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HEALTHCARE & GOVERNMENT
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President Trump Signs Executive Orders That Impact Healthcare |
President Trump has issued several executive orders (EOs) that significantly impact healthcare policies both domestically and internationally. Key actions include:
- Rescission of Biden-Era Healthcare Directives
- Freeze on Foreign Aid Affecting Global Health Programs
- Restrictions on Gender-Affirming Care for Minors
- Ban on Diversity, Equity, and Inclusion (DEI) Programs
- Eliminating "Harmful" AI Policies
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RFK Jr. Squeaked through the Senate Finance Committee Vote, 14:13, On Track to Become Health Secretary |
The nomination of Robert F. Kennedy Jr. to lead the Health and Human Services Department advanced Tuesday after a key swing Republican, Sen. Bill Cassidy (R., La.), a medical doctor, voted with all of the committee's Republicans to support Kennedy's confirmation in the Senate Finance Committee, likely clearing his path to confirmation.. Cassidy said he held a series of phone calls with Kennedy over the weekend and Tuesday morning before the committee's vote. During the calls, the senator said, Kennedy promised an unusually close working relationship with him, in addition to keeping federal vaccine recommendations and CDC webpages on vaccines and autism, committed to not set up alternate safety monitoring or approval systems for vaccines. Kennedy pledged that HHS would provide 30-day notice before any changes to vaccine-safety monitoring systems and would generally speak to Cassidy several times a month, the senator said. The nominee also offered Cassidy input on hiring decisions at HHS and promised Cassidy that the Senate health committee could choose a representative "on any board or commission formed to review vaccine safety," Cassidy said. (wsj.com)
Throughout the hearings, Kennedy pledged to "Make America Healthy Again" by focusing on addressing the rise of chronic diseases in the U.S. and limiting ultra-processed foods - (healthcaredive.com) (wsj.com)
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Bipartisan Lawmakers Introduce Bill Boosting Physician Pay by 6.6% from April through December |
A bipartisan group of representatives have introduced a bill that would offset and exceed a pay cut for doctors that went into effect at the top of this year. 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. (https://www.fiercehealthcare.com/providers/bipartisan-lawmakers-introduce-bill-boosting-physician-pay-66-april-through-december)
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White House Rescinds Memorandum Freezing Federal Assistance and Grants |
After a Trump administration memo calling for federal agencies to pause potentially trillions of dollars in federal grants, loans and other financial-assistance programs prompted chaos in Washington, it was temporarily blocked by a federal judge. The following day, the White House issued a second memo to federal employees rescinding the original. President Trump's press secretary Karoline Leavitt explained: "This action should effectively end the court case and allow the government to focus on enforcing the president's orders on controlling federal spending. In the coming weeks and months, more executive action will continue to end the egregious waste of federal funding." (wsj.com 1/29)
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Trump Administration Offers Buyouts to Federal Workers Who Don't Want to Return to Work |
The administration has ordered federal workers, many of whom had flexible work arrangements following the pandemic, back to the office to work in person. Federal workers who don't want to return to the office are being offered buyouts. The Workers who accept the buyout will need to resign by February 6 and would receive severance paid through September 30. (https://www.cnn.com/2025/01/28/politics/federal-worker-buyouts-trump-administration/index.html ) The administration anticipated that between 5% and 10% of federal employees might accept the buyout, potentially saving taxpayers around $100 billion annually. However, those choosing to remain were informed they would be subject to heightened performance standards and the possibility of downsizing. (https://nypost.com/2025/01/28/us-news/white-house-to-offer-buyouts-to-federal-workers-who-wont-return-to-office/)
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HEALTHCARE INDUSTRY TRENDS
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2025 JP Morgan Healthcare Conference Highlights Key Trends |
Following are some top takeaways from the recent 2025 JP Morgan Healthcare Conference:
- Artificial Intelligence (AI) Integration: AI continues to be a focal point, offering potential benefits such as more efficient drug design, improved patient enrollment in clinical trials, enhanced diagnostic tools, and streamlined clinical processes. (jdsupra.com)
- Data Ownership and AI in Drug Discovery: The role of AI in drug discovery was a significant topic, with discussions on how AI can revolutionize drug development. The importance of data ownership and quality was emphasized as critical factors in leveraging AI effectively. (ballardspahr.com)
- Health Technology Innovations: Health technology featured prominently, with companies showcasing tools designed to enhance provider efficiency, advance research, and expand telehealth capabilities. AI-driven tools aimed at improving patient care and experiences were particularly highlighted. (ballardspahr.com)
- Advancements in Radiotherapy: Radiotherapy, including radiopharmaceuticals like Lutathera and Pluvicto, has gained significant attention due to positive study results and new FDA approvals. The market is projected to grow from $7.21 billion in 2024 to $9.62 billion by 2030, driven by technological advancements and a growing cancer patient population. (medcitynews.com)
OTHER AREAS OF FOCUS INCLUDED women's health, obesity treatments, emergence of Decentralized Science (DeSci), China's biotech surge, and policy uncertainty with the new administration.
CEO's QUOTABLE QUOTE from JPM: Wright Lassiter, CEO of CommonSpirit Health, shared this insight into his organizations' strategy: "We will always be in the hospital business, but we also know that if we're only in the hospital business, we won't be financially sustainable." (fiercehealthcare.com)
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Cedars-Sinai Names 1st Chief AI Officer |
Los Angeles-based Cedars-Sinai appointed its inaugural chief data and artificial intelligence officer in December to boost its systemwide AI strategy. Mouneer Odeh, the former vice president of analytics at Fairfax, Va.-based Inova Health System, told Becker's he accepted the position to use technology to strengthen healthcare overall. In a recent Q&A, he said: The advancements in AI and analytics are unprecedented. The cost of computing has decreased, data availability is at an all-time high, and AI has transformed how we interact with that data. While progress in the short term may seem slow, the long-term impact will likely exceed what we can imagine today. (https://www.beckershospitalreview.com/ai/why-cedars-sinai-named-its-1st-chief-ai-officer.html)
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PAYER TRENDS
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Medicare Advantage Insurers Made Nearly 50 Million Prior Authorization Determinations in 2023 |
These prior authorization determinations reflect steady year-over-year increases since 2021 (37 million) and 2022 (42 million) as the number of people enrolled in MA has grown. The determinations represent requests for approval that providers are required to submit before providing a service. Substantially fewer prior authorization reviews for traditional Medicare beneficiaries were submitted to CMS - just under 400,000 in fiscal year 2023 - though the number of people enrolled in MA and traditional Medicare were similar in those years.
- In 2023, there were nearly 2 prior authorization determinations on average per MA enrollee, similar to the amount in 2019. In contrast, in 2023, about 1 prior authorization review was submitted per 100 traditional Medicare beneficiaries - a rate of about 0.01 per person - which reflects the limited set of services subject to prior authorization in traditional Medicare.
- 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%). Though there were substantially fewer prior authorization reviews for traditional Medicare beneficiaries, a larger share was denied - 28.8% in 2023.
- Read More: https://www.kff.org/medicare/issue-brief/nearly-50-million-prior-authorization-requests-were-sent-to-medicare-advantage-insurers-in-2023/
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Cigna to Tie Executive Compensation to Customer Satisfaction |
Cigna has released a plan it says will make healthcare more affordable and accessible for its members - including tying executive compensation to customer satisfaction - as health insurers continue to reckon with discontent with their industry since the killing of UnitedHealthcare's Brian Thompson in December. Cigna plans to start linking bonus awards for high-level officers to the company's net promoter score, a measure of customer loyalty and satisfaction, the Connecticut-based insurer said. Cigna will also invest in more care advocates, pare back hurdles to receiving care and make it easier for doctors to update patients on the status of prior authorization requests. Cigna also plans to release an annual "customer transparency" report starting next year with information on its business practices, including data on prior authorization requests, appeals and denials. (https://www.healthcaredive.com/news/cigna-tie-executive-compensation-customer-satisfaction/739028/)
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UnitedHealth Estimates 190M People Impacted by Change Healthcare Cyberattack |
Change Healthcare now estimates that 190 million people were affected in the massive cyberattack that took down its services nearly a year ago. In a previous estimate, filed with the OCR in October, Change projected that 100 million people were affected by the breach. The cyberattack posed a significant financial cost to UnitedHealth, with the company projecting that it would take a $2.9 billion hit. Individuals who were impacted by the breach can access free credit monitoring provided by UnitedHealthcare here. (https://www.fiercehealthcare.com/payers/unitedhealth-estimates-190m-people-impacted-change-healthcare-cyberattack)
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PHARMA NEWS
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FDA Approves Novo Nordisk's Ozempic to Treat Chronic Kidney Disease in Those with Diabetes |
The FDA recently approved Novo Nordisk's Ozempic to treat chronic kidney disease in patients who also have Type 2 diabetes, expanding the use of the wildly popular injection in the U.S. The drug is already widely used and covered to treat Type 2 diabetes. The FDA's decision means Ozempic can now be used to reduce the risk of kidney disease worsening, kidney failure, and death from cardiovascular disease in patients with both chronic kidney disease and diabetes. (https://www.cnbc.com/2025/01/28/novo-nordisks-ozempic-wins-fda-approval-for-chronic-kidney-disease.html)
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The Other Side of Obesity Drugs: Huge Study Identifies New Health Risks |
Blockbuster obesity drugs such as Ozempic have been celebrated for their ability to promote weight loss and treat a surprising range of other conditions, from heart problems to Parkinson's disease. Now, an analysis of data from nearly 2 million people is revealing insights into the effects of these medications - including the risks they pose. The findings, published in Nature Medicine, confirm that these drugs, called glucagon-like peptide 1 (GLP-1) receptor agonists, offer more than just weight-loss benefits. But the work highlights newly recognized risks of the medicines, including an increased likelihood of developing arthritis and a potentially deadly condition called pancreatitis. (https://www.nature.com/articles/d41586-025-00173-5)
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