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Characterization of Research Grant Terminations at the National Institutes of Health: Targeted grant terminations have affected more than $1.8 billion in NIH funding. Terminations were spread across nearly all NIH institutes and centers, although cuts disproportionately impacted the NIMHD (30% of all funding).
The proportion of terminated grant funding was higher than the proportion of grants terminated across most institutes and centers, suggesting that larger-than-average grants were more likely to be terminated. Although most terminated grants were classified as independent research projects, 20% were formal training, fellowship, or career development awards. Study findings also demonstrate that grant terminations have affected both public and private recipient institutions across the US.  

About pharma

Teva to cut nearly 3000 jobs as shift from pure-play generics picks up pace: Teva plans to cut 8% of its workforce as part of efforts to trim $700 million in costs and achieve its target of reaching a 30% operating profit margin by 2027. The move means that the company's workforce of just over 36,000 will be slashed by around 2900 positions. 

About the public’s health

Immunogenicity and Safety of Influenza and COVID-19 Multicomponent Vaccine in Adults ≥50 Years:  In this phase 3 study, mRNA-1083 elicited noninferior immune responses against standard care immunization: licensed standard-dose or high-dose seasonal influenza vaccine (A/H1N1, A/H3N2, B/Victoria, B/Yamagata) coadministered with licensed SARS-CoV-2 (Omicron XBB.1.5) vaccine. The multicomponent vaccine mRNA-1083 had an acceptable tolerability and safety profile.   

About healthcare personnel

Physician Flash Report: Key Takeaways
Two out of five providers in physician practices are advanced practice providers (APPs). The gap between APPs and physicians continues to close and is driven primarily by surgical and primary care.
Subsidies for surgical specialties continue to grow. Physician practices must carefully consider site of service, which impacts revenue and margin.
Provider compensation is growing slowly. Physician practices should consider retention strategies to keep talent in today’s highly competitive marketplace for physicians and clinicians. 

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Health Care (From U.S.News Best State Rankings): FYI

About hospitals and healthcare systems

Hospital Price Transparency in Action: An Analysis of Radiology Procedure Price Variation in Children's Hospitals Between 2023 and 2024: Findings show a statistically significant decrease in price variation, with the coefficient of variation (CV) for negotiated rates declining by 19.2% but overall prices continuing to rise, with payer specific negotiated rates increasing by an average 6.7%. Price transparency policies may contribute to reduced price dispersion; however, the average price did increase.

Monthly Healthcare Industry Financial Benchmarks: Highlights from the March 2025 data include: 

  • Operating margins for U.S. health systems narrowed slightly to 0.9% in March, after holding steady at 1% for both January and February, while hospital operating margins rose year-over-year (YOY). 

  • Non-labor expenses continued to rise faster than other expense categories, due in part to double-digit increases in both drug and supply expenses versus the same month last year. 

  • Patient demand was up nationwide across most metrics in March, following decreases in February, as growth in outpatient visits outpaced inpatient admissions.  

  • Gross outpatient revenues led overall hospital revenue increases, jumping 10.0% YOY as hospitals and health systems continue to see care shift from inpatient to outpatient settings.  

  • Per-physician expenses rose to $1.2 million in the first quarter, representing an increase of 3% compared to Q4 2024 and 10.3% versus Q1 2024. 

Northwell, Nuvance's 28-hospital merger crosses the finish line: As expected, Northwell Health and Nuvance Health have consummated their 28-hospital merger.
The resulting nonprofit juggernaut delivers care to more than 13 million people in New York and Connecticut by way of a $22.6 billion operating budget. It employs more than 104,000 people, and alongside the hospitals runs over 1,050 ambulatory care sites, 73 urgent care locations and three medical research and education organizations.  

About pharma

The 25 priciest drug classes for hospitals FYI. By far, the largest class is Antineoplastic targeted agents: $7.3 billion.

About the public’s health

FDA label updates aim to make it easier to choose healthy foods: FDA updates to criteria for using the term “healthy” on manufactured and packaged foods are aimed at helping consumers quickly and easily identify what they need to eat for a healthful diet, experts said during an FDA webinar
The FDA released the final rule updating the definition of the nutrient content claim “healthy” for manufactured and packaged foods in December 2024.   

About healthcare IT

Mercer launches tool that allows employers to predict healthcare costs linked to climate events: Climate-related health challenges are driving up employer spending, and a new tool built by Mercer aims to help firms anticipate the potential costs.
The Climate Health Cost Forecaster was developed in partnership with the National Commission on Climate and Workforce Health. It seeks to arm employers with the data necessary to estimate the long-term health costs tied to weather events like extreme heat, poor air quality, flooding and hurricanes.
The tool is designed to offer companies a local perspective on the vulnerabilities that could impact their workforces. It leans on a combination of Mercer's proprietary models for healthcare costs and key weather and epidemiological research, according to an announcement. 

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5 Places to Turn for Accurate Health Information In view of the federal government’s cutbacks on information, this article is a good source of other sources you can use.

About pharma

Trump signs order to boost domestic drug manufacturing as pharma tariffs loom: The order directs the Food and Drug Administration to reduce the amount of time it takes to approve manufacturing plants in the U.S. by eliminating unnecessary requirements, streamlining reviews and working with domestic drugmakers to “provide early support before facilities come online,” according to a White House fact sheet.
It also directs the agency to raise inspection fees for foreign manufacturing plants, improve the enforcement of active-ingredient source reporting by overseas producers and consider publicly listing facilities that don’t comply.

About healthcare IT

Parental Technology Use in a Child’s Presence and Health and Development in the Early Years: This systematic review and meta-analysis found that parental technology use in their child’s presence was significantly associated with poorer cognition and prosocial behavior, lower attachment, higher levels of internalizing and externalizing problems, and higher levels of screen time. 

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Postdischarge contact within 7 d does not reduce use of acute care at 30 d: In adults, PDC interventions delivered by nonclinician providers within 7 days of hospital discharge do not reduce use of acute care at 30 days.
Comment: Many health plans use the metric of contact within 7 days of discharge to calculate quality bonuses.

Trump’s 2026 budget plan cuts healthcare funds: 6 notes FYI- a good update.

About Covid-19

UVA research finds distinct changes in immune systems of COVID-19 survivors: New groundbreaking research from the University of Virginia's School of Medicine has revealed that the immune systems of COVID-19 survivors, specifically those with breathing issues, have distinct changes.
According to a release from the university, officials say these findings shed light on the complexity of Long COVID and may pave the way for more personalized and effective treatments. 

About health insurance/insurers

IRS unveils new HSA limits for 2026. Here’s what investors need to know FYI

Medicaid cuts, mortality, and health-care expenditure in the USA: Based on projected coverage losses, we estimate that approximately 623 000 additional individuals aged 25–64 years (95% CI 91 000 to 1·07 million) will face catastrophic health-care costs annually. 

Payers ranked by Q1 profits FYI

Estimating the Budgetary Impact of Reforms to the Medicare Advantage Quality Bonus Program: Reforms to the Medicare Advantage QBP could save the federal government $2.6 billion to $14.1 billion in 2026. The impact of reforms varies considerably over contract characteristics due to differences in quality and the geographic location of contracts. These estimates are consistent with other research about QBP spending.

About hospitals and healthcare systems

Hospital Capital Expenditures Associated With Prices And Hospital Expansion Or Withering, 2010–19:  This study investigated the market dynamics linking hospital capital expenditures during the period 2010–19 to changes in volume, market share, and prices. We found that hospitals investing more in capital gained market share and raised prices, whereas hospitals investing relatively less in capital lost market share and increased prices less. Taken together, these forces perpetuate a cycle of expanding and withering hospitals. Study findings suggest important limits to antitrust as a mechanism to address high and rising prices, and the findings could inform policies to forestall or eliminate the financial decline of withering hospitals, thereby preserving access and promoting competition.

Hospitals Acquired By Private Equity Firms: Increased Postoperative Mortality For Common Inpatient Surgeries: We found that PE acquisition was associated with a 2.7-percentage-point increase in thirty-day postoperative mortality compared with control hospitals, driven primarily by an increase in failure to rescue (3.9 percentage points), with no observed change in the rate of complications. Subset analysis revealed that the increase in mortality was particularly pronounced for unplanned (emergent) surgeries, whereas no significant changes were observed for planned (elective) surgeries. Our findings suggest that PE acquisition may adversely affect the management of emergent surgical cases, raising critical considerations for policy makers and health care stakeholders regarding the influence of PE ownership on patient safety.

About pharma

FDA probes compounding pharmacies over quality concerns: The FDA plans to gather information from 250 compounding outsourcing pharmacies amid safety and quality concerns. 
In a May 1 notice, the agency said it will survey outsourcing facilities about challenges and opportunities related to market and business viability, compliance, quality production and interactions with the FDA.  

About healthcare personnel

Europe unveils $565 million package to retain scientists, and attract new ones: The European Commission on Monday unveiled a roughly $565 million package to retain and attract scientists, as other countries try to leverage the Trump administration’s dismantling of research programs in the U.S. to build up their own enterprises. 
The funding program, amounting to 500 million euros, is designed to make “Europe a magnet for researchers,” Ursula von der Leyen, the president of the commission, said at an event at Paris’ Sorbonne University called “Choose Europe for Science.” Appearing along with French President Emmanuel Macron, von der Leyen said the funding, which will last through 2027, would support researchers from Europe and around the world. 

Pathways To Primary Care: Charting Trajectories From Medical School Graduation Through Specialty Training: Among 353,590 physicians who graduated during the period 2001–15, 11.8 percent pursued initial training in family medicine, 33.5 percent training in internal medicine, and 10.5 percent training in pediatrics. Primary care yield, defined as the percentage of physicians who complete their initial postgraduate training in a primary care specialty and conclude their training in any primary care specialty, was 97.0 percent for family medicine, 35.5 percent for internal medicine, and 54.4 percent for pediatrics. After internal medicine and pediatrics residencies, large percentages of physicians left primary care to train in subspecialties and other fields. Further research must document how many physicians enter careers in primary care practice.

About healthcare finance

Deerfield raises $600M healthcare fund to invest in therapeutics, AI:Deerfield Management closed its third Healthcare Innovations Fund on Monday, raising $600 million to invest in therapeutics and care delivery technologies, as well as machine learning and AI. 
The latest close comes about five years after Deerfield's last raise in 2020, when it clinched $840 million to fund healthtech innovations and novel treatments. 

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Trump’s budget proposes steep cuts to NIH, health funding: The 2026 proposal is seeking to cut $33.3 billion in discretionary funding for HHS, representing a 26.2 percent reduction compared to the fiscal 2025 budget.
This includes a $3.6 billion reduction in discretionary funding for the Centers for Disease Control and Prevention (CDC), an $18 billion reduction for the National Institutes of Health (NIH), a $674 million reduction for the Centers for Medicare and Medicaid Services (CMS) Program Management and a $240 million reduction for Administration for Strategic Preparedness and Response (ASPR) Hospital Preparedness Program.
The only health program that gains discretionary funding in the proposal is HHS Secretary Robert F. Kennedy Jr.’s Make America Healthy Again(MAHA) Commission, for which the budget provides $500 million. 

About health insurance/insurers

CMS sets up real-time medical fraud center with DOGE; Federal contractor rolls out commercial tool: The Centers for Medicare & Medicaid Services (CMS) has launched the Fraud Detection Operation Center (FDOC) to fight waste, fraud and abuse, the agency announced this week.
Comment: This task had been done by the Inspector General; it is not new or innnovative.

DOJ sues major insurers, brokers over alleged Medicare Advantage kickbacks:The Department of Justice has filed a sweeping lawsuit against Humana, Aetna, and Anthem, along with Medicare Advantage brokers eHealth, GoHealth, and SelectQuote, alleging a multi-year scheme involving unlawful kickbacks and discriminatory practices against disabled MA enrollees.
According to the May 1 complaint filed in the U.S. District Court for the District of Massachusetts, the insurers paid hundreds of millions of dollars from 2016 through at least 2021 to the brokers in exchange for preferential treatment, including steering enrollees toward their MA plans and away from competitors, regardless of the quality of the plans. The DOJ filed the lawsuit based on a whistleblower complaint initially filed by a former eHealth employee under the False Claims Act. 

About hospitals and healthcare systems

Understanding the Hospital Readmission Reduction Program FYI

About pharma

Lilly star weight-loss drug Zepbound faces coverage challenge from CVS Health: CVS Health said the drugs Wegovy and Saxenda from rival drugmaker Novo Nordisk will become the preferred options on its standard formulary, or list of covered drugs, as of July 1. Zepbound will be excluded. 

GLP-1s can help employers lower medical costs in 2 years, new study finds:
KEY POINTS

  • Aon researchers found that within two years, improved health outcomes for patients who were taking GLP-1 drugs lowers the growth rate of medical care costs.

  • Aon looked at medical claims data for 139,000 U.S.-based workers with employer health coverage who took GLP-1 medications between 2022 and 2024.

  • Since 2023, GLP-1s have driven up employer spending on drugs at a faster pace than high-priced specialty drugs used to treat cancer and autoimmune conditions, according to an Evernorth study.

About the public’s health

Diabetes deaths fall to lowest levels in years, in early CDC figures:There were 103,294 deaths from diabetes in 2021, up more than 17% from 87,647 deaths in 2019 before the pandemic. Provisional data reported so far for 2024 have tallied 94,294 diabetes deaths last year. 

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Aetna to exit individual market: Aetna will exit the individual ACA exchange market in 2026, citing continued underperformance. 
CVS Health reported its first quarter earnings May 1. On a call with investors, CEO David Joyner said the company determined there is “not a near or long-term pathway for Aetna to materially improve its position in the market.”  

How National Medicaid Work Requirements Would Lead to Large-Scale Job Losses, Harm State Economies, and Strain Budgets: Key Findings and Conclusions: Between 4.6 million and 5.2 million adults could lose Medicaid in 2026 if work requirements are imposed, cutting federal funding to states by $33 billion to $46 billion in the first year and $362 billion to $504 billion over a decade. States overall could see a $43 billion to $59 billion reduction in economic activity in 2026; a loss of 322,000 to 449,000 jobs; and a $3.2 billion to $4.4 billion reduction in state and local tax revenues. The DC matching rate reduction would cut $712 million in federal funding in 2026 and lead to 7,300 total jobs lost in DC and neighboring states.

About hospitals and healthcare systems

Spring 2025 Leapfrog Hospital Safety Grade Searchable by hospital and state. 

About pharma

25 drugs ranked by 2024 healthcare expenditure  FYI

Novartis bolsters renal disease pipeline with $1.7B deal for Regulus: Novartis moved to expand its renal disease portfolio via an agreement to acquire Regulus Therapeutics for up to $1.7 billion, gaining the latter's microRNA therapeutic farabursen. The deal — announced Wednesday — includes $7 per share in cash upfront, or around $800 million, as well as a similarly priced contingent value right (CVR) of about $900 million linked to a regulatory milestone.

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Humana posts $1.2B profit in Q1: Humana recorded a net income of $1.2 billion in the first quarter of 2025, up from a net income of $741 million during the same period last year, according to its April 30 financial report. 
Total revenue for the three months ended March 31 was $32.1 billion, up from $29.6 billion during the same quarter last year. 
Humana reported total operating expenses of $30.1 billion in the first quarter, up from $28.4 billion. 
The payer’s medical loss ratio was 87.4% in the first quarter of 2025. The company expects a medical loss ratio between 90.1% and 90.5% for the full year.

Omnicare Hit With $136M Jury Verdict For Bilking Feds: A New York federal jury on Tuesday returned a verdict finding that CVS Health Corp. subsidiary Omnicare illegally billed the federal government to the tune of $135.6 million, one of the largest jury verdicts in a False Claims Act case… 

About pharma

U.S. Attorney Announces $202 Million Settlement With Gilead Sciences For Using Speaker Programs To Pay Kickbacks To Doctors To Induce Them To Prescribe Gilead’s Drugs FYI

Mark Cuban’s drug company leans further into specialty market: Mark Cuban Cost Plus Drug Co. has secured another partnership targeting the specialty pharmaceutical market, according to an April 28 news release shared with Becker’s
EverPharm, a specialty unit-dose medication company, is joining its portfolio with Cost Plus Drugs’ pricing model, which is the drug’s manufacturing cost plus a 15% markup and a $10 shipping and labor fee. On April 16, Cost Plus Drugs launched a similar partnership with Morris & Dickson, a full-line and specialty pharmaceutical distributor. 

About healthcare IT

Healthcare data breaches, by the numbers: Here are five things to know from Verizon Business’ 2025 Data Breach Investigations Report, released April 23:
1. Healthcare had 1,542 data breaches from late 2023 to late 2024, an increase from the year prior.
2. System intrusion was the top kind of breach.
3. Of the threat actors, 67% were external while 30% were internal.
4. Financial interest was the No. 1 motive (90%) of hackers.
5. The top data compromised were medical (45%) and personal (40%). 

About health technology

Generalizability of FDA-Approved AI-Enabled Medical Devices for Clinical Use: In this cross-sectional study, clinical performance studies at the time of approval were reported for approximately half of AI-enabled medical devices, yet the information was often insufficient for a comprehensive assessment of their clinical generalizability, emphasizing the need for ongoing monitoring and regular re-evaluation to identify and address unexpected performance changes during broader use. 

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U.S. Supreme Court rules against Advocate Christ in fight over billions in Medicare payments: In the 7-2 decision on Advocate Christ Medical Center v. Kennedy announced Tuesday, the high court determined the Centers for Medicare and Medicaid Services does not need to count all beneficiaries enrolled in both Medicare and Supplemental Security Income, or SSI, when tallying how many low-income patients a hospital treats. As a result, health systems will get paid less than they sought.
CMS only counts Medicare enrollees who got SSI cash payments during the same month they received hospital care — not anyone merely eligible for or enrolled in SSI — when calculating disproportionate share hospital payments for facilities that treat large shares of low-income patients.
Advocate Christ Medical Center in southwest suburban Oak Lawn and more than 200 other hospitals filed the lawsuit in 2017. 

Mental health network misled policyholders about provider options, lawsuit claims:  Elevance Health is facing a second lawsuit alleging it misrepresented providers as in-network, creating what are known as "ghost networks." The plaintiffs in this lawsuit, who are state employees covered under New York state health benefits, claim that Elevance Health's subsidiary, Carelon Behavioral Health, misled them, causing financial harm. The lawsuit seeks class-action status. 

About hospitals and healthcare systems

The cost of hospital closures in 21 numbers: See the article for the numbers. For example: An NIH National Center for Advancing Translational Sciences report from March 2023 found of the 53 rural hospitals that closed, 66% were located in the South and 21% were in Appalachia. The spillover from these closures resulted in a $1.4 million average annual cost increase at for-profit hospitals, $2.1 million at government hospitals and $7.3 million for nonprofit hospitals.  

About pharma

Novo Nordisk strikes telehealth deals for obesity drug, following Eli Lilly: Novo Nordisk is expanding its efforts to sell its obesity drug Wegovy directly to patients, striking agreements with telehealth companies including Hims & Hers, Ro, and LifeMD.
Novo last month launched a new direct-to-consumer website called NovoCare Pharmacy that sells Wegovy, which normally carries a list price of about $1,350 a month, at $499 a month to patients who are paying on their own without insurance. With the new deals, patients can order this lower-priced Wegovy directly on the telehealth companies’ sites and get the treatment delivered to their homes. 

1st pediatric patient receives FDA-approved gene therapy: At Children’s Hospital of Philadelphia, an 11-year-old girl with severe beta thalassamia, became the first pediatric patient to receive Zyntelgo, the first FDA-approved gene therapy for transfusion-dependent beta thalassamia. 
Since receiving the therapy, the patient, Rahameen Nabeel, no longer requires blood transfusions and has seen dramatic improvements in her health and daily life, according to an April 28 news release from the hospital. 

Germany’s Merck to buy US biotech SpringWorks for $3.9bn: German pharmaceutical group Merck has agreed to buy US biotech SpringWorks Therapeutics for an equity value of $3.9bn, expanding its portfolio of cancer treatments and investing in the US despite policy uncertainties.

About the public’s health

Phthalate exposure from plastics and cardiovascular disease: global estimates of attributable mortality and years life lost: New evidence has emerged that plastic polymers and their chemical additives, particularly di-2-ethylhexylphthalate (DEHP), contribute to cardiovascular disease (CVD). Phthalates are commonly used in the production of plastic materials and have been linked to increased oxidative stress, metabolic dysfunction, and cardiovascular disease…
 In 2018, an estimated 356,238 deaths globally were attributed to DEHP exposure, representing 13.497% of all cardiovascular deaths among individuals aged 55–64. Of these, 349,113 were attributed to the use of plastics. Geographic disparities were evident, with South Asia and the Middle East suffering the greatest percentage of cardiovascular deaths attributable to DEHP exposure (16.807%). The Middle East, South Asia, East Asia, and the Pacific accounted for the largest shares of DEHP-attributable CVD deaths (73.163%). Globally, DEHP resulted in 10.473 million YLL. 

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About health insurance/insurers

Long-Term Spending of Accountable Care Organizations in the Medicare Shared Savings Program: In this difference-in-differences study of more than 8 million patients, ACO formation was associated with a mean differential reduction of $142 (1.2%) in annual per-patient spending over 3 years and $294 (2.4%) over 6 years. Physician-group and small ACOs generated relatively large reductions. Spending changes resulted in $4.1 billion to $8.1 billion in savings to Medicare between 2012 and 2019.
See, also: Reflecting on 2 Decades of Medicare ACO Experience

About hospitals and healthcare systems

From -18.5% to 28.8%: 28 health systems ranked by operating margins FYI

Sutter Health to pay $228M to settle antitrust lawsuit: Sacramento, Calif.-based Sutter Health has agreed to pay $228.5 million to settle a long-running class action lawsuit that the health system used its market power to charge supracompetitive rates to major insurers, which resulted in higher premiums for members.
There is no admission of liability and the settlement is subject to court approval, according to an April 25 filing in the U.S. District Court for the Northern District of California.    

About pharma

Exclusive: US pharma tariffs would raise US drug costs by $51 billion annually, report finds: A 25% U.S. tariff on pharmaceutical imports would increase U.S. drug costs by nearly $51 billion annually, boosting U.S. prices by as much as 12.9% if passed on, a report commissioned by the industry's U.S. trade group and reviewed by Reuters shows.
The analysis, conducted by Ernst & Young, found the United States imported $203 billion in pharmaceutical products in 2023, with 73% coming from Europe -- primarily Ireland, Germany and Switzerland. Total U.S. sales of finished pharmaceuticals that year were $393 billion.

About the public’s health

U.S. government researchers present ‘phenomenal’ new data on HPV vaccines: A clinical trial run by the National Cancer Institute seems to confirm that a single dose of the vaccine used to prevent infection with the human papilloma virus is just as effective as two — and, therefore, also helps to prevent cancer.

9 in 10 Americans have put off health checkups, life-saving screenings: Key findings from Aflac’s third annual “Wellness Matters Survey” reveal that most Americans (94%) put off getting a health checkup or screening that could help identify and treat serious illness early. Why? Fear of bad news, personal embarrassment, inconvenience, logistical barriers, and distrust or dislike of doctors — especially among younger adults — rank among the most common reasons, according to the survey. 

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Gen Z increasingly listens to peers over doctors for health advice: In all age groups, but especially among adults younger than age 35, peer-driven health care decisions surged between 2024 and 2025.
—45% of adults age 18 to 34 said they've disregarded their health provider's guidance in favor of information from a friend or family member in the past year — a 13-point increase from the previous year.
—38% of young adults said they've ignored their provider in favor of advice from social media, a 12-point increase from the year before. 

In a reversal, the Trump administration restores funding for women's health study: The Trump administration is restoring financial support for a landmark study of women's health, an official said Thursday, reversing a defunding decision that shocked medical researchers.

About health insurance/insurers

Payers ranked by CEO-to-worker pay ratios FYI

Centene posts $1.3B profit in Q1: Centene posted $1.3 billion in net income in the first quarter, per its earnings report published April 25.
Total revenues in the first quarter were $46.6 billion, up 15.4% year over year.
The company reaffirmed its year-end adjusted EPS guidance of greater than $7.25.
The company’s medical loss ratio was 87.5% in the first quarter and 87.1% during the same period last year. 

Insurers not required to cover medical marijuana, federal judge rules: A federal judge has dismissed a proposed class-action lawsuit that aimed to require insurers in New Mexico to cover medical cannabis as a behavioral health treatment. 
The complaint was originally filed in June 2022. On April 23, U.S. District Judge Martha Vazquez granted the defendants’ motion to dismiss, ruling that New Mexico state law does not mandate insurance coverage for medical marijuana and that federal law would overrule any such requirement. 

About pharma

Ozempic copies restricted after US judge denies injunction: A U.S. judge on Thursday rejected a bid by compounding pharmacies to keep making copies of Novo Nordisk's popular diabetes and weight-loss drugs Ozempic and Wegovy while a legal challenge over drug shortages unfolds, court records showed.
The decision came in response to a February lawsuit from a compounding industry group against the U.S. Food and Drug Administration's decision that there was no longer a shortage of the medicines' active ingredient, semaglutide. 

Fiscal Impact of Expanded Medicare Coverage for GLP-1 Receptor Agonists to Treat Obesity: In this economic evaluation of 30 million cumulative Medicare beneficiaries identified as eligible for new GLP-1RAs for obesity treatment over the next 10 years, Medicare’s total projected costs for drug coverage of the GLP-1RAs were $65.9 billion. Health care savings of $18.2 billion were estimated to result in $47.7 billion in net increased spending.

U.S. Emergency Department Visits Attributed by Clinicians to Semaglutide Adverse Events, 2022–2023: With more than 5 million patients dispensed semaglutide in 2023, the estimated 20 226 ED visits in 2023 suggests a rate of fewer than 4 ED visits for adverse events per 1000 patients dispensed semaglutide. Most ED visits were due to adverse effects previously observed during randomized controlled trials of semaglutide, including gastrointestinal adverse effects and hypoglycemia when combined with other diabetes agents.
Comment: Note the study’s dates. With increased use of this class of medications, the overall number of ED visits is probably much larger today.

About the public’s health

[U.S.] Aid Funding Cuts Disrupt Child Vaccinations Almost as Much as Pandemic, Says UN: "Setbacks (are) at a similar level to what we saw during COVID-19. We cannot afford to lose ground in the fight against preventable disease," said Catherine Russell, UNICEF executive director.

USDA withdraws a plan to limit salmonella levels in raw poultry: The Agriculture Department will not require poultry companies to limit salmonella bacteria in their products, halting a Biden Administration effort to prevent food poisoning from contaminated meat.
The department on Thursday said it was withdrawing a rule proposed in August after three years of development. Officials with the USDA’s Food Safety and Inspection Service cited feedback from more than 7,000 public comments and said they would “evaluate whether it should update” current salmonella regulations.

Trump's surgeon general nominee, Dr. Janette Nesheiwat, faces scrutiny over credentials: President Trump's nominee to be the U.S. surgeon general, the Fox News contributor and family medicine physician Dr. Janette Nesheiwat, has described herself as a double board-certified physician with a degree from the University of Arkansas School of Medicine — credentials the president touted in his announcement.
But those claims about her certification and schooling appear to be misleading.  

State and Sociodemographic Trends in US Cigarette Smoking With Future Projections: The findings of these repeated cross-sectional surveys suggest that the difference in cigarette smoking prevalence between historically high vs low prevalence states will shrink by 2035, primarily from much faster declines among young adults in the traditionally highest prevalence states. Slower prevalence declines among older adults are likely to slow the decline in health consequences in these states.

Geographic Variation of Racial and Ethnic Differences in Uterine Cancer Survival: In this cohort study of 162 500 patients with uterine cancer, uterine cancer–specific survival was better among Asian patients, worse among Black patients, and not different among Hispanic patients compared with White patients. Location-stratified analyses comparing Asian, Black, and Hispanic patients with White patients with uterine cancer showed disparate survival within less and more diverse US locations; however, associations varied by race and ethnicity.

Association between non-skimmed milk consumption and metabolic dysfunction-associated fatty liver disease in US adults: insights from NHANES data: Our findings suggest a significant association between frequent non-skimmed milk consumption and risk of MAFLD, particularly in highly educated individuals. These results highlight the importance of dietary modifications, specifically reducing non-skimmed milk intake, as a potential preventive strategy for MAFLD, especially in high-risk populations.
Comment: RFK Jr. is pushing to add non-skimmed milk to Head Start programs and school lunches.

About healthcare IT

EHR interoperability by country: Where the US ranks: FYI (Spoiler alert: the US is at the bottom.)

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Do higher premiums drive more healthcare usage? : “We’re seeing a significant and disproportionate increase in utilization largely within our public sector group retiree business. This population experienced the greatest year-over-year premium increases,” UnitedHealthcare CEO Tim Noel told investors. “We did assume that we would see some care activity level increases in this population, but what we’re seeing far surpasses what we would have recently anticipated. And in that population as well, we are seeing more preventative care, more annual wellness visits, more in-home clinical assessments. The driver there is also really the follow-on care that results from that.”
Comment: The unknown is whether it is a cause and effect relationship.
What would drive more usage? People trying too get their “money’s worth.”
Or, higher premiums drive sicker people away so that the remaining sicker population skews the average usage higher.

About pharma

The 25 most expensive hospital drugs FYI

About the public’s health

Nearly Half of People in U.S. Exposed to Dangerous Air Pollution Levels: Nearly half of the people living in the U.S. breathe unhealthy levels of air pollution, according to the American Lung Association’s 2025 “State of the Air” report, which was released today. In total, the report finds that 156 million people, 25 million more than last year’s report, are living in areas that received an “F” grade for either ozone or particle pollution. Extreme heat and wildfires contributed to worse air quality for millions of people across the U.S.
Comment: Regardless of opinions about pollution causing climate change, there is no doubt about its adverse role in health. In related stories, see what the EPA has announced and Trump officials consider shrinking 6 national monuments in the West.

Funding cut for landmark study of women's health:The Trump administration is shutting down most of a landmark federal project studying women's health, stunning researchers around the country.
"It's a huge loss. I can't put into words what a huge loss it is," says Marian Neuhouser, who chairs the steering committee for the federally funded Women's Health Initiative. The study, begun in the 1990s, has produced a series of groundbreaking results and was continuing to gather valuable data about women's health.
The Department of Health and Human Services is terminating contracts with all four regional centers that have been following tens of thousands of women who have been participating in the project for decades, according to the project's coordinating center.

About healthcare personnel

What noncompete laws look like in every state FYI

About healthcare finance

9 payer M&A deals in 2025 FYI

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In other news:

DOGE has access to 19 HHS systems: Report: The U.S. Department of Government Efficiency has access to sensitive information in 19 HHS databases and systems, according to a court filing obtained by Wired.
HHS submitted the filing as part of the discovery process for a lawsuit the American Federation of Labor and Congress of Industrial Organizations’ filed against the federal government, aiming to restrict DOGE’s access to federal systems. Nine such systems had not been previously disclosed as being accessed by DOGE. HHS did not respond to Wired‘s request for comment. 
[See the article for specifics of which systems are affected.] 

About health insurance/insurers

CHRAs Gain Favor Among Large Employers Due To Reduced Health Insurance Expenses: Individual Coverage Health Reimbursement Arrangements are gaining traction among large employers as a cost-effective alternative to traditional health insurance plans, offering potential savings, employee choice, and broader market adoption in the face of economic uncertainties and rising healthcare costs. 
At a Glance
-About 44% of large employers consider ICHRAs to cut health insurance costs, offering pre-tax funds for individual plans.
-ICHRAs reduce premiums by 23% on average, distributing risk across broader population segments.
-Experts predict ICHRAs will dominate the employer-sponsored health insurance market within 10 years.

Highest-paid payer CEOs in 2024 FYI

Healthcare billing fraud: 10 recent cases FYI

About the public’s health

Dose Response of Incidental Physical Activity [IPA] Against Cardiovascular Events and Mortality: Any daily IPA amount of vigorous or moderate intensity was associated with lower CVD risk in a dose-response manner. LIPA had weak associations with all outcomes. One minute of vigorous or ≈3.0 to 3.5 minutes of moderate IPA was associated with a similar degree of lower CVD risk. Our findings highlight the potential cardiovascular health value of incidental physical activity, especially for people who struggle to do structured exercise. 

Food companies agree to phase out synthetic dyes, handing MAHA a victory: Food manufacturers will phase out eight synthetic dyes from all U.S. products by the end of 2026, the federal government announced today in a move that reflects the growing reach of the Make America Healthy Again movement.

Americans unsure what to believe about the measles vaccine, poll shows: Most Americans have encountered false claims about the measles vaccine, and many aren’t sure what the truth is, according to a KFF poll released Wednesday.

With future of gun research in question, new report finds US emergency departments see a firearm injury every 30 minutes: Every 30 minutes, an emergency department treats another firearm injury, according to a new analysis from researchers at the US Centers for Disease Control and Prevention that looked at 10 jurisdictions, including the District of Columbia.
But cuts from the US Department of Health and Human Services and proposed changes to the federal budget could threaten research that reveals these kinds of firearm injury patterns. Experts say it would be nearly impossible to replicate the scale and scope of the timely firearm research the federal government is able to conduct.

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In other news:

As Trump eyes coal revival, his job cuts hobble black lung protections for miners:
Summary

  • Layoffs halt black lung protection programs for miners

  • NIOSH and MSHA programs suspended amid Trump administration cuts

  • Miners face increased risk as safety regulations enforcement weakens

About pharma

The top 20 pharma companies by 2024 revenue: For the second straight year, there was no change at the top as No. 1 Johnson & Johnson, No. 2 Roche, No. 3 Merck, No. 4 Pfizer and No. 5 AbbVie each held their positions. Each company delivered modest revenue increases in 2024 of between 3% and 7%.

About the public’s health

Annual Report to the Nation on the Status of Cancer From The National Cancer Institute:
Key Points

  • Overall, from 2018 to 2022, cancer death rates decreased an average of 1.7% per year for men and an average of 1.3% per year for women.

  • Cancer death rates decreased an average of 1.5% per year from 2001–2022 among children (ages 0-14 years).

  • Among adolescents and young adults (AYAs) ages 15-39, death rates fell by 2.9% per year from 2001–2005, 1% per year from 2005–2020, and then remained stable from 2020–2022.

  • Overall cancer mortality declined for over 20 years, even during the COVID-19 pandemic.

  • The rate of new cancer cases is higher among men than women. However, the rate has increased for women by 0.3% per year from 2003 through 2021. Rates of new cancer cases among men decreased by 1.6% – 2.2% per year from 2001 through 2013 before stabilizing through 2021.

  • Rates of new cases and deaths for tobacco-related cancers have been decreasing, but rates for cancers associated with excess body weight have been increasing.

RFK Jr. to announce intent to phase out synthetic food dyes: Robert F. Kennedy Jr. is slated to announce an intent to phase out the use of petroleum-based synthetic food dyes in a bid to ramp up pressure on an industry he has often derided. 

About healthcare personnel

Physicians and Surgeons From The U.S. Bureau of Labor Statistics: Overall employment of physicians and surgeons is projected to grow 4 percent from 2023 to 2033, about as fast as the average for all occupations.
About 23,600 openings for physicians and surgeons are projected each year, on average, over the decade. Many of those openings are expected to result from the need to replace workers who transfer to different occupations or exit the labor force, such as to retire.
[The statistics are broken down by specialty.]

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NIH moving to ban grants to universities with DEI programs, Israeli boycotts: The National Institutes of Health says it will pull medical research funding from universities with diversity and inclusion programs and any boycotts of Israeli companies, according to a policy note issued Monday.
The agency “reserves the right to terminate financial assistance awards and recover all funds” if grant recipients do not comply with federal guidelines barring diversity and equity research and “prohibited boycotts,” the notice stated

About Covid-19

Studies across 14 nations show 25% to 30% rate of long COVID: Among the 25.1% of participants who said they experienced long-COVID symptoms, 12.8% reported sleeping disorders, 9.8% reported joint pain, 8.7% had fatigue, and 8.1% noted headaches. Almost a third of participants (29.8%) from lower middle-income countries said they had long COVID, compared with 14.4% in high-income countries (adjusted odds ratio [aOR] 1.53; 95% confidence interval [CI], 1.10 to 2.14).
The highest long-COVID prevalence was seen in patients with Arab/North African ethnicity (36.1%), and hospitalized patient were also at increased risk of long COVID (aOR, 2.04; 95% CI, 1.63 to 2.54). 

About health insurance/insurers

U.S. Supreme Court appears likely to uphold ACA preventive care coverage mandate: The Supreme Court seemed likely to uphold a key preventive-care provision of the Affordable Care Act in a case heard Monday.
Conservative justices Brett Kavanaugh and Amy Coney Barrett appeared skeptical of arguments that Obamacare’s process for deciding which services must be fully covered by private insurance is unconstitutional.  

About pharma

Walgreens paying up to $350M as it tries to close the book on opioid lawsuits: Walgreens Boots Alliance has agreed to pay a $300 million settlement to resolve allegations that the pharmacy chain illegally filled invalid opioid prescriptions and filed false Medicare claims for the invalid prescriptions, federal agencies announced this morning.
The settlement further states that Walgreens will have to pay an additional $50 million if it is sold, merged or transferred before fiscal year 2032.
That eventuality seems likely, as Walgreens in the midst of a turnaround strategy and in March announced it is pursuing a private-equity sale. 

About the public’s health

Differential Associations of Cigar, Pipe, and Smokeless Tobacco Use Versus Combustible Cigarette Use With Subclinical Markers of Inflammation, Thrombosis, and Atherosclerosis: The Cross-Cohort Collaboration–Tobacco Working Group: Use of noncigarette tobacco products is linked to subclinical markers related to cardiovascular harm. Inflammatory markers, such as high-sensitivity C-reactive protein and interleukin-6, have the potential for assessing early cardiovascular harm from using these products and aiding regulatory authorities in evaluating their associated risks. 

China’s restrictions on rare earths could hurt U.S. health care Among these metals used for healthcare applications are gadolinium, lutetium and yttrium.

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Medical journal receives U.S. attorney letter seeking information about alleged bias: This week, at least one scientific journal has received an unexpected inquiry from a top government official requesting that it detail some of the thinking behind its editorial practices. 
“It has been brought to my attention that more and more journals and publications like CHEST Journal are conceding that they are partisans in various scientific debates,” reads the letter, sent by the interim U.S. attorney for the District of Columbia, Edward R. Martin Jr., to the editor in chief of the American College of Chest Physicians journal.  
The letter goes on to ask six questions of the journal, largely about alleged bias in the decision to publish content. 

Access to SNAP-Authorized Retailers and Diet Quality Among SNAP Recipients: This cross-sectional study, including 5041 SNAP recipients, found that living closer to SNAP-authorized retailers, particularly superstores and grocery stores, was associated with higher Healthy Eating Index-2015 scores among participants.

NIH said to have halted awarding of new grants to more top universities: Internal email instructs agency staff not to communicate with institutions about the decision. Embattled universities whose funding from the National Institutes of Health has been frozen may face further financial strain as the agency holds off awarding new grants to at least half a dozen of them, according to an email obtained by STAT.

And in a related article: DOGE begins to freeze health-care payments for extra review: The U.S. DOGE Service is putting new curbs on billions of dollars in federal health-care grants, requiring government officials to manually review and approve previously routine payments — and paralyzing grant awards to tens of thousands of organizations, according to 12 people familiar with the new arrangements.
The effort, which DOGE has dubbed “Defend the Spend,” has left thousands of payments backed up, including funding for doctors’ and nurses’ salaries at federal health centers for the poor. Some grantees are waiting on payments they expected last week.  

About health insurance/insurers

Patient-Reported Characteristics Across Dual-Eligible Medicare Advantage Plan Types: This cross-sectional study including 147 923 dual-eligible beneficiaries found differences in the characteristics of full-benefit dual-eligible beneficiaries across MA plan types. Older dual-eligible individuals and those with multiple functional limitations were more likely and those in highly socioeconomically disadvantaged neighborhoods were less likely to enroll in fully integrated dual-eligible Special Needs Plans compared with less integrated plan types.
 
About hospitals and healthcare systems

One-quarter of small employers ditch health premiums every year, analysts find: About 27% of the small employers that were paying health insurance premiums in 2022 stopped paying the premiums in 2023, according to a new report from a research arm of JPMorgan Chase.  

About pharma

FDA to limit pharma employees from serving on adcoms, citing 'undue influence' The FDA announced on Thursday a new policy to limit employees of pharmaceutical companies from serving on advisory committees (adcoms), as part of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr.'s initiative to introduce "radical transparency" into the department. Instead, the agency will prioritise appointing patients and caregivers to review panels.
According to the FDA, the goal is to "mitigate perceived industry influence and conflicts of interests" while increasing the public's trust in the US regulator and its decisions.  

About the public’s health

Nicotine and Toxicant Exposure among Individuals using both Combustible Cigarettes and E-cigarettes Based on Level of Product Use: In this population-based cross-sectional study, individuals reporting dual use appear to have nicotine and toxicant exposure at least at the same level as those using cigarettes alone and higher than exclusive e-cigarette use (except for metals). Given the adverse health consequences of dual use, including potential cancer risk, our findings highlight the need for clinicians and public health practitioners to increase awareness of the potential risks associated with dual use. A

Analysis of USAID’s Active and Terminated Awards List: How Many Are Global Health?:
—Global health awards account for 12% of all awards on the list but the majority (53%) of all unobligated funding.
—80% of global health awards are listed as terminated, totaling $12.7 billion in unobligated funding.
—Many global health awards are multi-sectoral, spanning more than one global health area, with HIV/AIDS accounting for the greatest number.

RFK Jr.’s cuts to CDC eliminate labs tracking STIs, hepatitis outbreaks:Lab scientists at the Centers for Disease Control and Prevention had been analyzing blood samples for weeks to determine how dozens ofpatients across six states had become infected with viral hepatitis, a disease that can cause serious liver damage.
But their DNA detective work stopped abruptly last week. Widespread layoffs across federal health agencies earlier this month had resulted in the firing of all 27 lab scientists who worked in the only U.S. facility that could perform the sophisticated genetic sequencing needed to investigate hepatitis outbreaks, lab experts said.
Another lab, the only one in the United States capable of testing for and tracking antibiotic-resistant gonorrhea, often called “super gonorrhea,”was also recently effectively shut down. 

Today's News and Commentary

Note: Due to technical site problems, yesterday’s blog was not transmitted. Appologies.

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In other news:

Estimated Impact Of Medically Tailored Meals On Health Care Use And Expenditures In 50 US States: Medically tailored meals (MTMs) can reduce health care use among high-risk patients with diet-related conditions. However, the potential impact of providing coverage for MTMs across fifty US states remains unknown…Assuming full uptake among eligible people, MTMs were net cost saving in the first year in forty-nine states, with the largest savings seen in Connecticut ($6,299 per patient). The exception was Alabama, where MTMs were cost-neutral. The number of treated patients needed to avert one hospitalization ranged from 2.3 (Maryland) to 6.9 (Colorado). These findings can inform state-level policy makers and health plans considering MTM coverage through state-specific strategies. 

States with the highest, lowest health equity scores FYI. The results are not obvious.

Internal budget document reveals extent of Trump’s proposed health cuts:

  • The proposal would reduce the more than $47 billion budget of the NIH to $27 billion — a roughly 40 percent cut. It would consolidate NIH’s 27 institutes and centers into just eight. Some of its institutes and centers would be eliminated, including the National Institute on Minority Health and Health Disparities and the National Institute of Nursing Research.

  • Many of NIH’s institutes would be fused. A National Institute on Body Systems, for example, would absorb three separate institutes: the institute focused on heart and lung diseases; the institute focused on diabetes, kidney and digestive disorders; and a third focused on muscle, skeletal and skin diseases.

  • A new, $20 billion agency named the Administration for a Healthy America would be created. AHA would include many pieces of other agencies that are being consolidated — such as those focused on primary care, environmental health and HIV.

  • AHA would have $500 million in policy, research and evaluation funding to be allocated by Kennedy to support “Make America Healthy Again” initiatives, including a focus on chronic childhood diseases. But many specific programs would be eliminated under AHA, according to the document, including programs focused on preventing childhood lead poisoning, bolstering the health-care workforce, advancing rural health initiatives and maintaining a registry of patients with amyotrophic lateral sclerosis, or ALS.

  • The proposal would fund the Food and Drug Administration at a level that allows it to continue to collect drug and medical device fees from the industries the agency regulates. Unless the agency is funded at a certain level, the FDA’s ability to use these funds, which help expedite safety reviews for devices, drugs and other products, would be limited.

  • The proposal would cut the CDC’s budget by about 44 percent, from $9.2 billion to about $5.2 billion, and would eliminate all of the agency’s chronic disease programs and domestic HIV work. The chronic disease programs being eliminated include work on heart disease, obesity, diabetes and smoking cessation.

  • Rural programs formerly under the Health Resources and Services Administration appear to be hard-hit. The rural hospital flexibility grants, state offices of rural health, rural residency development program and at-risk rural hospitals program grants are listed as eliminations under AHA.

  • Money for the Head Start program, which provides early child care and education for low-income families and is funded by HHS’s Administration for Children and Families, would be eliminated. “The federal government should not be in the business of mandating curriculum, locations and performance standards for any form of education,” the document says.

About health insurance/insurers

Supreme Court to hear challenge to ACA rule requiring free preventive care, cancer screenings: or a decade and a half, Americans have been guaranteed that no matter their health insurer, certain preventive care like cancer screenings are free of charge. That’s because an Affordable Care Act provision has required insurers to fully cover services given an A or B recommendation by an expert task force.That may soon change. On Monday, the U.S. Supreme Court will hear a challenge to this statute in the case of Kennedy v. Braidwood Management. Either way the court decides, legal and medical experts told STAT, the ruling could have profound ramifications for the future of preventive health care in the United States.

In a related article: Use of No-Cost Preventive Services Jeopardized by Kennedy v Braidwood: This cross-sectional study presented a detailed, comprehensive assessment of ACA-mandated no-cost preventive service use potentially jeopardized by Braidwood and future challenges. Among ESHI enrollees in 2018 aged 18 to 64 years, nearly 1 in 3 (and nearly half of women) received no-cost preventive services from 2018 to 2022 covered under the ACA mandate but threatened by Braidwood. While results varied across states, proportions were higher than 20% in every state.

UnitedHealth cuts earnings guidance amid rising Medicare Advantage costs: UnitedHealth Group posted nearly $6.3 billion in net income during the first quarter of 2025, but the company reduced its year-end earnings outlook amid rising use of physician and outpatient services among its Medicare Advantage membership and “unanticipated changes in the profile of Optum Health members.”
UnitedHealth stock decreased 20% on the morning of April 17 following “an overall performance that was frankly unusual and unacceptable,” CEO Andrew Witty told investors. In its earnings report, the company also cited “a greater-than-expected impact to current and new complex patients from the ongoing Medicare funding reductions enacted by the previous administration.” 

About hospitals and healthcare systems

10 Things to Know About Rural Hospitals FYI. One reason this study is important is that “Rural hospitals account for about one third of all community hospitals nationwide and at least a third of all hospitals in most states.” 

About pharma

Eli Lilly’s 1st GLP-1 pill shows favorable results in late-stage trial:Eli Lilly completed a phase 3 trial for its weight loss drug, orforglipron, which showed promising results in evaluating its safety and efficacy for adults with Type 2 diabetes and inadequate glycemic control. 
The once-daily oral GLP-1 receptor agonist significantly reduced blood sugar and body weight in adults with Type 2 diabetes and had a safety profile consistent with injectable therapies, according to an April 17 news release from the drugmaker. 
Comment: If the results hold up, this medication could replace the injectables in its class, probably at lower cost.

Trump Seeks to Lower Drug Prices Through Medicare and Some Imports: President Trump signed an executive order on Tuesday outlining a series of actions intended to lower drug prices, including helping states import drugs from Canada.
The policies were more modest than proposals to reduce drug prices that Mr. Trump offered in his first term.
And one of his new directives could increase drug prices. It calls for the Trump administration to work with Congress to change a 2022 law in a way that could defang a negotiation program meant to reduce Medicare’s spending on commonly used or costly drugs.
Such a change has the potential to increase costs for the government, because it would most likely delay the existing timetable for some drugs to become eligible for Medicare price cuts.

Arkansas first state to ban PBMs from owning pharmacies: Arkansas has become the first state to ban pharmacy benefit managers from owning pharmacies after Gov. Sarah Huckabee Sanders signed House Bill 1150 into law April 16. 
The legislation, sponsored by state Rep. Jeremiah Moore and state Sen. Kim Hammer, prohibits state pharmacy permits from being issued to PBMs beginning Jan. 1, according to an Jan, 16 press release from the governor’s office.  

About healthcare IT

Evolving Remote Monitoring: An Evidence-Based Approach to Coverage and Payment Not all remote monitoring programs are effective. Look at page 9of this report for a summary of evidence.

 About healthcare personnel

40% of nurses eye exit by 2029: 5 findings from NCSBN’s new workforce report  Worth skimming the report’s main findings.

About health technology

Device maker that helped UnitedHealth collect billions offers to settle fraud claims with DOJ United used a device from this company to document decreased peripheral blood flow-allowing the company to claim a higher patient severity and get more Medicare Advantage payments.

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In other news:

FTC probes antitrust regulations after Trump’s executive order: 7 things to know FYI

Impacts of Communication Type and Quality on Patient Safety Incidents: A Systematic Review: Four studies investigated whether poor communication was the only identified cause of a patient safety incident; here, poor communication caused 13.2% (IQR, 6.1% to 24.4%) of safety incidents. Forty-two studies investigated whether poor communication contributed to patient safety incidents alongside other causes; here, poor communication contributed to 24.0% (IQR, 12.0% to 46.8%) of safety incidents. Study heterogeneity was high in terms of setting, continent, health care staff, and safety incident type. The strength of the evidence was low or very low. 

About health insurance/insurers

Medicare Advantage rate boost likely to ‘significantly support’ payers’ financial recovery: Fitch: CMS’ payment increase of 5.03% in 2026 “will likely significantly support the recovery” of Medicare Advantage plans as they continue to face rising medical costs, according to Fitch Ratings.
Increased government scrutiny, reduced base payments and rising utilization in the last couple of years has put pressure on the program, leading plans to reduce benefits or pull back from unprofitable markets. CMS’ rate hike will increase payments to MA plans by more than $25 billion in 2026. 

Around 1 in 4 small businesses are dropping insurance coverage: 5 notes:
Here are five findings to note: 

  1. The share of businesses dropping employees varied by industry. Among personal service businesses with employees, 33% discontinued insurance coverage between 2022 and 2023. Among real estate businesses, the share was 25%. 

  2. A 10% hike in premiums cost was associated with a higher likelihood of discontinuing coverage, the analysts found. 

  3. Most small businesses that stopped paying health insurance premiums continued to operate in the following years, according to the report. This indicates that discontinuing health insurance is often a “strategic move to manage expenses, rather than an indication of financial distress or impending closure.” 

  4. In 2023, small businesses spent an average of 4.2% of total operating expenses on health insurance, a 3.1% jump from 2023. 

  5. Policies to keep premiums affordable and predictable could help small businesses retain consistent coverage, according to JPMorganChase. 

Read the full report here.  

About the public’s health

RFK Jr. plans changes to vaccine injury reporting system: Health secretary Robert F. Kennedy Jr. said Tuesday that he plans to roll out changes to the vaccine injury monitoring system that would automate and increase data collection as well as look for negative impacts of the shots.  

About healthcare IT

The Healthcare AI Adoption Index 
Top takeaways
—AI adoption is accelerating,
driven by internal teams co-developing with Big Tech and cloud providers—not just startups (i.e., healthcare AI applications).
60% of execs report AI budgets outpace IT spend, with funding decisions centralized within the C-suite.
Only 30% of AI pilots reach production, held back by security, data readiness, integration costs, and limited in-house expertise.
Startups have significant growth opportunities ahead: As of now, only 15% of AI projects involve vertical AI applications, and just 32% of executives believe GenAI solutions from startups are superior to those from large tech incumbents. Yet 48% of executives say they prefer working with startups over established players, highlighting the potential for startup founders to co-build and serve emergent AI strategies.
Trust and outcomes matter most—procurement is shifting toward co-development as 64% of execs are open to co-developing with early-stage partners, particularly with those startups that show clear and attributable ROI.

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About health insurance/insurers

CMS Cuts Medicaid Funding For Some Non-Medical In-Home Services: The Centers for Medicare & Medicaid Services (CMS) announced Thursday that it would no longer approve funding for some services previously covered by state section 1115 demonstrations, including some in-home non-medical services.
In a letter addressed to state Medicaid directors, CMS stated that the organization “did not anticipate” approving new federal funding for designated state health programs (DSHP) and designated state investment programs (DSIP) under section 1115 demonstration authority.
Among the examples of expenditures that would not be approved moving forward, CMS cited $241 million for a program in New York dedicated to non-medical in-home services, including housekeeping.

CMS drops 5 proposed payment rules for 2026: 25 things to know A great review of the proposed changes across provider types.

About hospitals and healthcare systems

Hospital M&A plummets amid market volatility: Hospital mergers and acquisitions dropped in the first quarter as the economic and political climate changed, according to Kaufman Hall’s “M&A Quarterly Activity Report: Q1 2025.
There were five transactions in the first quarter and no mega-mergers where the smaller party had $1 billion revenue or more. Comparatively, the first quarter of 2024 had 20 transactions and the first quarter of 2020 had 29. 

CMS weighs dropping some quality measures: What to know: The agency outlined the changes April 11 as part of its 2026 proposed rule for the Medicare payment systems that cover inpatient and long-term care hospitals. 

Under the hospital inpatient quality reporting program, hospitals that fail to meet requirements or submit quality data face a 25% reduction in their annual payment update.
The agency has proposed modifying four current quality measures:
Total hip arthroplasty/Total knee arthroplasty complication rate and 30-day stroke mortality rate: CMS is proposing to include Medicare Advantage patients, shortening the performance period from three to two years, and revising the risk adjustment methodology for both measures (including a refinement for stroke severity in the latter).
Hybrid, hospitalwide readmission and mortality measures: CMS is proposing allowing up to two missing lab results and two missing vital signs per case, and reducing the submission thresholds for core clinical data elements and linking variables to 70% of discharges for both hybrid measures.

About the public’s health

Not Just Measles”: Whooping Cough Cases Are Soaring as Vaccine Rates Decline:
Reporting Highlights
Vaccine Hesitancy:
Texas’ measles outbreak has been blamed on vaccine hesitancy. But parents are not getting their children other vaccines as well.
Not Just Measles: Vaccine rates for other childhood diseases have fallen, contributing to rising cases of whooping cough and other illnesses.
Government Failure: The Trump administration’s cuts to public health jobs and funding make it harder for agencies to fight outbreaks and prevent disease with vaccines. 

About healthcare personnel

Physician pay growth stalls: Physicians are seeing slower pay growth in the last year amid economic uncertainty, according to Medscape’s “Physician Compensation Report 2025.”
The company surveyed 7,322 physicians across 29 specialties from Oct. 3, 2024 to Jan. 15, 2025, and found compensation increased around 3.6% on average for physicians, which was the lowest growth rate since 2011 when Medscape first began reporting compensation.
Pay gains were around 1.4% for primary care physicians, hitting $281,000 last year, and 1% for specialists, hitting $398,000. Pay growth was the lowest since 2021 at the height of the pandemic. The pay figures cover base salary, incentive bonus and other income including profit-sharing. 

The state of the physician workforce in 2025 A nice summary of trends.

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In other news:

RFK Jr.: If you eat doughnuts or smoke, should society pay for your health care?: Robert F. Kennedy Jr. asked whether society should pay for the health care of Americans who eat doughnuts or smoke when they know those habits can contribute to poor health outcomes.
“If you’re smoking three packs of cigarettes a day, should you expect society to pay when you get sick?” the nation’s top health official asked in an interview released Wednesday with CBS News chief medical correspondent, physician Jon LaPook. 
Comment: This remark raises the ever-present question: to what extent are we responsible for our own health behaviors and is there is a monetary cost to bad habits?
Society covers some cost of individual bad behaviors through taxation, such as tobacco taxes. But what about untaxed items and taxes that do not pay for the costs of care?

Health Spending Issues to Watch This Year Great overview from KFF.

About health insurance/insurers

Trump to end federal funding of certain non-medical services in Medicaid The Trump administration said Thursday that it will no longer help states fund non-medical services that often are aimed at improving housing and nutrition for people in the Medicaid program. The change is a departure from the Biden administration’s efforts to improve the health of Medicaid enrollees by paying for non-medical services.
The Centers for Medicare and Medicaid Services sent a letter to states notifying them that it no longer intends to let states use federal matching funds for two types of programs: designated state health programs (DSHP) and designated state investment programs (DSIP). It said it won’t take new applications for these programs, or renew existing efforts as they expire.  

About healthcare IT

Lack of Financial Resources, Determining a Cohesive Enterprise Strategy Cited as Top Implementation Concerns  
Key results from the survey include:
Payer Responses:
• For the API requirements, 43% have not yet started work and 31% are one quarter completed.
• The top three challenges reported are: 1) determining a cohesive enterprise strategy for interoperability; 2) digitizing prior authorization policies; and 3) sufficient funding.
• The majority (35%) estimate a cost of $1 million - $5 million for implementing the API components of the rule.  
Provider Responses:
• For the API requirements, 52% reported they had not yet started work.
• The top three implementation issues reported are: 1) sufficient funding; 2) determining a cohesive enterprise strategy for interoperability; and 3) sorting out the various networks and how they interplay (e.g., TEFCA, QHIN, HIE, etc.).
• A majority (44%) are unsure of the total cost for implementing the final rule requirements and training their employees.
• Most (79%) view having the majority of their payers supporting the prior authorization requirements as very important or extremely important.
Clearinghouse Responses:
• A strong majority (84%) intend to assist payers and providers with the API requirements of the rule.
• For the Prior Authorization API, 81% plan to implement both the FHIR and X12 solutions.
Vendor Responses:
• Eighty-one percent plan to assist payers and providers comply with the requirements of the rule.
• Thirty-six percent plan to support consumers with the Patient Access API, while 32% do not.  

Today's News and Commentary

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In other news:

RFK Jr. suggests some vaccines are risky or ineffective, downplays measles threat: In an interview with CBS News that aired Wednesday, the nation’s top health official said that “people should get the measles vaccine,” a more direct assertion than has been typical from Kennedy, who has a long history of questioning vaccine safety. 
At the same time, however, he appeared to minimize the threat of a growing outbreak centered in Texas and New Mexico and sent mixed signals about vaccines, saying many vaccines “aren’t safety tested.” He went on to argue they’re not tested against placebo groups or only over short periods of time. Public health officials across independent bodies have repeatedly approved vaccines based on their safety and efficacy evidence, including placebo-controlled trials and long-term studies.

Government shuts CDC office focused on alcohol-related harms and prevention: A small office that produced data on alcohol-related deaths and harms, and worked on policies to reduce them, has been shuttered by the Trump administration. Those involved with the work say it was the only group in the federal government focused on preventing excessive drinking and the many problems associated with it, including chronic diseases.
At least 11 states directly relied on the Alcohol Program in the Centers for Disease Control and Prevention for funding, data assistance and other guidanc 

About hospitals and healthcare systems

The 24 hospitals fined for price transparency violations, by state FYI

About pharma

41% of drug shortages span more than 2 years: More than one-third (41%) of active drug shortages began in 2022 or earlier, according to a new report from the American Society of Health-System Pharmacists. 
The report tracks national drug shortage trends from January 2001 through March 2025. So far this year, the ASHP has reported 26 new drug shortages. Since an all-time high of 323 active drug shortages in early 2024, the number of active shortages is now 270.   

About the public’s health

Routine medical appointments and cancer screenings head in the wrong direction: The Prevent Cancer Foundation’s 2025 Early Detection Survey…revealed just 51% of U.S. adults 21 years of age and older say they have had a routine medical appointment or routine cancer screening in the last year.1 This is a 10-percentage point drop from the 2024 survey.