giant Eagle Inc. and others, Rite Aid Chief Executive Officer Matthew Schroeder told employees…

HHS must preapprove pharma's proposed 340B rebate models, judge rules: Several big pharmas attempting to introduce a rebate model under the 340B programme, rather than offering an upfront discount on medicines, were hit with a setback Friday after a US district judge rejected lawsuits from several drugmakers. 
Bristol Myers Squibb, Eli Lilly and Johnson & Johnson had each filed suit last year after the US Health Resources and Services Administration (HRSA) rejected proposals from the drugmakers that would change how they deliver reduced-cost drugs to hospitals and clinics that serve uninsured and low-income patients…Judge Dabney Friedrich ruled on Friday that HHS has the authority to approve or reject the proposed rebate models, blocking the pharmas from moving forward with their 340B plans until they receive an explicit OK from Secretary Robert F. Kennedy. 
Per a notice filed earlier this month in the US District Court for the District of Columbia, HHS said it will be "in a position to provide guidance" about the proposed rebate models by the end of May.

About healthcare IT

Top 20 global cities for EHR interoperability FYI.
Also, according to the report conducted in March and April 2025:
• 88% of healthcare organizations outside the U.S. now prioritize regional software providers due to improved localization and faster compliance with local regulations.
• User satisfaction rates for regional EHR solutions reached an average of 91%, compared to a
declining rate of 68% for U.S.-based systems.
• 79% of international healthcare leaders report political and digital sovereignty considerations
influencing vendor selections, reflecting heightened awareness and sensitivity towards national data control and security.
• Over 84% of surveyed respondents identified regional vendors as providing superior customization and adaptability to specific local clinical workflows.
• Implementation timelines for regional vendors are on average 40% shorter than those of major U.S.-based EHR providers, enhancing their attractiveness in dynamic healthcare environments.
• Cost transparency and predictable pricing structures from regional vendors achieved an approval rate of 82%, contrasting sharply with 47% satisfaction for major U.S.-based competitors.

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About hospitals and healthcare systems

63 health systems ranked by annual revenue  FYI 

About the public’s health

The Domestic Consequences of Defunding Global Health A really good summary of the issue.
In a related article: WHO: 70% of Countries Already Face Health Disruptions Amid Aid Cuts 

About healthcare IT

276 Million Patient Records Compromised — What You Need To Know: A May 5 HIPPA Journal report has confirmed that in 2024 healthcare attacks resulted in a staggering “276 million breached records.” Now, a May 13 Check Point report has warned that the hackers behind a newly-identified and healthcare-focused attack are looking to steal even more sensitive employee and consumer data.  

About health technology

FDA endorses first-of-its-kind blood test for Alzheimer’s disease: The test, called Lumipulse, measures two proteins found in the blood’s plasma to determine whether a patient has amyloid plaques in the brain. Up until now, physicians have mostly used costly, more invasive tests that involve puncturing the lumbar — known as a spinal tap — and brain scans that expose patients to radiation to confirm the presence of amyloid. The Lumipulse test takes a simple blood draw. 

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UnitedHealth Group Is Under Criminal Investigation for Possible Medicare Fraud: While the exact nature of the potential criminal allegations against UnitedHealth is unclear, the people said the federal investigation is focusing on the company’s Medicare Advantage business practices.

About hospitals and healthcare systems

Hospital expenses per inpatient day across 50 states FYI

About the public’s health

FDA to remove ingestible fluoride prescriptions for children from the market: 7 notes: The FDA plans to begin removing ingestible fluoride prescription drug products for children from the market later this year.
 Comment: Excessive fluoride can cause all the harms JFK, Jr claims; but, most water supplies have levels that are beneficial. Further, infants who are breast fed need supplements. Science loses again.

RFK Jr. says people should not take medical advice from him, defends HHS cuts during congressional hearings Yes, but they DO listen when he issues harmful and incorrect medical statements.

How Chronic Disease Became the Biggest Scourge in American Health A great comparison (in charts) of US healthcare versus other countries.

About healthcare IT

88% of breached patient records since 2010 tied to hacking: Study: From October 2009 to October 2024, ransomware and hacking have increasingly driven healthcare data breaches, a May 14 study published in JAMA Network Open found. 
The study examined ransomware attacks and other hacking incidents across all healthcare organizations covered by HIPAA from October 2009 through October 2024. It analyzed breaches affecting 500 or more patient records that were reported to the U.S. Department of Health and Human Services (HHS) Office for Civil Rights.

About health technology

Baby Is Healed With World’s First Personalized Gene-Editing Treatment: The baby, now 9 ½ months old, became the first patient of any age to have a custom gene-editing treatment, according to his doctors. He received an infusion made just for him and designed to fix his precise mutation.
The investigators who led the effort to save KJ are presenting their work on Thursday at the annual meeting of the American Society of Cell & Gene Therapy, and are also publishing it in the New England Journal of Medicine. 

Today's News and Commentary

Read today’s Kaiser Health News

About health insurance/insurers

CBO: GOP Medicaid plan would make 7.6 million people uninsured: The Medicaid portion of the House GOP’s massive domestic policy bill would result in 10.3 million people losing Medicaid coverage by 2034 and 7.6 million people going uninsured, according to a partial (CBO) Congressional Budget Office estimate. 

CMS proposes including Part B drugs in Medicare price negotiations: 5 key updates: CMS has proposed including select Medicare Part B drugs in the third round of its drug price negotiation program, according to draft guidance released May 12. 
The agency said the proposal is designed to enhance transparency, focus on high-expenditure drugs and ensure that efforts to establish fair pricing do not stifle pharmaceutical innovation.
Comment: Recall drug negotiations have been about Part D drugs.

Expect More Downside Risk in Medicare's Payment Models, CMS Official Says: Physicians should expect to see more Medicare alternative payment models that involve downside risk, Abe Sutton, JD, director of the Center for Medicare and Medicaid Innovation (CMMI), said Tuesday.
"We've found at the innovation center that when we have 'upside-only' payment models, there's not necessarily an incentive ... for participants to change how they engage in care delivery," Sutton said… 
Also on Tuesday, Sutton outlined a new approachopens in a new tab or window that CMMI is taking to its work, focused on three "pillars":
Promote evidence-based prevention
Empower people to achieve their health goals.
Drive choice and competition.

About hospitals and healthcare systems

Recognizing Outstanding Care: Healthgrades Announces 2025 Top Hospitals for
Patient Experience : FYI

About pharma

AbbVie paying $355M, potentially billions more, in deal for new RNA tech:AbbVie is entering a collaboration and license option deal with ADARx Pharmaceuticals to develop a new type of RNA technology for disease areas like neuroscience, immunology and oncology.
The deal could net San Diego-based ADARx several billion dollars in payments, if successful.
Late clinical-stage biotech ADARx is working on small interfering RNA, or siRNA, therapeutics, a class of molecules capable of regulating gene expression and protein production.

About the public’s health

EPA will weaken rule curbing forever chemicals in drinking water: The Environmental Protection Agency announced Wednesday that it plans to rescind and reconsider limits on four “forever chemicals” under a landmark drinking water standard implemented last year by President Joe Biden.

US Children Living With a Parent With Substance Use Disorder: Nearly 19 million children were estimated to be living in a household with at least 1 parent with SUD, accounting for one-quarter of all US children in 2023. Children in such households are more likely to develop adverse health outcomes than their peers without exposure to parental SUD.

Increased sedentary behavior is associated with neurodegeneration and worse cognition in older adults over a 7-year period despite high levels of physical activity: Highlights

• Greater sedentary behavior is related to neurodegeneration and worse cognition.

• Associations differed by APOE-ε4 carrier status in cross-sectional models.

• Sedentary behavior is an independent risk factor for Alzheimer's disease. 

About healthcare IT

A decade of AI rules on ice?: The proposed bill prohibits state and local governments from enforcing “any law or regulation regulating artificial intelligence models, artificial intelligence systems, or automated decision systems during the 10-year period beginning on the date of the enactment of this Act.”  

About healthcare personnel

The World Is Wooing U.S. Researchers Shunned by Trump: For examples:
—Last week, at the urging of more than a dozen members, the European Union announced it would spend an additional 500 million euros, or $556 million, over the next two years to “make Europe a magnet for researchers.”
—Of 1,600 people who responded to a March poll in the journal Nature — many of them Ph.D. or postdoctoral students in the United States — three out of four said they were considering leaving the country because of the Trump administration’s policies.