Study Finds Multiply Comorbid Drive Inpatient Admissions
A new report by Vizient finds that 11% of the U.S. population has multiple chronic conditions but these patients account for 52% of inpatient admissions, 35% of emergency department visits, and 32% of office visits. Patients with at least one chronic condition make up nearly 8 in 10 inpatient admissions.
Among Medicare beneficiaries, more than half of those aged 65 to 74 have at least one chronic condition, and the same is true among nearly two-thirds of those 75 and older. This creates huge cost challenges in Medicare as America ages. Controlling chronic disease states is key.
#aging #medicare #hospitals #chronicconditions
Employers Seeking Alternatives For Drug Price Relief
With drug spending and health costs surging for employers, more and more are looking for alternatives to traditional pharmacy benefit manager (PBM) arrangements. Drug pricing platform GoodRx announced its entry into the crowded field with an employer direct product that discounts brand products. Some are turning to Mark Cuban’s Cost Plus Drug and similar direct to consumer and employer players. At the same time, the big three PBMs are also seeking to become more transparent.
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#drugpricing #pbms
https://www.modernhealthcare.com/insurance/mh-goodrx-employer-direct-pbm-drug-pricing
Businesses Face Huge Cost Surge
The Federal Reserve Bank of New York says businesses faced some of the sharpest cost increases in recent years in 2025, with health insurance surges prompting smaller pay increases. Health insurance costs rose about 13% across services firms, and by almost 14% for manufacturers. Some firms reported increases as high as 50% when seeking to renew coverage.
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#employercoverage
https://www.modernhealthcare.com/insurance/mh-health-costs-employers-pay-federal-reserve
CMS Wants More VBC Models
Centers for Medicare and Medicaid Services (CMS) Administrator Dr. Mehmet Oz and innovation center director Abe Sutton outlined how the administration aims to get more providers, especially poor-performing ones, into value-based models. The innovation center is exploring more mandatory payment models to further boost value-based care.
#cms #medicare #medicaid #innovation #vbc
https://www.healthcaredive.com/news/cms-mandatory-model-push-cmmi-oz-sutton/813776
Leftist Lawmakers Introduce Billionaire Tax To Restore Healthcare Cuts
Sen. Bernie Sanders, I-VT., and Rep. Ro Khanna, D-CA, introduced legislation that would reverse the Medicaid and Affordable Care Act (ACA) changes under the One Big Beautiful Bill Act (OBBBA) and expand Medicare to cover dental, vision and hearing services for seniors. The bill would also restore the expired enhanced subsidies in the Exchange. All this would be paid by the “Make Billionaires Pay Their Fair Share Act,” which would levy a 5% annual wealth tax on individuals with a net worth exceeding $1 billion. Sanders said this would raise approximately $4.4 trillion over a decade.
Additional handouts include $3,000 per-person direct payments to households earning $150,000 or less, more than $856 billion for affordable housing over 10 years, a $60,000 minimum salary for public school teachers, and a childcare program ensuring no family pays more than 7% of income on childcare.
#healthcare #coverage #obbba
— Marc S. Ryan
