Read today’s Kaiser Health News
In other news:
America’s sickness economy An excellent review with useful charts.
Survey Highlights Progress, Persistent Barriers on Value-Based Care Journey: NAACOS, the National Association of ACOs, and Innovaccer, a company that has developed an interoperability platform for value-based care (VBC), have released a survey of healthcare professionals about their progress on value-based care transformation.
Here are some bullet-point highlights:
• 30% of organizations reported that 25% or more of their revenue is tied to VBC contracts.
• More than 60% of organizations have increased their participation in VBC programs.
• Nearly 20% of organizations report that over half of their revenue comes from fully capitated or downside risk contracts.
• Barriers to adoption cited by respondents include financial risk, provider resistance, lack of data interoperability and the cost of technology to facilitate VBC.
• Those surveyed cited greater financial support, improved data sharing capabilities with payers and clearer regulatory guidelines as factors that would greatly support VBC adoption.
Trump’s DOJ Accuses Medicare Advantage Insurers of Paying ‘Kickbacks’ for Primo Customers I wrote about this suit before but this article is a nice summary of the issue.
As Congress Debates Cutting Medicaid, a Major Study Shows It Saves Lives: Poor adults who gained Medicaid coverage after the Affordable Care Act expanded access were 21 percent less likely to die during a given year than those not enrolled, the research shows. By analyzing federal records on 37 million Americans, two economists found that deaths fell not only among older enrollees but also among those in their 20s and 30s — a group often assumed to have few medical needs, and who would have been far less likely to qualify for Medicaid before the expansion.
The findings were published this month in a National Bureau of Economic Research working paper…
About health insurance/insurers
Study suggests upcoding practices are fairly common across outpatient care: The report, compiled by researchers at Trilliant Health, found that the share of visits that were coded at higher intensities grew in emergency care, urgent care and physician office visits between 2018 and 2023. For example, the number of emergency department visits coded as 99284, or level four of five total, grew from 32.5% to 39.6% in the study window.
About pharma
GLP-1s may cut risk of obesity-related cancers: 3 study notes: A new study has found GLP-1s may reduce the risk of developing obesity-related cancers by 41% compared to bariatric surgery — a benefit researchers believe could be tied to the drugs’ ability to reduce inflammation.
White House, Cost Plus Drugs’ new drug manufacturing alliance: 5 notes: The White House has launched a new program focused on leveraging technology and private sector partnerships to find new ways to quickly produce key pharmaceutical ingredients and finished drugs at the point-of-care.
The initiative, called Equip-A-Pharma, involves collaborations with Mark Cuban’s Cost Plus Drugs and three other healthcare partners.
Regeneron to buy 23andMe out of bankruptcy for $256 million: Regeneron Pharmaceuticals said Monday it had entered into an agreement to buy the consumer genetics firm 23andMe out of bankruptcy for $256 million. The deal is subject to bankruptcy court and regulatory approvals.
The Tarrytown, N.Y.-based biotech said it would continue 23andMe’s consumer business and use the data the company has collected for drug development.
CVS, Walgreens bid for Rite Aid pharmacy assets: CVS Health Corp. is trying to buy stores and patient data from Rite Aid Corp., the beleaguered pharmacy chain that is going out of business after filing for bankruptcy a second time earlier this month….
Rite Aid has also received multiple bids on some of its pharmacy assets, such as patient data and inventory, from Walgreens Boots Alliance Inc., Albertsons Cos., Kroger Co., Giant Eagle Inc. and others, Rite Aid Chief Executive Officer Matthew Schroeder told employees…
HHS must preapprove pharma's proposed 340B rebate models, judge rules: Several big pharmas attempting to introduce a rebate model under the 340B programme, rather than offering an upfront discount on medicines, were hit with a setback Friday after a US district judge rejected lawsuits from several drugmakers.
Bristol Myers Squibb, Eli Lilly and Johnson & Johnson had each filed suit last year after the US Health Resources and Services Administration (HRSA) rejected proposals from the drugmakers that would change how they deliver reduced-cost drugs to hospitals and clinics that serve uninsured and low-income patients…Judge Dabney Friedrich ruled on Friday that HHS has the authority to approve or reject the proposed rebate models, blocking the pharmas from moving forward with their 340B plans until they receive an explicit OK from Secretary Robert F. Kennedy.
Per a notice filed earlier this month in the US District Court for the District of Columbia, HHS said it will be "in a position to provide guidance" about the proposed rebate models by the end of May.
About healthcare IT
Top 20 global cities for EHR interoperability FYI.
Also, according to the report conducted in March and April 2025:
• 88% of healthcare organizations outside the U.S. now prioritize regional software providers due to improved localization and faster compliance with local regulations.
• User satisfaction rates for regional EHR solutions reached an average of 91%, compared to a
declining rate of 68% for U.S.-based systems.
• 79% of international healthcare leaders report political and digital sovereignty considerations
influencing vendor selections, reflecting heightened awareness and sensitivity towards national data control and security.
• Over 84% of surveyed respondents identified regional vendors as providing superior customization and adaptability to specific local clinical workflows.
• Implementation timelines for regional vendors are on average 40% shorter than those of major U.S.-based EHR providers, enhancing their attractiveness in dynamic healthcare environments.
• Cost transparency and predictable pricing structures from regional vendors achieved an approval rate of 82%, contrasting sharply with 47% satisfaction for major U.S.-based competitors.