February 4, 2025

Party-Line Vote Advances Kennedy To Senate Floor

Robert F. Kennedy, Jr. turned the vote of Sen. Bill Cassidy and gained a 14-13 Senate Finance confirmation vote, which means he has survived and will likely gain Senate confirmation. Cassidy gained concessions from the Trump administration in return for supporting Kennedy’s nomination.

Whether you agree with Cassidy’s decision or not, the articles show that Cassidy spent a great deal of time gaining procedural and other commitments in return for supporting Kennedy. The concessions empower the Senate healthcare policy committees in a major way. He deserves a great deal of credit here for taking his role to advice and consent seriously. Vice President JD Vance also played a major role in working with Kennedy and Cassidy.

Additional articles: https://www.modernhealthcare.com/politics-policy/rfk-jr-nomination-advanced-senate-finance-committee and https://www.medpagetoday.com/publichealthpolicy/washington-watch/114079 and https://thehill.com/homenews/senate/5125761-cassidy-says-he-secured-key-vaccine-commitments-from-rfk-jr/ and https://www.healthcaredive.com/news/rfk-jr-clears-key-hurdle-on-path-to-hhs-secretary/739096/ and https://insidehealthpolicy.com/health-insider/rfk-jr-confirmation-sent-floor-cassidy-onboard-budget-resolution-stalled

(Some articles may require a subscription.)

#trump #rfkjr #hhs #congress #healthcare

https://www.fiercehealthcare.com/regulatory/top-republican-airs-concerns-about-rfks-bully-pulpit-and-vaccine-hesitancy

Trump Sets A Deregulation Target

President Donald Trump issued an executive order on Friday that solidifies his commitment to deregulate American industry. The order says that agencies will need to void ten rules, regulations, or guidance documents for every piece of regulation they want to promulgate. In Trump 45, the goals were two rescissions for every new regulation.

#regulations #trump #healthcare

https://www.fiercehealthcare.com/regulatory/trump-sets-10-1-target-deregulation-healthcare

Centene Beats The Street With Positive News Overall

Breaking with other big insurers that reported bad financial news for Q4 and 2024, Centene beat The Street with some better financial news than many. The Medicaid-dominant insurer with a strong Medicare Advantage (MA) and standalone Part D (PDP) business, reported $283 million in profit for the fourth quarter of 2024, a notable bump from the fourth quarter of 2023’s haul of $45 million. Both Q4 and 2024 revenue and margins were up year over year.

In other news, Oscar Health reported its first-ever annual profit in its fourth-quarter and year-end earnings. The company reported $25.4 million in profit in 2024, improving from a loss of $270.7 million in 2023. 

Additional articles: https://www.modernhealthcare.com/insurance/centene-earnings-call-medical-costs-aca and https://www.healthcaredive.com/news/centene-aca-medicare-medicaid-q4-2024/739126/ and https://www.beckerspayer.com/executive-moves/oscar-health-names-insurance-segment-president-posts-first-annual-profit.html

(Some articles may require a subscription.)

#centene #oscar #healthplans #margins

https://www.fiercehealthcare.com/payers/centene-beats-street-283m-profit-q4

Providers’ 2025 Healthcare Priorities

Groups representing hospitals, physicians and long-term care providers are setting their 2025 priorities. Among them include Medicare reimbursements, Medicaid funding, health insurance prior authorization requirements, and workforce issues. Hospitals are opposing what I view are necessary site-neutral policies. Physicians want a Medicare doc fix, which they deserve.

(Article may require a subscription.)

#providers #healthcare #siteneutral #medicare #medicaid #priorauthorization

https://www.modernhealthcare.com/politics-policy/prior-authorization-pay-staffing-policy-2025

Role Of Big Healthcare In Medicaid Managed Care

The Kaiser Family Foundation (KFF) issued a brief that looks at the big players in Medicaid managed care. As of September 2024, combined Medicaid enrollment across the five biggest national firms was 6.2 million (or 20%) higher than enrollment at the start of the pandemic. However, Medicaid enrollment across the firms declined by more than 7 million since March 2023 due to the reintroduction of Medicaid redeterminations.

Big firm Medicaid membership as a share of total Medicaid membership has declined for all five firms. But the firms still control just short of half of the 72 million enrollees in Medicaid managed care.  This is still below the rough 75% that big firms control in Medicare Advantage (MA).

#kff #medicaid #managedcare #medicareadvantage

https://www.kff.org/medicaid/issue-brief/a-look-at-medicaid-enrollment-and-finances-of-the-five-largest-medicaid-managed-care-plans/

— Marc S. Ryan

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