Read today’s Kaiser Health News
In other news:
About health insurance/insurers
The best-rated health plans of 2025: NCQA FYI
About hospitals and healthcare systems
Hospital group pushes Aetna to repeal inpatient reimbursement policy: Aetna’s new “level of severity inpatient payment” policy will take effect in less than two months, and the American Hospital Association said it is “deeply concerned.”
Aetna’s policy, set to go into effect Nov. 15, will approve inpatient stays without a medical necessity review but pay the claim at a lower severity rate. If the inpatient stay meets Aetna’s supplemental guidelines, the insurer will pay the claim according to the hospital’s agreement. This plan will apply to facilities participating in Aetna Medicare Advantage or Special Needs Plans for emergent or urgent inpatient stays greater than one midnight. The change’s goal is to expedite reimbursement, according to an Aetna update.
Hospital profitability: 24 statistics for 2025 so far: While overall operating margins are up 4% year to date compared to 2024, the picture is far from uniform. Large hospitals — particularly those with 300 to 499 beds — are driving much of the momentum, posting margin growth of more than 30%, while small facilities under 25 beds slipped into negative territory.
Geographically, the South and Midwest are emerging as bright spots, reporting double-digit operating margin gains of 21% and 15% respectively. In contrast, hospitals in the Northeast/Mid-Atlantic and Great Plains are struggling, with margins declining 6% and 7%. EBITDA performance reflects similar disparities, with growth concentrated in larger hospitals and declines among smaller facilities.
About pharma
Novartis inks a second degrader-focused deal with Monte Rosa: Novartis has returned to Monte Rosa Therapeutics to further bulk out its pipeline, this time as part of a deal potentially worth just shy of $6 billion focused on novel degraders to treat immune-mediated diseases.
Acetaminophen Use During Pregnancy and Children’s Risk of Autism, ADHD, and Intellectual Disability: Acetaminophen use during pregnancy was not associated with children’s risk of autism, ADHD, or intellectual disability in sibling control analysis. This suggests that associations observed in other models may have been attributable to familial confounding.
About the public’s health
Influenza-Associated Hospitalizations During a High Severity Season — Influenza Hospitalization Surveillance Network, United States, 2024–25 Influenza Season: Among a surveillance sample of the U.S. population, 2024–25 was a high severity influenza season. The cumulative influenza-associated hospitalization rate was the highest since 2010–11. During the 2024–25 season, the percentages of patients admitted to an intensive care unit (16.8%) and who received invasive mechanical ventilation (6.1%) were similar to past seasons’ estimates. Approximately one third of hospitalized patients were vaccinated. Children aged 5–17 years were the lowest percentage of hospitalized patients receiving antiviral treatment (61.6%).
What are the implications for public health practice? All persons aged ≥6 months should receive an annual seasonal influenza vaccine. All hospitalized patients with suspected or confirmed influenza should receive timely antiviral treatment to reduce the risk for influenza-associated complications.
About healthcare IT
Longitudinal study of the manifestations and mechanisms of technology-related prescribing errors [TRE]in pediatrics: TREs accounted for 32.5% (n = 428) of prescribing errors; an adjusted rate of 1.49 TREs/100 orders (95% confidence interval [CI]: 1.06, 1.92). At 1-year post-CPOE, the rate of TREs was 40% lower than immediately post (incident rate ratio [IRR]: 0.60; 95% CI: 0.41, 0.89). However, at 4-years post, the TRE rate was not significantly different to baseline (IRR: 0.80; 95% CI: 0.59, 1.08).
Amazon expands healthcare offerings: Amazon has added Fay, a dietitian platform, as the first nutrition care service available through its Health Benefits Connector.
The collaboration allows eligible Amazon customers to discover and enroll in Fay’s insurance-covered nutrition services while browsing for wellness and health benefits, according to a Sept. 16 news release.
About healthcare personnel
Workforce Education Trends Report Interesting report and great graphics. For example: OVER HALF of healthcare employees (55%) admit that they’ll look for job openings, interview for, or switch to a new role in the next year, either inside (38%) or outside their organization (40%).