Today's News and Commentary

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In other news:

15 defining healthcare trends and challenges Really thoughtful review of current trends.

About health insurance/insurers

Medicare Advantage enrollment growth slows drastically: The number of people enrolled in a private Medicare Advantage plan grew just 3.1% from 2024 to 2025 — well below projections from the federal government and Wall Street, and one of the slowest years of growth ever in the program.
A little more than 34.4 million older adults and people with disabilities were paying into a Medicare Advantage plan as of Feb. 1 compared with the 33.4 million people in a plan at the same time last year, according to new federal data analyzed by STAT.   

About pharma

'Big Three' PBMs seek appeal in legal spat with Federal Trade Commission: The three largest pharmacy benefit managers are looking to take their legal back-and-forth with the Federal Trade Commission (FTC) to the 8th Circuit Court, according to a court filing issued late last week.
CVS Health's Caremark, Cigna's Express Scripts and UnitedHealth's Optum Rx filed a notice of appeal Friday after a Missouri District Court determined that the FTC's case could move ahead. The agency filed suit against the so-called "Big Three" in September, alleging they played a key role in inflating the price of insulin.
The PBMs hit back with a countersuit in November, arguing the FTC's actions were unconstitutional. 

About the public’s health

The Political Rise of the Anti-Vax Movement An excellent analysis from The Financial Times.

Flu vaccine this season may be poorly matched, early CDC data suggests: This season's influenza vaccine may have been a poor match to a strain of the flu virus that caused many infections this winter, early data released by the Centers for Disease Control and Prevention suggests.
The CDC's latest data come as much of the U.S. is finally seeing signs of a slowdown in influenza activity after waves of illness this past fall and winter that climbed to the worst rates recorded from hospitals and doctor's offices since the 2009 swine flu pandemic.

Texas measles outbreak grows to 124 cases, mostly among unvaccinated: Almost all of the cases are in unvaccinated individuals or individuals whose vaccination status is unknown, and 18 people have been hospitalized so far, according to the Texas Department of State Health Services (DSHS). Five cases included those who have been vaccinated.
Children and teenagers between ages 5 and 17 make up the majority of cases with 62, followed by 39 cases among children ages 4 and under.

HHS may conduct 'rolling review' of health web pages for Trump EO compliance, judge rules: A federal judge is allowing a temporary restraining order related to the abrupt removal of health information web pages to expire, though those resources will for now remain as they are as the Trump administration begins a rolling review of their content.   

About healthcare IT

Digital Screen Time and Myopia :This systematic review and dose-response meta-analysis of 45 studies involving 335 524 individuals revealed a significant dose-response association, characterized by a sigmoidal curve, of screen time with the odds of myopia. Myopia risk increased significantly from 1 to 4 hours of screen time and then rose more gradually thereafter. 

About health technology

The US risks a heavy price for cutbacks in research spending  Excellent analysis by The Financial Times.
One particularly quotable paragraph is:
“Roughly 2 per cent of US federal spending is allocated to science and related R&D. This compares with about 12 per cent of the federal budget in the 1960s during the post-Sputnik space race and 5 per cent during the 1990s and early 2000s. There has also been a sharp reversal in the relative roles played by governmental and private expenditures. During the 1960s, the federal government paid for about two-thirds of all US R&D compared with 30 per cent by the private sector. More recently, the federal government has accounted for only 20 per cent of total R&D spending compared with 70 per cent by the private sector.”
The question is: what happens with further government cutbacks?

About healthcare finance

Blackstone and Omers look to offload healthcare groups in multibillion-dollar deals:
Blackstone and Omers have each put multibillion-dollar healthcare services companies up for sale, as private equity groups seek to offload their investments in a push to return cash to investors, according to people familiar with the matter. Private equity giant Blackstone has hired advisers to work on a sale of its majority stake in health insurance software provider HealthEdge, hoping to clinch a deal that values the company at more than $2.5bn, three people said. Meanwhile, Omers, one of Canada’s largest pension funds, is also working with advisers to sell Premise Health, which operates one of the biggest direct-access care networks in the US, seeking a valuation of about $2bn, the people added. 

Today's News and Commentary

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In other news:

Affordability solutions for the health of America From the BCBSA, this report cites the same sources of health costs, like markups by corporate hospital systems, hospital consolidation,  big pharma's manipulation of patents, etc. Easier said than done with all the special interests. What is interesting is the estimates of how much each factor costs.

DOGE Is Searching for Wasteful Spending. It Isn’t Hard to Find.Instead of fraud, “Last year, more than 90% of improper payments were overpayments.” Medicare and Medicaid accounted for $62.8B and Medicare Advantage another $19.1B. By contrast, $2.76B is due to fraud.
Comment: Instead of firing people, fix the systems! 

About health insurance/insurers

The states that would be the hardest hit by Medicaid cuts FYI

Prevalence of Chronic Medical Conditions Among Medicare Advantage and Traditional Medicare Beneficiaries:In this nationally representative study from 2015 to 2018, the prevalence of obesity, hypertension, hyperlipidemia, and chronic kidney disease was not higher among MA compared with FFS beneficiaries; however, the prevalence of diabetes was higher among MA beneficiaries.
Comment: Differences in the severity of specific medical conditions between groups could not be assessed and the dual eligibles were not separated. Still…with the majority of Medicare recipients in MA plans, it is time to eliminate the risk adjustment payments.

About the public’s health

US flu still high, COVID low but elevated in some areas, RSV declining, CDC says Latest stats on these infections.

2025 Heart Disease and Stroke Statistics Update Fact Sheet:
Heart Disease, Stroke, and other Cardiovascular Diseases

• Cardiovascular disease (CVD), listed as the underlying cause of death, accounted for 941652 deaths in the United States in 2022.

• Heart disease and stroke claimed more lives in 2022 in the United States than all forms of cancer and chronic lower respiratory disease combined.

• Between 2017 and 2020, 127.9 million US adults (48.6%) had some form of CVD. Between 2020 and 2021, direct and indirect costs of total CVD were $417.9 billion ($233.3 billion in direct costs and $184.6 billion in indirect costs/mortality).

• In 2017 to 2020 in the United States, 59.0% of non-Hispanic Black females and 58.9% of non-Hispanic Black males had some form of CVD. This race category had the highest prevalence of CVD.  

About healthcare IT

Hackers Score $1,000 Per Healthcare Data Breach Vs. $5 Per Credit Card Theft Latest stats on how much these breaches cost. Healthcare is still at the top of the list as the most lucrative for hackers.

About healthcare personnel

The Health of US Primary Care: 2025 Scorecard Report — The Cost of Neglect An excellent summary of the issues around primary care shortages.

About health technology

FDA clears first direct-to-consumer celiac disease genetic test Considering how many people are cutting out gluten, this test may be a winner for the company; but will consumers act on the results if negative?

About healthcare finance

In $4.1B deal, Thermo Fisher buys 3M spinoff's filtration unit to beef up bioproduction: The buyout target is Solventum’s purification and filtration business, which generated about $1 billion in revenue last year and is expected to grow sales at mid- to high-single-digit percentages in the future, according to Thermo Fisher.

Today's News and Commentary

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About hospitals and healthcare systems

The most common reasons for hospitalizations Top 5 reasons:
Sepsis — 739 stays per 100,000
COVID-19 — 468
Heart failure — 328
Diabetes with complication — 206
Heart attack — 177 

About pharma

Novo's Wegovy and Ozempic removed from US FDA shortage list, compounders on notice: The U.S. Food and Drug Administration said on Friday there was no longer a shortage of Novo Nordisk's popular weight-loss and diabetes drugs, Wegovy and Ozempic, a declaration that will curtail widespread sales of cheaper copies made by compounding pharmacies. 

About the public’s health

France just banned PFAS. Here’s why the U.S. hasn’t.: hemicals” in common products including cosmetics, ski wax and clothing, a move that could reverberate beyond its borders.
These chemicals, known as PFAS, or per- and polyfluoroalkyl substances, include thousands of compounds manufactured to make products and coatings that repel grease, water, oil and heat. The persistent chemicals are found in hundreds of household items, including nonstick cookware, menstrual products, dental floss and medicines. 

Cancer statistics for African American and Black people, 2025: Black men have experienced the largest relative decline in cancer mortality from 1991 to 2022 overall (49%) and in almost every 10-year age group, by as much as 65%–67% in the group aged 40–59 years. This progress largely reflects historical reductions in smoking initiation among Black teens, advances in treatment, and earlier detections for some cancers. Nevertheless, during the most recent 5 years, Black men had 16% higher mortality than White men despite just 4% higher incidence, and Black women had 10% higher mortality than White women despite 9% lower incidence. Larger inequalities for mortality than for incidence reflect two-fold higher death rates for prostate, uterine corpus, and stomach cancers and for myeloma, and 40%–50% higher rates for colorectal, breast, cervical, and liver cancers.

New bat coronavirus discovered in China sparks pandemic concerns:The discovery of a new bat coronavirus in China has sparked concerns about another pandemic.
The virus, named HKU5-CoV-2, is similar to SARS-CoV-2, the virus that causes COVID-19, in that it targets the same human receptor, angiotensin-converting enzyme (ACE2), according to a report in the South China Morning Post.
HKU5-CoV-2 could potentially lead to human-to-human or even cross-species transmission, the researchers found.

Measles, once eliminated in the U.S., sickens 99 in Texas and New Mexico:Nearly 100 people across Texas and New Mexico have contracted measles, state officials say, escalating anxiety over the spread of a potentially life-threatening illness that was declared eliminated in the United States more than two decades ago.
Ninety cases of measles — the majority affecting children under 17 — were detected in Texas’s South Plains, a sprawling region in the state’s northwest, the Texas Department of State Health Services said Friday. The spread marks a significant jump from the 24 cases reported earlier this month. The DSHS said “additional cases are likely to occur in the outbreak area and the surrounding communities.”

About healthcare personnel

Mass firings at HHS: FDA rescinds termination for 'hundreds' of probationary workers: FDA employees started receiving calls late Friday night from the human resources (HR) department. It’s unclear exactly how many workers the department is hoping to reinstate, but early indications suggest hundreds could be asked to rejoin their teams. 

Today's News and Commentary

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In other news:

Federal judge extends restraining order on Trump administration’s cap on NIH indirect costs: “After two hours of arguments from the Trump administration and three sets of plaintiffs, a federal judge on Friday kept in place an order blocking  the Trump administration from implementing a cap on how much indirect costs the National Institutes of Health pays grant recipients.
The temporary restraining order was set to expire on Monday, and has been extended until U.S. District Judge Angel Kelley can make a final decision on whether to issue an injunction on the proposed change.

About health insurance/insurers

DOJ Investigates Medicare Billing Practices at UnitedHealth: The new civil fraud investigation is examining the company’s practices for recording diagnoses that trigger extra payments to its Medicare Advantage plans, including at physician groups the insurance giant owns…
UnitedHealth’s shares fell 7% Friday, wiping out more than $30 billion in market value. The news dragged on rivals too, with No. 2 Medicare Advantage insurer Humanadown more than 5% for the day.

About the public’s health

Trump cuts long COVID, health equity committees in new EO: Both advisory committees were established in the Biden administration. Meetings for the long COVID advisory committee had not yet begun. The health equity advisory committee was even less established and had not yet selected its members.

Texas Measles Outbreak Nears 100 Cases, Raising Concerns About Undetected Spread: Health officials expect a measles outbreak in West Texas to exceed 100 cases because of low vaccine rates and undetected infections. Vaccine misinformation and new laws may make such situations more common and harder to contain. 

Today's News and Commentary

Check today’s KFF Health News. Especially note:
NPR: Trump Administration Terminates CDC Flu Vaccine Campaign:
The Centers for Disease Control and Prevention is stopping a successful flu vaccination campaign that juxtaposed images of wild animals, such as a lion, with cute counterparts, like a kitten, as an analogy for how immunization can help tame the flu. The news was shared with staff during a meeting on Wednesday, according to two CDC staffers who spoke with NPR on the condition of anonymity because they were not authorized to speak publicly, and a recording reviewed by NPR.

Meeting of key CDC vaccine advisory panel, under scrutiny by RFK Jr., is postponed: A committee of experts that advises the Centers for Disease Control and Prevention on vaccine policy — a group believed to be in the crosshairs of Health and Human Services Secretary Robert F. Kennedy Jr. — will not meet for its regularly scheduled February meeting, a senior HHS official confirmed Thursday.
The Advisory Committee on Immunization Practices was to meet from Feb. 26 to 28, its first gathering since the Trump administration took office. That will not happen, Andrew Nixon, the HHS director of communications, told STAT in an email. Later on Thursday, a notice of the postponement was posted on the ACIP’s homepage.

In other news:

Patients as Consumers: New Research Report Shows A New Era of Expectations in Healthcare:
Key findings include:

  • AI Adoption: Over one-third of consumers use AI for healthcare-related purposes like researching treatments and looking up physicians, but 75% expect transparency when AI is involved in patient communications.

  • Friction Costs Loyalty: Nearly half (48.4%) of consumers face appointment barriers—and these types of patient friction leading to a 13.1-point drop in “likelihood to recommend” scores.

  • Online Reviews Matter: 59% rely on online search and would delay appointments if high-quality reviews from former patients are lacking.

  • Accuracy Is Non-Negotiable: 9-in-10 consumers consider accurate information online about their clinicians as a top priority; nearly half will walk away if details are outdated or missing.

  • Online Scheduling Drives Choice: 80% consider it essential, yet only 25% rate current experiences as “excellent.” 
    Comment: These opinions are all on the access to care theme.

About health insurance/insurers

Trump administration backs ACA preventive coverage mandate: The Trump administration plans to defend the ACA requirement that requires insurers to fully cover certain preventive services for their members. 
On Feb. 18, the Justice Department filed a brief with the Supreme Court, arguing in favor of maintaining the Biden administration's stance regarding the landmark case that centers on whether employers can exclude covered services on religious grounds. Specifically, the case addresses the authority of the U.S. Preventive Services Task Force (USPSTF) in mandating coverage for preventive services, including medications such as PrEP for HIV prevention.

UnitedHealth Group offers buyouts to eligible employees: reports : UnitedHealth Group is offering a voluntary separation package to thousands of employees, anonymous workers are posting on social media and layoff forums.
Employees said they left departmentwide meetings Feb. 17 where they were offered a severance plan. The workers estimate around 30,000 employees are eligible for the severance option.
These reports were confirmed by Health Payer Specialist. The company’s benefits operations unit is one of the divisions offered the buyout, CNBC reported.  

About hospitals and healthcare systems

Newsweek: US Warned Of 2032 Hospital Crisis:
U.S. hospitals are on track for a crisis come 2032 that may lead to hundreds of thousands of additional deaths each year. This is the warning of a study by researchers from the University of California, Los Angeles (UCLA), who found that hospitals are not only fuller now than they were before the COVID-19 pandemic—but are on track to exceed the critical threshold of 85 percent hospital occupancy within just seven years.

 CommonSpirit Health logs $135M Q2 operating gain on higher volumes, checked labor spend:CommonSpirit Health reported an operating gain of $135 million (1.3% operating margin) for its second financial quarter ended Dec. 31, turning around the prior year’s loss with higher volumes, faster churn and more efficient labor spending.
The results, announced Friday, come as the massive nonprofit grapples with “considerable challenges” surrounding inflationary expenses and securing adequate payments from insurers, it said. 

Mass General Brigham opens FY25 with $54M operating loss; expects layoffs to save over $200M annually: Shortly after disclosing a wave of ongoing layoffs, nonprofit Mass General Brigham has reported a $53.8 million operating loss (-1% operating margin) but a $281.7 million net gain for the quarter ended Dec. 31.
Despite an 11% increase in total operating revenues largely driven by patient care, it’s a downturn over the same quarter the year before when the system logged a $32 million operating loss (-0.7% operating margin, excluding $114 million of certain prior year revenue) and $579.4 million excess of revenues over expenses.
Across the full 2024 fiscal year ended Sept. 30, MGB had reported a $72 million operating loss (-0.4% operating margin, again excluding prior year revenue).

About pharma

Pharma in the crosshairs as Trump floats 25% tariff on drug imports: n remarks to reporters Tuesday, Trump said the new duties would be around 25% and "go very substantially higher over a course of a year," but companies that establish domestic facilities would avoid the penalties. "When they come back into the United States and they have their plant or factory here, there is no tariff," Trump said.
It remains unclear if and when such tariffs on pharma products would be imposed, but Trump indicated that he wants to allow producers to expand their manufacturing capacity in the US, "so we want to give them a little bit of a chance."
The US imported close to $176.7 billion worth of pharmaceutical products in 2023, according to data from the US International Trade Commission. The country has become increasingly reliant on drug imports since the 1990s, with an estimated 80% of active pharmaceutical ingredients used in US prescription drugs being produced abroad, mostly in China and India. 

Baxter IV plant restores pre-hurricane production : Baxter's North Cove manufacturing facility in Marion, N.C., has returned to pre-hurricane production levels following extensive flooding from Hurricane Helene, which halted operations and triggered a nationwide IV-fluid shortage. 
Comment: This lengthy time-to-restoration indicates how precarious our supply chain is— particularly if we slow down imports through tariffs.

About the public’s health

New York accuses popular vape brands of fueling public health crisis: New York Attorney General Letitia James filed a sweeping lawsuit Thursday against several major e-cigarette companies, arguing that the distributors and manufacturers have caused a public health crisis by strategically marketing their products to young people.
The companies promoted “deceptive and misleading” messages about e-cigarettes’ safety despite knowing that their products post health risks to users, the lawsuit alleges. It also accuses the firms of flouting a 2020 state law banning flavored vapes, which studies have shown young people prefer.

About healthcare IT

Accelerating scientific breakthroughs with an AI co-scientist Google is developing AI software to help scientists develop study hypotheses.

Today's News and Commentary

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In other news:

FDA Official With Oversight of Musk’s Neuralink Devices Fired: An official who oversees a team at the Food and Drug Administration that reviews Neuralink Corp. devices was fired, according to an email the agency sent to staff Tuesday morning viewed by Bloomberg.
Ross Segan, who was formerly the director of the Office of Product Evaluation and Quality at the FDA’s medical device center, was one of thousands of employees fired across the US Department of Health and Human Services in recent days.

Missouri bill proposes registry for pregnant women to ‘reduce preventable abortions’:The bill summary states that, if passed, Missouri would create a registry of every expecting mother in the state “who is at risk for seeking an abortion” starting July 1, 2026. The list would be created through the Maternal and Child Services division of the Department of Social Services, but the measure did not specify how the “at risk” would be identified. 

About health insurance/insurers

MultiPlan rebrands amid price-fixing allegations : Data analytics firm MultiPlan is rebranding to Claritev…
The name change comes as the company has faced a series of lawsuits from the American Medical Association; Franklin, Tenn.-based Community Health Systems; Altamonte Springs, Fla.-based AdventHealth and others alleging the firm colluded with commercial payers in a price-fixing scheme to underpay providers by tens of billions annually.

About the public’s health

Kennedy says panel will examine childhood vaccine schedule after promising not to change it: To earn the vote he needed to become the nation’s top health official, Robert F. Kennedy Jr. made a special promise to a U.S. senator: He would not change the nation’s current vaccination schedule.
But on Tuesday, speaking for the first time to thousands of U.S. Health and Human Services agency employees, he vowed to investigate the childhood vaccine schedule that prevents measles, polio and other dangerous diseases.

Food for Thought 2025: Hospitalizations, deaths from contaminated food doubled in 2024 as recalls from Salmonella, Listeria and E. coli increased by 41%; 98% of all illnesses linked to just 13 outbreaks, ranging from cucumbers to deli meat. 

Measles outbreak in Texas rises to at least 58 cases — the state's worst in over 30 years: A measles outbreak in Texas has grown to 58 confirmed cases, local health officials confirmed to CBS News Tuesday, making it the state's worst in over 30 years — and officials say additional casesare likely. At least 13 people have been hospitalized in the outbreak so far, Texas officials said.
Other states are seeing cases too. New Mexico's Health Department confirmed a case there last week in an area that borders Gaines County, Texas, where the outbreak in centered. It said the teenager who got sick had not traveled to Texas and it's unclear how they were exposed to the virus.”\

 

Today's News and Commentary

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About health insurance/insurers

Payers ranked by 2024 medical loss ratios FYI. Recall that the “sweet spot” is about 85%.

About hospitals and healthcare systems

22 health systems dropping Medicare Advantage plans | 2025:Medicare Advantage provides health coverage to more than half of the nation's older adults, but some hospitals and health systems are opting to end or not renew contracts with some MA plans over administrative challenges.
Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers

Hospital labor, drug expenses rising: 18 statistics FYI. Note that these figures are changes.

Nearly half of rural hospitals in the red, 432 vulnerable to closure, report finds: The portion of rural hospitals operating with negative margins has dipped slightly from last year, though the number of facilities most likely to close has also crept up, healthcare advisory services firm Chartis found.

The group’s latest report on the state of rural healthcare providers found that 46% of rural hospitals are operating at a loss while 432 hospitals are deemed to be “vulnerable to closure.” This comes as 18 rural hospitals either closed or shifted to an operating model excluding inpatient care, per cited data from the Sheps Center for Health Services Research.
For comparison, the 2024 edition of the same report outlined 50% of rural hospitals operating in the red and 418 hospitals at risk of closure. 

About pharma

Walgreens shares soar after report that private-equity deal is 'alive': Walgreens Boots Alliance Inc. shares soared after CNBC said that a take-private deal with private equity firm Sycamore Partners is still possible. 

FDA OKs 1st rapid-acting insulin biosimilar: Sanofi-Aventis' Merilog is the first FDA-approved rapid-acting insulin biosimilar. 
On Feb. 14, the agency approved the drug, a biosimilar to Novolog, for glycemic control improvement in adult and pediatric diabetic patients. 

2024's top 10 clinical trial flops FYI

About the public’s health

UnitedHealth, HAC study examines how obesity is impacting employer health costs: The report notes that 75% of adults in U.S. are either overweight or obese, up from 50% in 1990. Obesity rates grew fastest among younger adults, according to the report.
The HAC represents about 230 self-funded employers, and, among its members, about a quarter (26%) have been diagnosed with obesity. The obese population accounts for 46% of the employers' medical spend, according to the report.

About healthcare personnel

The Health of US Primary Care: 2025 Scorecard Report — The Cost of Neglect Read this summary.
In short: “This year, the Scorecard spotlights the poor financing of primary care, describing how persistent challenges in primary care arise from insufficient investment (or in the case of training, misplaced investment) and a FFS payment model that rewards volume rather than the value of care. While providing updates on performance on the measures in each dimension, we analyze the impact of primary care financing, or the lack thereof, on primary care workforce/access, training, information technology, and research.
This report highlights how systemic financial issues not only undermine the effectiveness of primary care delivery but, more importantly, jeopardize the overall health of our communities.”

Today's News and Commentary

In honor of President’s Day, HealthcareInsights.MD will not publish on Monday, February 17.

Check KFF Health News

In other news:

Drivers of Variation in Health Care Spending Across US Counties: In this cross-sectional study of health care spending from 3110 US counties in 2019, 65% of the cross-county variation was explained by variation in service utilization, while price and intensity of services, disease prevalence, and population age explained 24%, 7%, and 4% of the variation, respectively. Insurance coverage and median income were associated with service utilization, while the fraction of Medicare with Medicare Advantage was associated with less utilization.
And in a related article:Tracking US Health Care Spending by Health Condition and County: This observational study showed considerable variation in spending across health conditions, types of care, age groups, payers, and counties—with spending being greatest for type 2 diabetes. Across counties, there was more variation in utilization rates rather than price and intensity of care.

About pharma

Moody's downgrades Walgreens outlook to negative: Moody’s warned in a report today that Walgreens struggles with a weak consumer environment that could hurt retail sales, and ongoing legal disputes, including a nearly $1 billion liability attached to an arbitration award won by a former partner. Moody’s also said Walgreens is challenged by “dark rent” on closing stores, persistent inflation and prescription reimbursement rate pressures.
Despite Walgreens paying down some debt and reporting modest growth, Moody’s expects Walgreens to face negative free cash flow over the next 12 months. Even the recent decision to suspend the dividend won’t help Walgreens in the near-term, Moody’s says.

About the public’s health

Trump creates MAHA commission on chronic disease, chaired by RFK Jr.: The commission will look to address health research, the food system and expanded coverage options. The executive order outlines a need for “fresh thinking” on physical activity and new technological habits, and the role the private sector currently holds. It will study contributing causes to childhood chronic disease such as "the American diet, absorption of toxic material, medical treatments, lifestyle, environmental factors, Government policies, food production techniques, electromagnetic radiation, and corporate influence or cronyism."
Federally funded health research should “avoid conflicts of interest” through renewed transparency and open-source data, according to a fact sheet. The new effort also calls for “gold-standard research on why Americans are getting sick in all health-related research funded by the federal government.”

About healthcare IT

Patients’ Trust in Health Systems to Use Artificial Intelligence: This analysis found low trust in health care systems to use AI responsibly and protect patients from AI-related harms. General trust in the health care system, but not health literacy or AI knowledge, was associated with these perceptions. 

Trends in Obesity-Related Measures Among US Children, Adolescents, and Adults: From 2013-2014 to August 2021-August 2023, there were small increases in the percentage of children and adolescents with obesity, as well as in adults with severe obesity (but not obesity). There were no other significant changes in obesity-related measures, including waist circumference. This period included the COVID-19 pandemic; a study using electronic health records found a small increase in mean weight among adults during the pandemic.

About healthcare personnel

Trump administration to fire thousands at health agencies: Senior officials were informed in meetings Friday morning that roughly 5,200 people on probationary employment — recent hires — across agencies including the National Institutes of Health and the Centers for Disease Control and Prevention will be fired that afternoon, according to sources briefed on the meetings. CDC leadership was told the Atlanta-based agency would lose about 1,300 workers. The numbers at the NIH are not clear, but exceptions are being made for certain probationary employees, according to a memo viewed by STAT.
Also, see: Thousands more fired as Trump, Musk intensify assault on US agencies  

Today's News and Commentary

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In other news:

RFK Jr. confirmed, elevating anti-vaccine activist to nation’s top health post “Kennedy was confirmed in a 52 to 48 vote largely along party lines, with Sen. Mitch McConnell (R-Kentucky) as the lone exception.”

About health insurance/insurers

Payers ranked by 2024 profits FYI

UnitedHealth Group, Amedisys plan to divest facilities in bid to close $3.3B merger “In a court filing issued late last week, UHG said it intends to pursue a divestiture plan that would sell off ‘at minimum’ 128 combined home health and hospice facilities. The company said in the filing that once the divestitures are completed, it will operate only 10% of home health services in the U.S. and 4% of hospice services.” 

About hospitals and healthcare systems

Tenet has 'outstanding' 2024 with $6B operating income, 28.9% margin “Dallas-based Tenet Healthcare reported an operating income of $6 billion (28.8% margin) for the year ended Dec. 31, 2024, up from $2.5 billion (12.2% margin) in 2023, according to its financial report released Feb. 12.” 

432 rural hospitals at risk of closure, breakdown by state “There are 432 rural hospitals vulnerable to closure, according to a Feb. 11 report from Chartis, a healthcare advisory services firm.
Chartis analyzed 15 vulnerability indicators and found that 10 were statistically significant in predicting hospital closures, including: Medicaid expansion status, average length of stay, occupancy, percentage change in net patient revenue and years of negative operating margin.”

About pharma

Diet drug boom weighs heavily on state budgets “…with the number of prescriptions skyrocketing past projections — more than 1 in 10 Americans reported taking a GLP-1 drug, according to a May 2024 KFF Health Tracking poll — some states are limiting or ending the benefit.”

About health technology

Johnson & Johnson puts stroke care business up for sale “Johnson & Johnson has put its stroke care business up for sale, aiming for a valuation of more than $1bn, as part of its efforts to reorganise its medical technology division, according to people familiar with the matter.”

Today's News and Commentary

I just heard the sad news that healthcare “futurist” Ian Morrison died. He approached healthcare with great wit and insight. Ian liked to say that he went from Scotland where death was imminent, to Canada where death was inevitable, to California where death was optional.

Read KFF Health News
In other news:

Healthcare lobbying 2025: Here are the top policy issues for hospitals, payers, docs and tech FYI

About health insurance/insurers

CVS Health posts $4.6B profit in 2024 “Net income was $4.6 billion in 2024, down from $8.4 billion in 2023. Fourth quarter net income was $1.6 billion, down from $2 billion during the same period last year. Total revenues in 2024 were $130.7 billion, up 23.7% year over year. Total revenues in the fourth quarter were $33 billion.”

About pharma

AbbVie inks another billion-dollar oncology deal “Under the terms, which include an option to license, AbbVie will pay $52 million up-front to Waltham, Mass.-based Xilio Therapeutics and as much as $2.1 billion in total payments for option-related fees and royalties, the North Chicago drugmaker said in a press release this morning.”

DNA sequencing shares slide amid 'headwinds' from Trump's NIH funding cuts “After the National Institutes of Health (NIH) announced late Friday that it would be following a Trump administration directive to cut the cost of medical research grants, major makers of DNA sequencing and cell analysis hardware saw their stock prices take a hit.” 

Walgreens ordered to pay $987M in COVID-19 testing dispute “A federal judge ruled that Walgreens must pay $987 million to the virtual care company PWNHealth, upholding an arbitration award following a breach-of-contract dispute. 
At the beginning of the COVID-19 pandemic, Walgreens partnered with PWNHealth to facilitate physician-ordered COVID-19 tests for customers. However, when regulations shifted, Walgreens allegedly began to use its own pharmacists to order tests through the same system without consulting with PWNHealth, according to court documents obtained by Becker's.”

About the public’s health

Kaiser Permanente, Tufts University launch food as medicine network with half-dozen partners “The institute is housed at the Friedman School of Nutrition Science and Policy at Tufts. The network’s other founding members comprise Blue Cross and Blue Shield of North Carolina, CVS Health, Devoted Health, Elevance Health, Geisinger and Highmark Health.
The Food is Medicine National Network of Excellence will focus on integrating nutritional interventions with existing treatment models and use research and training to enhance patient care and education. It will also aim to raise the rates of patient buy-in and participation. Members will develop frameworks to assess the impact of food as medicine interventions, and they will advocate for the movement with policymakers and the public.” 

About healthcare IT

Apple broadens research ambitions, unveils large-scale study into physical, mental health “The tech company is now broadening its health research ambitions to use its devices, including iPhones, Apple Watch and AirPods along with third-party devices, for a longitudinal, virtual study to monitor changes in participants’ health, spanning a wide range of health and disease areas.
Apple wants to tap into the devices and apps that individuals use everyday to evaluate the connections between physical and mental health as well as social determinants, such as whether someone lives alone or with family, and how all these aspects of health factor into a person's overall well-being.” 

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About health insurance/insurers

Humana posts $693M loss in Q4 “Humana lost $693 million in the fourth quarter of 2024, according to the company's year-end earnings report published Feb. 11.
The results reflect increased benefits expenses, particularly in Medicare Advantage and state-based contracts. Despite the challenges, the company projected earnings per share of $15.88 for 2025, with an adjusted EPS of approximately $16.25.”

UnitedHealth to pay $20M to settle emergency claims lawsuit from Labor Department “UnitedHealth Group reached a $20.25 million settlement with the U.S. Department of Labor on Feb. 7, resolving allegations that its subsidiary, UMR, improperly denied claims for emergency room visits and urinary drug screenings for thousands of patients. 
The Labor Department originally filed its lawsuit against UnitedHealth subsidiary UMR in July 2023 in a Wisconsin federal court. UMR is UnitedHealthcare's third-party administrator that provides health benefits services to more than 2,100 self-funded employer plans, according to the complaint.”  

Kaiser Permanente clears $115B revenue in 2024 thanks to Risant Health additions “Kaiser Permanente pushed its annual operating revenues to new heights last year thanks to the addition of its value-based care subsidiary Risant Health.
The integrated nonprofit health system shared Friday that it brought in $115.8 billion in operating revenues across 2024, up 14.9% from the prior year. Operating expenses also leapt 14.6% to $115.2 billion.
Taken together, Kaiser and new Risant acquisitions Geisinger Health and Cone Health posted an operating income of $569 million (0.3% operating margin) for the year.”

About hospitals and healthcare systems

20 large health systems growing bigger FYI

About pharma

How Medicare Says It Arrives At ‘Fair’ Prescription Drug Prices A great review of this process.

Novartis inks $925M Anthos takeover to buy back phase 3 clot-busting candidate “Novartis has brought abelacimab back into the fold. Six years after spinning the asset out to form Anthos Therapeutics, Novartis has struck a deal to buy Anthos for $925 million upfront to add the clot-busting prospect to its late-phase pipeline.
Abelacimab, an anti-factor XI/XIa antibody, is designed to stop blood clot formation without raising the risk of bleeding and bruising.”

About the public’s health

COVID vaccination saved more than 5,000 US lives in 7 months in 2023-24, CDC estimates “COVID-19 vaccination averted more than 5,000 US in-hospital deaths, 13,000 intensive care unit (ICU) admissions, and 68,000 hospitalizations in 7 months in 2023-2024, researchers from the US Centers for Disease Control and Prevention (CDC) estimatedlate last week in Vaccine, although with considerable uncertainty.”  

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About pharma

The US relies on China for key medicines. They won’t be spared from tariffs “President Trump’s tariffs in China are in place and hitting all products imported from the country — including a number of pharmaceutical drugs that Americans rely upon.
Chinese imports account for a significant proportion of U.S. prescriptions and over the counter drugs. Many of the Chinese-produced drugs are generics, which account for 91 percent of prescriptions dispensed in the U.S.” 

Hims & Hers faces scrutiny from senators on Super Bowl ad that ‘risks misleading’ patients “Sens. Dick Durbin, D-Ill., and Roger Marshall, R-Kan., wrote a letter to the U.S. Food and Drug Administration on Friday expressing concerns over an ‘upcoming advertisement’ that ‘risks misleading patients by omitting any safety or side effect information when promoting a specific type of weight loss medication.’”
Also, their drug is compounded, which avoids direct FDA scrutiny.

About the public’s health

Flu season in the US is the most intense it’s been in at least 15 years “One indicator of flu activity is the percentage of doctor’s office visits driven by flu-like symptoms. Last week, that number was clearly higher than the peak of any winter flu season since 2009-2010, when a swine flu pandemic hit the nation, according to data posted Friday morning by the Centers for Disease Control and Prevention.”

Measles outbreak expands in West Texas around county with low vaccination rate A measles outbreak is growing in a rural area of West Texas where vaccination rates are well below the recommended level.
In late January, two children in Gaines County were hospitalized for measles. On Wednesday, the state health department shared in a health alert that the number of confirmed cases had grown to six. As of Friday afternoon, the outbreak has jumped to 14 confirmed cases and six probable cases among people who are symptomatic and had close contact with infected individuals, Zach Holbrooks, executive director of the South Plains Public Health District, told CNN.”

About healthcare technology

BD bids farewell to its diagnostic, bioscience divisions with company split “After parting ways with its diabetes franchise nearly three years ago, BD is slimming down even further with a plan to divest its diagnostic and biosciences businesses as the company nears the finish line in its five-year ‘BD 2025’ strategy.
The ‘New BD,’ as the company describes it, will continue on as a pure-play medtech company with its enterprises in medical essentials—such as its ubiquitous hardware for collecting blood samples and delivering IV medications, which number in the tens of billions of units per year—as well as its interventional devices and connected care programs, with the latter including the recent acquisitions from Edwards Lifesciences.” 

About healthcare personnel

Physicians working more but generating less revenue Physician productivity and pay increased during the fourth quarter of 2024, but reimbursement for hospitals remained low, according to Kaufman Hall's Physician Flash Report.
The report, issued Feb. 4, includes data from 200,000 providers showing the investment or subsidy per physician was up 5% to $306,792 and work relative value units increased 8% to 6,313 year over year for the quarter.

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Gallup, Rollins Survey Reveals Americans’ Public Health Priorities, Trust “Health care access and affordability was ranked by Americans as the highest public health priority for government leaders to address. One in four selected this issue as their highest priority, and more than half (52%) rated it in their top three priorities. However, the percentage varies across subgroups.
Republicans and Republican-leaning independents ranked ‘ensuring safe water and food’ (24%) as their highest priority, followed by reducing chronic disease (16%) and health care access and affordability (19%). Democrats and Democratic-leaning independents ranked health care access and affordability (32%) as the highest priority, followed by food and water safety (13%) and strengthening safety net programs (12%).”

About health insurance/insurers

Independence Blue Cross excludes accelerated approval drugs from coverage for 18 months “Philadelphia-based Independence Blue Cross has set a benefit exclusion for products that receive accelerated approval from the FDA in most plans.

The health insurer said in a notice that drugs, biologics or gene therapies that earn an accelerated approval "are considered a benefit contract exclusion for most plans" and as such are not eligible for reimbursement for 18 months after the approval is made.
Independence said in the notice that these therapies will be covered after the 18-month mark based on certain criteria, including that they do not have a traditional FDA approval in place and that the accelerated approval was based on a surrogate endpoint.”
Comment: This move is a major change from insurance policy and may not be allowed in other states or with federal programs.

About pharma

After $2.2B Zantac settlement, GSK now faces investor lawsuit over the heartburn medication “In October, when GSK agreed to a $2.2 billion settlement to resolve approximately 80,000 lawsuits brought by users of Zantac, it appeared that the drugmaker’s legal issues with the heartburn treatment were largely in its rearview mirror.
But four months later, the company is embroiled in more Zantac litigation—this time with investorOn Tuesday in federal court in Pennsylvania, a group of shareholders filed a proposed class-action complaint, accusing GSK of hiding an internal report which suggested that Zantac might contain a cancer-causing compound.”

Federal appeals court axes $650M opioid judgment against CVS, Walmart and Walgreens “A federal appeals court axed a $650 million judgment and corresponding injunction against CVS Pharmacy, Walgreens Boots Alliance and Walmart stemming from a lawsuit filed by two Ohio counties in 2018.
A federal jury in Cleveland concluded in November 2021 that an oversupply of addictive pain pills and the diversion of those opioids to the black market created a public nuisance in the counties and that the pharmacies helped cause it, as Reuters reported.
In 2022, a Cleveland federal judge ordered CVS, Walmart and Walgreens to pay a combined $650.9 million to help the two counties address, or abate, the harms caused by the epidemic.”

About healthcare personnel

Trump Administration Live Updates: Judge Temporarily Halts Federal Worker Resignation Program “A federal judge in Massachusetts has stopped, at least temporarily, the Trump administration’s effort to get federal employees to leave their jobs by accepting delayed resignation offers. The judge said the government could not move forward with the program — which gave workers until 11:59 p.m. to accept offers to stop working and collect pay until September — pending a hearing Monday afternoon on a legal challenge. The administration said Thursday that more than 40,000 workers had already accepted.”
However: Trump Administration Live Updates: Nearly All Jobs Are Said to Be Cut at Aid Agency “The Trump administration plans to retain only about 290 of the more than 10,000 employees worldwide at the U.S. Agency for International Development, according to three people with knowledge of the planned cuts to the work force. The cuts were communicated to agency leaders in a call on Thursday. Most of the employees expected to stay on are those who specialize in health and humanitarian assistance. About 800 grants and contracts awarded through U.S.A.I.D. were also starting to be canceled on Thursday, the people said.

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Elevance Health, Centene donated to Trump inaugural fund, key lawmakers “Companies spanning many industries donated to Trump’s fund, hoping to soften or improve relationships and advance organizational priorities in the new administration.
In healthcare, the Pharmaceutical Research and Manufacturers of America, Johnson & Johnson and Bayer all donated $1 million. Abbott Laboratories donated $500,000. The National Association of Manufacturers, which also represents pharmaceutical interests, donated $1 million. So did Amazon, with its executive chairman and founder Jeff Bezos attending the indoor inauguration in person.
Others in healthcare donated to the fund, albeit to a lesser degree. HCA Healthcare, the country's largest for-profit hospital chain, gifted $250,000 to the cause. Insurers Elevance Health and Centene donated $150,000 and $50,000, respectively. Elevance and Centene did not respond to a request for comment.”

About hospitals and healthcare systems

National Hospital Flash Report: December 2024 Data (Published 2/4/2025)
“Key Takeaways − 2024 Year in Review
1. Hospital performance improved compared to 2023. Outpatient revenue increased and over the year, there was a decrease in patient observation days.
2. Expenses rose in 2024 but did not outpace inflation on a volume-adjusted basis. The workforce continues to be competitive.
3. Bad debt and charity care rose in 2024. This trend may reflect the continued Medicaid redetermination process and increase in the rate of payer denials.” 

About the public’s health

Dietary Sodium- and Potassium-Enriched Salt Substitutes—The Tipping Point? “Regulatory agencies including the US Food and Drug Administration should work in collaboration with consumers, scientists, and the food industry to reexamine the level of existing evidence to consider implementation of mandatory sodium limits in processed foods. If the conclusion of those discussions is that more evidence is necessary before taking steps toward mandatory limits, strong consideration should be given to examining existing observational evidence using evolving contemporary rigorous statistical approaches to offer the necessary confidence for decisions. Delaying the crucial step of limiting dietary sodium in the American diet is predicted to cost hundreds of thousands of quality-adjusted life-years.”

10 Things to Know About U.S. Funding for Global Health A great review of the topic. Not the least revelation is that: “U.S. global health funding totals approximately $12 billion but only represents less than 0.1% of the federal budget.”

About healthcare IT

Press Ganey partners with Microsoft in generative AI expansion “Press Ganey inked a strategic partnership with Microsoft to leverage the tech giant's artificial intelligence and cloud computing capabilities.
The patient experience monitoring company plans to bring new generative AI tools to market, including ambient listening for patient satisfaction, the company said.”

Teladoc to buy home testing company Catapult for $65 million “Teladoc Health will buy at-home testing company Catapult Health for $65 million in cash as it aims to grow its business around care for chronic diseases, the company announced Wednesday.”

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The Senate HELP subcommitte Approved RFK Jr.’s advancement to the full Senate for approval. The key vote was from Republican Senator Bill Cassidy (a physician) after receiving several assurances from Kennedy and the Trump administration. These assurances include:
1. Commitments on Vaccine Policy: Kennedy pledged to maintain existing vaccine approval and safety frameworks, keep the CDC’s Advisory Committee on Immunization Practices intact, and ensure no removal of CDC statements affirming that vaccines do not cause autism.
2. Collaborative Oversight: Cassidy was promised an “unprecedentedly close collaborative working relationship,” with Kennedy agreeing to meet or speak with him multiple times a month, provide input on HHS hiring decisions, and give 30 days’ notice before altering vaccine safety monitoring programs.
3. Senate Health Committee Role: Kennedy agreed to allow the Senate HELP Committee, chaired by Cassidy, to appoint representatives to any new vaccine safety boards and to appear before the committee quarterly if requested.
Cassidy emphasized his belief in vaccine safety, despite Kennedy’s controversial anti-vaccine stance, and cited these commitments as critical to his decision. Political pressures, including lobbying by Vice President JD Vance and grassroots supporters of Kennedy’s “Make America Healthy Again” agenda, also influenced Cassidy’s vote.
The question remains whether those assurances are genuine.

N.Y. Moves to Shield Doctors Who Send Abortion Pills to States With Bans “The newly signed law comes days after a New York doctor was indicted in Louisiana for prescribing and sending abortion pills to someone in the state. The charges represented an escalation in the fractious battle between mostly Republican-led states that ban abortion and Democratic-led states seeking to protect or expand abortion access.
The law, which takes effect immediately, will allow health-care practitioners to avoid putting their names on prescriptions for medications used in abortions, and instead use the names of their medical practices.”

C.D.C. Site Restores Some Purged Files After ‘Gender Ideology’ Ban Outcry Read the full article to understand what was restored and what is still missing.

Key Findings From New Polling on Public Opinion on Vaccines Read this short report. Americans are still overwhelmingly pro-vaccines and think the U.S. should maintain its leadership role in their development.

Loretta Ford, ‘Mother’ of the Nurse Practitioner Field, Dies at 104 “Loretta Ford, who co-founded the first academic program for nurse practitioners in 1965, then spent decades transforming the field of nursing into an area of serious clinical practice, education and research, died on Jan. 22 at her home in Wildwood, Fla. She was 104.”

FDA approves pig organ transplant trials for patients with kidney failure “The Food and Drug Administration has given two biotechnology companies approval for clinical trials that will transplant organs from genetically modified pigs into patients with kidney failure, an experimental but potentially groundbreaking innovation for thousands of Americans on the waiting list for organ transplants.”

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Pro-RFK Jr. letter to the Senate includes names of doctors whose licenses were revoked or suspended “The AP found that in addition to the physicians who had faced disciplinary action, many of the nearly 800 signers are not doctors. The letter with the names of those who signed was provided to the AP by Sen. Ron Johnson’s office after he entered it into the Congressional Record on Wednesday during the first of Kennedy’s two confirmation hearings…
Over 20 were chiropractors, representing an industry that has funded Kennedy’s work. An AP investigation found that donations from a chiropractic group represented one-sixth of the revenues collected by Kennedy’s anti-vaccine nonprofit in 2019.”

Trump administration indefinitely suspends meetings of HHS' health IT advisory committee “The Trump administration indefinitely canceled meetings of the Health Information Technology Advisory Committee (HITAC), an advisory panel that helps the federal government establish rules and standards for the use of healthcare data and technologies.
The HITAC was established by the 21st Century Cures Act, was enacted in 2016 and began having its first public meetings in 2018.”

Trump tariffs threaten US drug supplies and risk higher prices, trade groups warn Comment: As of this writing, the Mexican and Canadian tarrifs have been suspended for a month pending further talks.

Bipartisan lawmakers introduce bill boosting physician pay by 6.6% from April through December “The proposed adjustment would take effect April 1 and run through the rest of 2025, thereby leaving the year’s 2.83% Medicare pay cut in place for services furnished from January to March. Services furnished after the cutoff, however, would see a 6.62% increase—offsetting the pay cut, adjusting for inflation and prorating the first three months of pay cuts.”

In a first, scientists find microplastics are building up deep in our brains “A paper published Monday in Nature Medicine found that the tiny fragments of plastic are passing the blood-brain barrier and into human brains, and the amount of microplastics in the brain appears to be increasing over time. There were 50 percent more fragments in brains analyzed in 2024 than in 2016.
The scientists also examined the brains of 12 deceased patients diagnosed with dementia, and found that they had three to five times more microplastics than normal brains.”

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About health policy/law

Setting Public Health Priorities in the United States A thoughtful framework for setting these priorities.

States secure sweeping temporary restraining order against Trump's federal assistance 'pause' “A second federal judge has put the Trump administration's "temporary pause" and review of federal financial assistance on ice, and this time the temporary restraining order is indefinite and much more sweeping. 
The order, handed down Friday afternoon by Judge John J. McConnell, Jr., of the U.S. District Court for the District of Rhode Island, comes after the Office of Management and Budget (OMB) rescinded a memo outlining a funding freeze that threw much of the country's federal funding recipients into a panic.”
In a related story: National Science Foundation suspends salary payments, leaving researchers unable to pay their bills “Though a judge blocked that suspension on Tuesday before it could take effect, and the administration rescinded the memo that ordered it on Wednesday, on Thursday the NSF’s online payment system was still down, throwing lives into uncertainty. An NSF email seen by STAT suggested salaries had been suspended to ‘ensure only eligible activities’ are funded.”

CDC removal of databases on sexual orientation, gender identity sparks alarm “Data from an expansive federal survey on youth behavioral habits, including their sexual orientation and gender identity, have been removed from the website of the Centers for Disease Control and Prevention, which maintains the data.
The CDC and other federal agencies appeared to be racing to meet a Friday afternoon deadline to remove “gender ideology” from their websites, in accordance with a memo from the Office of Personnel Management. NBC News reported that all the CDC’s HIV pages were removed, but the main page appeared to have been restored later.”

N.Y. doctor charged with prescribing abortion pills to Louisiana girl “A New York doctor was criminally indicted Friday for allegedly prescribing abortion pills to a girl in Louisiana, setting up one of the first major legal challenges to ‘shield laws’ enacted by some Democratic-led states to protect doctors providing abortion access since Roe v. Wade was overturned in 2022.
Louisiana prosecutors accuse Margaret Carpenter, 55, of affecting a criminal abortion by means of abortion-inducing drugs. They also indicted her company, Nightingale Medical. Carpenter faces one to five years in prison and a $5,000 to $50,000 fine if convicted of violating a 2022 Louisiana law that bans abortion.”

KFF Tracking Poll on Health Information and Trust: January 2025 Too much information to summarize but look at the Figures. The level of mistrust and misunderstanding is very worrisome.

About pharma

Walgreens suspends quarterly dividend, stock plunges “Walgreens Boots Alliance is suspending its quarterly stock dividend to shareholders for the first time in 92 years, the latest sign that the Deerfield-based pharmacy chain is struggling to cut costs, improve margins and find stability.
The company said the dividend suspension is part of management’s plan to evaluate and refine its capital allocation policy amid a broader long-term turnaround plan. Doing so is aimed at strengthening Walgreens' balance sheet and allows it to focus on reducing debt and improving free cash flow.”

About health insurance

Allstate sells group health business to Nationwide in $1.25 billion cash deal “Insurance giant Allstate is selling its group health business to rival Nationwide for $1.25 billion in cash as part of its plan to focus on its core products such as property and casualty insurance.
Allstate is expected to post a financial book gain of $450 million from the sale of the business, which it acquired in 2021 as part of its purchase of National General, company Chief Financial Officer Jess Merten said in a statement.
The group health business, which provides insurance protecting small businesses from unexpected large medical claims, had revenue of $608 million and adjusted net income of $69 million for the first nine months of 2024, Allstate said.”

Cigna set to close $3.7B MA sale to HCSC in Q1 “age business in the first quarter of 2025, in line with its expectations.
The insurer announced plans to sell off its MA plans to Health Care Service Corporation in January 2024 in a deal valued at $3.7 billion. Chief Financial Officer Brian Evanko said that all federal antitrust approvals have been received, as have all but one state approval.”

Medicare Advantage Insurers Made Nearly 50 Million Prior Authorization Determinations in 2023
—"In 2023, there were nearly 2 prior authorization determinations on average per Medicare Advantage enrollee, similar to the amount in 2019.
—In 2023, insurers fully or partially denied 3.2 million prior authorization requests, which is a somewhat smaller share (6.4%) of all requests than in 2022 (7.4%).
—A small share of denied prior authorization requests was appealed in Medicare Advantage (11.7% in 2023).
—Though a small share of prior authorization denials were appealed to Medicare Advantage insurers, most appeals (81.7%) were partially or fully overturned in 2023. That compares to less than one-third (29%) of appeals overturned in traditional Medicare in 2022.”

Aetna, Centene, Blue Shield launch 'single payment' primary care model in California “Instead of each health plan using its own payment system, the three insurers use a single, shared system that rewards physicians for providing high-quality care, especially among underserved populations. The CQC will help practices implement the new system, improve care coordination, and integrate mental and physical health services. A platform called Cozeva will provide data to help physicians track their performance and close care gaps.
Participating providers are here. A full model guide is available here.”

Today's News and Commentary

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Freeze on Federal Funds Rescinded, and Trump Signs Law Easing Deportation for Migrants “The White House on Wednesday rescinded a directive that froze trillions of dollars in federal grants and loans after the order led to mass confusion and legal challenges that accused the Trump administration of violating the law.
The order, issued Monday night, was an attempt to purge the government of what President Trump has called a ‘woke’ ideology. A federal judge in the District of Columbia temporarily blocked it Tuesday afternoon, but the lack of clarity sent schools, hospitals, nonprofits and other organizations scrambling to understand if they had lost their financial support from the government.
On Wednesday, Matthew J. Vaeth, the acting director for the Office of Management and Budget, told federal agencies that the memo freezing aid had been ‘rescinded.’”

RFK Jr. grilled about his views on vaccines and abortion at first confirmation hearing

Three key takeaways from Robert F. Kennedy Jr.’s Senate confirmation hearing

About health insurance

Plans on Healthcare.gov denied 20% of claims in 2023 “Plans available through Healthcare.gov denied an average of 20% of claims in 2023, according to a new analysis from KFF.
Researchers found that exchange plans denied 19% of in-network claims and 37% of out-of-network claims, averaging out to 20%. There was notable variation between payers and states, according to the study, with denial rates ranging from 1% to 54%.
Insurers cited multiple reasons for denials, including 18% that were denied for administrative reasons, 16% for excluded services and 9% for lack of prior authorization or referral. Just 6% of denied claims cited a lack of medical necessity, according to the report.”

About pharma

GLP1Ra-based therapies and DXA-acquired musculoskeletal health outcomes: a focused meta-analysis of placebo-controlled trials “Approximately 30% of body weight lost with GLP1Ra-based therapy is LM [lean body mass].”

Independent pharmacies weigh stocking drugs under Medicare price negotiation “The National Community Pharmacists Association (NPCA) is warning the feds that independent pharmacists are likely to face significant financial hardship due to Medicare drug price negotiations.
In comments submitted on the latest Medicare advance notice, the organization says it conducted a survey of 8,000 pharmacy owners and managers about the drug price negotiation program and found that 93.2% have either decided not to stock drugs under negotiation or are considering not stocking these products.
The survey found that 32.8% of independent pharmacists have already made the decision to not stock one or more of the 10 drugs in the first round of negotiations. In addition, 60.4% of those surveyed said they are considering similar steps.
The NCPA said this is because they're concerned about ‘financial losses’ through the program.”

About the public’s health

Dangerous Virus’: Bird Flu Enters a New Phase “A human pandemic is not inevitable, even now, more than a dozen experts said in interviews. But a series of developments over the past few weeks indicates that the possibility is no longer remote.
Toothless guidelines, inadequate testing and long delays in releasing data — echoes of the missteps during the Covid-19 pandemic — have squandered opportunities for containing the outbreak, the experts said.”

Overview of President Trump’s Executive Actions on Global Health FYI

Today's News and Commentary

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Today’s big healthcare story is the governmental freeze on Medicaid funds. The disbursement site ceased working this morning. White House spokesperson said the website problem is being fixed. But other parts of the government say that funds are being withheld to make sure they are not provided for inappropriate services.
A DC District Court passed the freeze until Feb. 3.
This story is still evolving. See the following articles for some background:
Payment System That Provides Medicaid Funding to States Stops Working, Officials Say 
Trump federal assistance 'pause': Court orders delay, states confirm Medicaid portal disruptions 
White House pauses all federal grants, sparking confusion
BREAKING: Judge Temporarily Halts Trump's Funding Freeze