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October 1, 2024

Hospital Consolidation Has Meant Little Competition In Many Markets A great Kaiser Family Foundation (KFF) analysis shows the impact of massive hospital consolidation over the past many years. Nearly half (47%) of metropolitan areas had only one or two hospitals or health systems providing inpatient hospital care in 2022. About one in five (19%) metropolitan areas have only one hospital or health system providing hospital care. More than a quarter (27%) are controlled by two hospitals or systems. Digging deeper, in 82% of metro areas, one or two hospitals or health systems were responsible for at least three quarters of all inpatient hospital discharges. This signifies these markets are highly concentrated under federal antitrust guidelines. We know that hospital consolidation has led to major price increases. As well, hospitals and healthcare systems have acquired physician practices, raising prices for physician care by changing practice patterns to more expensive hospital locations.

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September 30, 2024

Biden Administration Announced Q3 Drug Inflation Rebates The U.S. Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS) announced that many Medicare enrollees will pay less for 54 drugs available through Medicare Part B. The drugs will have a lower Part B coinsurance rate from October 1, 2024 – December 31, 2024 because drug makers increased prices higher than applicable inflation. Over 822,000 people with Medicare use these drugs annually to treat conditions such as cancer, osteoporosis, and pneumonia. The inflation cap and rebate were passed as part of the Inflation Reduction Act (IRA), the same bill that has Medicare drug price negotiations. Savings on some drugs could be in the thousands. Additional articles: https://www.hhs.gov/about/news/2024/09/30/hhs-announces-cost-savings-for-prescription-drugs-thanks-to-medicare-inflation-rebate-program.html and https://www.fiercehealthcare.com/payers/hhs-releases-cost-savings-54-prescriptions-including-cancer-drug #ira #drugpricing #branddrugmakers https://thehill.com/policy/healthcare/4904127-medicare-savings-rebates-inflation-reduction-act CVS Facing Possible Activist Investor; To Layoff 2,900 Glenview Capital Management, a key hedge fund investor for CVS Health, will meet with the

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September 27, 2024

CMS Says Medicare Advantage and Part D Stable For 2025 Contrary to everything we hear on the street, the Centers for Medicare and Medicaid Services (CMS) is reporting that all is well in Medicare Advantage (MA) and the standalone Part D (PDP) program. It reports that the average monthly plan premium for all MA plans, which includes MA plans that provide prescription drug coverage and MA Special Needs Plans (SNPs), is projected to decrease from $18.23 in 2024 to $17.00 in 2025. It also says benefit options will remain stable. CMS says the average standalone Part D plan total premium is projected to decrease from $41.63 in 2024 to $40.00 in 2025 (a decrease of $1.63). This is largely due to the special demonstration program put in place by CMS when it saw standalone Part D premiums slated to skyrocket. It says approximately 99% of people with Medicare enrolled in a

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