With the election 22 days away and inflation the key issue for voters, the latest Consumer Price Index report from the Bureau of Labor Statistics is especially important. Released last Tuesday, it shows:
- The all-items CPI for urban consumers increased 0.2% in September and 2.4% in the last 12 months–down from its troubling spike at 9.1% in June, 2022.
- Food, energy and housing prices, which account for 57% of the entire CPI, have moderated including a gradual monthly decline in energy prices.
- But prices for healthcare–medical products, professional services and health insurance—have increased more than other categories. In fact, since 1982 when the BLS began recording monthly CPI price changes, prices for all items increased 215% vs. medical product prices (i.e. prescription drugs, OTC, et. al.) up 316%%, medical services prices (i.e. physicians, dentists et al) up 515% and hospital prices up 992%.
| Category | Relative Importance | Unadjusted % Change: 9/23-9/24 | Unadjusted % Change: 8/24-9/24 | % Change from 1982 Baseline
|
| All items | 100.00% | +2.4% | +0.2% | +215% |
| Food prices | 13.43 | +2.3 | +0.3 | +232 |
| Energy prices | 6.80 | -6.8 | -2.4 | +172 |
| Housing prices | 36.52 | +4.9 | +0.2 | +304 |
| Medical care commodities | 1.47 | +1.6 | -0.7 | +316 |
| Medical care services | 6.48 | +3.6 | +1.6 | +515 |
| Hospital/Related services | 2.31 | +4.8 | +0.3 | +992 |
Sources: University of Michigan: Consumer Sentiment (UMCSENT) | FRED | St. Louis Fed (stlouisfed.org); Consumer Price Index for All Urban Consumers (CPI-U): U. S. city average, by detailed expenditure category – 2024 M09 Results (bls.gov)
The next CPI report for October 2024 is scheduled for release November 13, so last Tuesday’s report for September 2024 is the last before election day. The Presidential campaigns will shape their economic messaging around the CPI, inflation (down from 3.4% to 2.4% in the LTM) and unemployment rate (up from 3.8% to 4.1% in the LTM) with contrasting interpretations. Both will focus on food, energy and housing prices but the differences in healthcare prices will get scant mention. Here’s why:
- Voter anxiety about prices for routine household purchases is at a peak (Conference Board Sentiment Index): Per Pew Research polling, 7 of 10 voters think prices for their household staples are out of control and they want the federal government to do something. Though prices for these appear to be moderating and inflation has slowed, consumer anxiety has not followed suit. So, stoking anxiety about household prices is a winning strategy for campaigns, especially in a political environment in which the economy is issue one and misinformation/disinformation is widely used.
- Healthcare prices are confusing and risky for political campaigns. The enormous disparity between prices for healthcare products and services and all other items in the economy is mind-boggling. Most elected officials don’t understand its root causes of healthcare prices nor the multi-layered structures involving middlemen, brokers, insurers, rebates and much more. Most healthcare insiders leverage its lack of price transparency and its complicated structure for maximum pricing latitude. Though healthcare represents a bigger share of the CPI than energy, its pricing is eminently more complicated.
- Awareness of healthcare prices goods and services has not had a major impact on consumer behavior: Prices for healthcare services and products have been available for many years, but with rare exception, they’ve not influenced a significant portion of consumer spending. Technologies to enable price awareness and incentives to reward its use are promising.
Healthcare prices account for 10.2% of the CPI but attention to these is decidedly less than food, energy, housing and other categories. For consumers, that neglect is harmful’ for industry insiders, it’s a pressure point that’s been avoided. Price estimators, posted chargemasters, open-panel benefits design, website queries and other tactics work OK for now. So…
Do Healthcare Prices Matter? Not much today. But they’re mission critical in healthcare tomorrow.
Paul
Last week, I participated in Alvarez and Marsel’s Annual Client Summit in Kiawah SC. This week, I’ll be at The Governance Institute’s con-fab for Not-for-Profit health system board members in Dallas. Two organizations with similar pursuits—to help healthcare organizations make better decisions about the future by using resources wisely and executing effectively. It’s clear healthcare organizations are under unprecedented pressure to perform. It’s also clear the future of the U.S. health system is uncertain but no less essential. That means its leaders and boards must slay sacred cows and false assumptions and take a fresh look at everything!
Resources
- Prices up across US metros, but in some more than others | Pew Research Center
- University of Michigan: Consumer Sentiment (UMCSENT) | FRED | St. Louis Fed (stlouisfed.org)
- Pew Research Center https://www.pewresearch.org/politics/2024/09/09/economic-ratings-and-concerns/#top-economic-concerns-food-and-consumer-prices-housing-costs
- US Consumer Confidence the Conference Board https://www.conference-board.org/topics/consumer-confidence
Quotables
Re: healthcare price transparency: “Since the beginning of the 21st century, high prices have been recognized as a key driver of the differences in health care spending between the U.S. and other countries, yet quality has remained largely unclear and inconsistent. To date, this is only worsening, not improving. Second, policymakers and society as a whole have continued to shift towards a health care delivery system that is more consumer-directed, incentivizing patients to take more control of their health and care decisions. This includes financial decisions related to how they spend their health care dollars. Some health insurance coverage options have shifted to include health savings accounts (HSAs), and there are many more high deductible plans available in which patients now bear a greater portion of financial risk. This increased financial risk for consumers is intended make health care consumers more cautious about their health care decisions and to use that caution to help control health care spending by incentivizing them to choose lower cost care.”
Re: hospital consolidation, site neutral payments: “Rampant consolidation in health care has resulted in higher prices for patients. This consolidation — whether by private equity firms or other large health systems — has not resulted in higher quality care, and in some cases, it has made care quality worse… Under current law, Medicare pays two to three times more for routine treatments administered in a hospital-owned outpatient clinic than it does for those in an independent doctor’s office. In many situations, paying hospitals more makes sense. Hospital systems must be built to move fast and contend with constant crises, which require a higher level of resources to do the job well. But profit-maximizing hospitals, advised by astute financial engineers, have sought to capitalize on this difference even for routine services where this does not apply.
Today, large hospital systems are increasingly buying up small physician practices, changing the sign on the door, and often tripling the amount that they can bill patients for the exact same procedures, including routine, run-of-the-mill services that are easily and safely performed outside of a hospital setting. Not only are hospitals buying private practices to take advantage of this billing loophole, but they are also seeking to “consolidate” with smaller hospitals, which limits patients’ options and squeezes them into paying higher prices. Hospital chains often promote consolidation to employers, patients, and taxpayers to increase coordination, improve quality of care, and lower costs. But these claims are dubious. A substantial body of evidence shows that prices go up without corresponding increases in the quality of care.
This is a problem throughout the United States. About 90% of metropolitan hospital markets in the United States are highly concentrated, and more than 52% of physicians work under one of these consolidated hospital systems….
When a physician’s office is acquired by a hospital system, prices for the same services increase by 14% on average….
Thankfully, even in today’s highly polarized Washington, there is bipartisan support to address costs by advancing what’s called site-neutral payment reform—which would ensure patients pay the same price for routine services regardless of whether they’re provided in a hospital-owned physician’s office. One such bill — the Lower Costs, More Transparency Act — passed the House of Representatives in late 2023 with overwhelming bipartisan support. And there is room for Congress to go even further and enact comprehensive site-neutral payment reforms that could save Medicare more than $150 billion over the next decade….”
John & Laura Arnold ‘Hospital consolidation’ means higher prices | STAT (statnews.com) October 5, 2024
Re: Medical debt: While hot-button health care issues such as abortion and the Affordable Care Act roil the presidential race, Democrats and Republicans in statehouses around the country have been quietly working together to tackle the nation’s medical debt crisis.
About 100 million people in the U.S. are burdened by some form of health care debt, forcing millions to drain savings, take out second mortgages, or cut back on food and other essentials. A quarter of those with debt owed more than $5,000 in 2022.
Bottom of Form
Medical debt remains a more polarizing issue in Washington, where the Biden administration has pushed several efforts to tackle the issue, including a proposed rule by the Consumer Financial Protection Bureau, or CFPB, to bar all medical debt from consumer credit reports.
Similarly, nationwide polls have found more than 80% of Republicans and Democrats back limits on medical debt collections and stronger requirements that hospitals provide financial aid to patients.”
Even Political Rivals Agree That Medical Debt Is an Urgent Issue – KFF Health News
Re: future of the Affordable Care Act: “To address rising healthcare costs, President Biden temporarily expanded Affordable Care Act subsidies, but they are set to expire in 2025. If Republicans regain control in the coming November elections, they could let them expire, potentially increasing healthcare costs for millions of Americans and leading many to drop their insurance…
Republicans argue that these subsidies distort the insurance market by artificially lowering prices, leading to higher costs to the taxpayer. Their permanent extension would increase the budget deficit by $335 billion over the next decade, according to a Congressional Budget Office projection.
Policy wonks on both sides of the political spectrum agree that Obamacare is far from perfect. Perhaps one reason it has endured is that it reflects a compromise between Democrats’ desire to expand access to healthcare and Republicans’ preference to maintain a role for the private market in determining coverage.
Although it has changed shape more frequently than Play-Doh in a kindergarten, it doesn’t look like Obamacare will disappear. The outcome of the elections will determine its next form.”
Obamacare Will Survive This Election—The Fight Will Be About Paying for It – WSJ
Re: digital health investing: “If we’ve learned anything from digital health’s recent history, it’s to avoid conflating volume of activity (e.g., venture or M&A deal counts) with quality of activity (e.g., strategic M&A). With $2.4B raised across 110 deals in Q3 2024, the U.S. digital health market continued operating in a smaller, more focused manner. While deal count slowed compared to Q1 and Q2, average deal size remained steady, with investors making sharper bets on a smaller cohort of companies. M&A activity also dipped, though Q3 saw some digital health players use M&A to integrate new features and capabilities into their offerings—types of arrangements we’ve dubbed tapestries. Dario Health, Commure, and Fabric Health are just a few of the tapestry-weavers at the loom, quilting together multiple products and capabilities to appeal to buyers. We’re watching these threads and how they might change digital health’s competitive landscape—i.e., who can compete for large contracts at scale.”
Economy
Report: Deficit projections of Trump, Harris plans: Per analysis by the Committee for a Responsible Federal Budget. “Under our central estimate, Vice President Harris’s plan would increase the debt by $3.50 trillion through 2035, while President Trump’s plan would increase the debt by $7.50 trillion.
These estimates come with a wide range of uncertainty, reflecting both different interpretations and estimates of the policies. Under our low- and high-cost estimates, we estimate Vice President Harris’s plan could have no significant fiscal impact or increase debt by $8.10 trillion through 2035, while President Trump’s plan could increase debt by between $1.45 and $15.15 trillion. Our analysis will be updated if additional policies are introduced.”
Employers
KFF’s annual Employer Health Benefits Survey. KFF based its analysis on input from 2,000 firms. Highlights:
- The average annual premiums for employer-sponsored insurance for families increased by 7% in 2024
- The average annual premium for employer-sponsored insurance in 2024 was $8,951 for individuals and $25,572 for families.
- Premium costs rose faster than wages in 2024. Workers’ wages increased by 4.5% from 2023 to 2024, and inflation was 3.2%. Individual coverage was 6% more expensive in 2024 than in 2023, and family coverage was 7% more expensive.
- In the past five years, the average premium for family coverage has increased by 24%, while wages have increased by 28%.
- Though overall premium costs increased, the percentage of premiums employees paid decreased. In 2024, individuals paid 16% of their premiums in 2024.
- In 2024, individuals paid $1,368 for premiums, and families paid $6,296 on average, similar amounts to 2023.
- In 2024, 48% of workers were in PPO plans, and 27% of workers were in high-deductible plans. Another 13% had HMO plans, and 11% had POS plans.
- In 2024, 63% of workers were enrolled in plans self-funded by employers.
- Around 1 in 3 workers are enrolled in a plan with an annual deductible of $2,000 or more in 2024, a similar percentage to 2023.
- Among firms with 200 or more employees, 18% said they cover GLP-1 drugs for weight loss. Among firms with 1,000 or more employees, 25% cover the drugs for weight loss.
- Around 25% of firms with more than 200 employees cover IVF in 2024.
2024 Employer Health Benefits Survey | KFF
PE Pitchbook: Direct Primary Care Market: “We estimate the current market for DPC for employees and dependents covered by self-insured plans at around $11 billion in the US, split roughly 50/50 between those covered by employers with 250-999 employees (midsized) and those covered by employers with 1,000-plus employees (large). Adding in employees in employer-sponsored plans, state and local government employees, and Taft-Hartley plan members, the market size grows to around $24 billion. The addressable market will increase further if DPC providers increase upsell with specialty services, move into third-party administrator (TPA) services, and increase clinic footprint and/or digital engagement, all of which would increase revenue per eligible member. Another relevant trend is toward employers joining consortiums or associations to contract collectively for healthcare and other benefits, which should create more scaled and sophisticated potential buyers of DPC services and could unlock more of the small-employer market. A proprietary analysis shared with us pegs the current penetration of DPC among large US employers (1,000-plus employees) at approximately 10%, and we believe penetration among small to midsized employers to be much lower. “
“Investable Strategies in Direct Primary Care” PE Pitchbook October 10, 2024 www.pitchbook.com
Hospitals
Longitude Health launched: Last Tuesday, four major not-for-profit health systems—Dallas, TX-based Baylor Scott & White Health; Houston, TX-based Memorial Hermann Health System; Winston-Salem, NC-based Novant Health; and Renton, WA-based Providence—announced the formation of a new, for-profit company, Longitude Health.
The four plan to launch businesses that will create profits for their member-investors with their initial focus on access to complex pharmaceuticals, coordinating care for Medicare Advantage patients, and streamlining billing processes. The venture is being led by former McKinsey-CMS executive Paul Mango and plans to add other system owner-investors.
Four health systems form Longitude Health | Healthcare Finance News
Insurers
Study: Disparities in high-deductible health plans: Researchers examined the equity implications of high-deductible health plans within the context of racial and ethnic wealth disparities for the 2011-2018 period. Findings:
“Results show that White households consistently held significantly more wealth than did Black and Hispanic households across income levels. In the lowest income quartile, White privately insured families had more than 350 percent more in financial assets than their Black counterparts. Low-income Black and Hispanic families with high-deductible health plans but no savings accounts had median financial assets ($2,200 and $2,000, respectively) that were well below the average family coverage deductible. Study findings highlight the role of systemic racial wealth disparities, beyond that of income, to establish a unique pathway whereby high deductibles can exacerbate health care inequities.”
Study: MA supplemental benefits: “Medicare Advantage (MA) supplemental benefits offered at no or low premiums are a key value proposition for low-income beneficiaries. Despite nearly $20 billion in rebate payments to MA plans for funding supplemental benefits, their quality or enrollee access is not monitored. Using 2018–19 Medicare Current Beneficiary Survey data linked to MA plan data, we found that regardless of plan benefit generosity, low-income beneficiaries were more likely to report dental, vision, and hearing unmet needs because of cost. Enrollment in plans with higher corresponding-year (that is, the same year as unmet need measurement) star ratings was associated with lower dental unmet need. Income-related disparities in dental unmet needs were lower in the highest-rated plans. However, prior-year star ratings that determined plan payments were not associated with unmet needs or disparities in those needs. Policy makers should consider monitoring supplemental benefits for equity and access, and they should assess the value added by quality bonus payments to high-rated plans for beneficiaries’ access.”
High-Deductible Health Insurance May Exacerbate Racial and Ethnic Wealth Disparities
MA star ratings released: Last Thursday, CMS released the latest Medicare Advantage star ratings:
- The average Medicare Advantage star rating for 2025 is 3.92, down from 4.07 in 2024. Plans must earn a rating of 4 or higher to receive bonus payments from CMS. 2025-star ratings affect the quality bonus payments plans receive in 2026
- For 2025, 40% have four stars or more, compared to 44% for the 2024 plan year. The average star rating declined from 4.07 to 3.91. Open enrollment begins Tuesday and ends Dec. 7.
- Among the 10 insurers with the largest enrollment, Humana experienced the steepest ratings decline. The insurer reported last weekthat it appealed its scores to CMS after discovering that 25% of its members were enrolled in plans that generated bonus revenue, down from 94%.
- Payments from the government to MA plans are expected to increase on average by 3.70 percent, or over $16 billion, from 2024 to 2025. The federal government is projected to pay between $500 and $600 billion in Medicare Advantage payments to private health plans in 2025.
2025 Medicare Advantage and Part D Rate Announcement | CMS
Physicians
Bain survey: Net promoter scores for physicians: Bain compared net promoter scores for 130 physician-led and 183 health system-led physicians Highlights:
“There’s a widening chasm in the healthcare workforce: Physicians at practices owned by or serving hospitals and healthcare systems are almost three times more likely to be dissatisfied than those at practices owned by physicians.” Related findings:
- Health system-led practices have consistently underperformed on the “Net Promoter Score” — a measure of employees’ willingness to recommend their workplace — by 25 to 40 points compared to physician-led practices since 2017.
- Nearly 25% of physicians in health system-led organizations are contemplating a change in employers, compared to just 14% in physician-led practices. Of those considering a switch, 37% are looking to move to physician-owned settings.
- Physician satisfaction in hospital-led organizations is driven by fair compensation, sufficient staffing, manageable workloads, leadership alignment, involvement in decision-making and greater autonomy.
- Physician-led organizations outperform in satisfaction across all professional metrics. The average satisfaction scores range from 70% to 90%, while hospital-employed physicians report lower satisfaction, between 50% and 75%.
- 87% in physician-led practices reported having access to necessary supplies and equipment, compared to 68% in health system-led practices.
- 78% of physicians in physician-led practices said their organizations have effective processes and workflows, compared to only 59% in hospital-led organizations.
- 60% of hospital-employed physicians expressed satisfaction with their organization’s leadership alignment.
- 81% of physicians in physician-led organizations reported satisfaction with their involvement in strategic decision-making, compared to just 50% in health system-led practices.
Boosting Physician Satisfaction: Lessons from Physician-Owned Practices | Bain & Company
Population Health
Study: longevity: “Here using demographic survivorship metrics from national vital statistics in the eight countries with the longest-lived populations (Australia, France, Italy, Japan, South Korea, Spain, Sweden and Switzerland) and in Hong Kong and the United States from 1990 to 2019, we explored recent trends in death rates and life expectancy. We found that, since 1990, improvements overall in life expectancy have decelerated. Our analysis also revealed that resistance to improvements in life expectancy increased while lifespan inequality declined and mortality compression occurred. Our analysis suggests that survival to age 100 years is unlikely to exceed 15% for females and 5% for males, altogether suggesting that, unless the processes of biological aging can be markedly slowed, radical human life extension is implausible in this century.”
Implausibility of radical life extension in humans in the twenty-first century Nature Aging October 7, 2024 https://www.nature.com/articles/s43587-024-00702-3
KFF analysis: International health system comparisons: “Generally, the U.S. performs worse in long-term health outcomes measures (such as life expectancy), certain treatment outcomes (such as maternal mortality and congestive heart failure hospital admissions), some patient safety measures (such as obstetric trauma with instrument and medication or treatment errors), and patient experiences of not getting care due to cost. The U.S. performs similarly to or better than peer nations in some other measures of treatment outcomes (such as mortality rates within 30 days of acute hospital treatment) and patient safety (such as rates of post-operative sepsis).
How does the quality of the U.S. health care system compare to other countries? | KFF
Study: government funding of household income: “Income from government transfers is the fastest-growing major component of Americans ‘personal income. Nationally, Americans received $3.8 trillion in government transfers in 2022, accounting for 18% of all personal income in the United States. That share has more than doubled since 1970. Transfer income has grown three times as quickly as non-transfer income over the past several decades.
Transfers’ significance as a source of income for American communities has accelerated dramatically since the turn of the century. In 2000, only about 10% of counties received a quarter or more of total personal incomes from transfers. By 2022, the most recent data year, 53% did.”
The Great Transfer-mation Economic Innovation Group September 2024https://eig.org/great-transfermation/?utm_source=newsletter&utm_medium=email&utm_campaign=newsletter_axiosam&stream=top
Study: disparity in Covid mortality rate: Researchers analyzed overall and age-specific all-cause excess mortality by race and ethnicity during the COVID-19 PHE to assess whether measured differences reflected changes from pre-pandemic disparities. Findings:
“In the total population aged younger than 25 years, the Black population accounted for 51.1% of excess mortality, despite representing 13.8% of the population. Had the rate of excess mortality observed among the White population been observed among the total population, more than 252 000 (18.3%) fewer excess deaths and more than 5.2 million (22.3%) fewer YPLL would have occurred.
In this cross-sectional study of the US population during the COVID-19 PHE, excess mortality occurred in all racial and ethnic groups, with disparities affecting several minoritized populations. The greatest relative increases occurred in populations aged 25 to 64 years. Documented differences deviated from pre-pandemic disparities.”
Correlation: Voting and public health: The Health and Democracy Index, which assesses 12 public health indicators and state voting policies, shows that states with less restrictive voting policies and more civic engagement are healthier. “When patients are empowered to elect representatives that advocate for their best interests — such as greater healthcare accessibility, less economic disparity, and improved education, social services, and housing — patients and communities ultimately see improved health as a result.
Appreciating the connection between increased civic engagement and improved health outcomes, many health organizations are working to improve civic engagement within their respective communities. For example, Healthy People 2030 is working to increase the proportion of voting-age citizens who vote. While their target is having at least 58.4% of voting age citizens vote in federal, local, and/or state elections, only 52.2% of voting age individuals reported voting in these elections in 2022. Also, according to America’s Health Rankings , only 59.5% of U.S. citizens ages 18 or older voted in the last presidential and midterm national elections. Despite the established link between increased voting and overall public health, we still have a long way to go to increase voter turnout rates.”
Health & Democracy Index (hdhp.us)
Social Security COLA adjustment: Last Thursday, the 2025 cost-of-living adjustment will be 2.5% ($50/month) bringing the average check to the 72.5 million SSN and SSI recipients to average of $1976/mo. Notes:
- The COLA adjustment was + 8.7% in 2023 and +3.2% in 2024.
- Based on that increase, the maximum amount of earnings subject to the Social Security tax (taxable maximum) is slated to increase to $176,100 from $168,600.
- Over the last decade the cost-of-living adjustment (COLA) increase has averaged about 2.6%.
- Over the past five years, only the 2023 adjustment has beaten the rate of inflation. The COLAs lagged inflation by as much as 1.1 percentage points the other years.
- More than a third of retirees say their Social Security checks are a major source of income, according to an April 2024 Gallup survey.
Social Security Announces 2.5 Percent Benefit Increase for 2025 | SSA
Prescription Drugs
CBO Report: alternatives to reduce prescription drug prices by 2031: “One examined approach would reduce prices by more than 5%—and possibly substantially more. That approach would set maximum allowed prices based on prices outside the United States.
An approach that expanded the Medicare Drug Price Negotiation Program would lead to a small reduction (1-3%) or a very small reduction (less than 1%) in average prices. An approach requiring manufacturers to pay inflation rebates for sales in the commercial market would lead to a small price reduction.
Four approaches would lead to a very small price reduction, no reduction, or a price increase.
- Allow commercial importation of prescription drugs distributed outside the United States (0.1-1.0% reduction)
- Eliminate or limit direct-to-consumer prescription drug advertising (0.1-1.0%)
- Facilitate earlier market entry for generics and biosimilar drugs (which are analogous to generic drugs but are made from living organisms) (0.1-1.0%)
- Increase transparency in brand-name drug prices.”
“Alternative Approaches to Reducing Prescription Drug Prices” Congressional Budget Office https://www.cbo.gov/system/files/2024-10/58793-rx-drug-prices.pdf
Teva settles anti-kickback, price fixing litigation: “In the largest settlement of its kind, Teva Pharmaceuticals agreed to pay $425 million to resolve allegations the company and a related business paid kickbacks to charitable foundations in order to boost usage of a pricey medicine. Separately, the drugmaker agreed to pay $25 million to settle charges of participating in a price-fixing scheme with other generic companies.
The kickback case began four years ago when the Department of Justice accused Teva of using the foundations to ensure that, from 2006 through 2017, Medicare patients did not have to make a copayment or deductible for the Copaxone multiple sclerosis drug. At the same time, Teva steadily raised the price of its drug by thousands of dollars.
The Justice Department had alleged at the end of each year, Teva used information from the pharmacy and the foundations to determine how much money each foundation would need to cover the Medicare copays of existing Copaxone patients for the following year. And Teva then paid each foundation.”
Study: Access to new medicines: “Our analysis comprised 119 medicines with 6,871 observed launches. Nearly three-quarters (74 percent) of first launches occurred in just eight countries (in order of the most first launches, the US, the Netherlands, Sweden, Switzerland, the United Kingdom, France, Germany, and Japan). From the first launch globally, the median time to availability was 2.7 years for high-income countries, 4.5 years for upper-middle-income countries, 6.9 years for lower-middle-income countries, and 8.0 years for low-income countries. The gap between richer (high- and upper-middle-income) and poorer (lower-middle- and low-income) countries remained largely unchanged over time. Strategies to address the disparities highlighted by this analysis are urgently needed.
Regulators
FTC issues expanded pre-merger requirements proposed rule: Last Thursday, the Federal Trade Commission voted 5-0 to finalize changes to premerger notifications under the Hart-Scott-Rodino Act, which requires organizations to report large transactions to the FTC and Justice Department for antitrust review. Highlights:
The move aims to help the FTC and Justice Department’s antitrust division detect illegal mergers and acquisitions prior to consummation. It requires:
- Additional details from the supervisor of each merging party’s deal team as well as a small set of high-level business plans related to competition.
- A description of the business lines of each filer to reveal existing areas of competition between the merging parties (including for products or services that are in development) and supply relationships.
- Disclosure of investors in the buyer, including those with management rights.
Note: In 2019, only 13.3% of transactions reported to the agencies exceeded $1 billion vs. 24% today. The final rule will take effect 90 days after it is published in the Federal Register.
Premerger Notification; Reporting and Waiting Period Requirements https://www.ftc.gov/system/files/ftc_gov/pdf/p110014hsrfinalrule.pdf
Workforce
Klas: study: Nurse Burnout Factors:
- Staffing: 55%
- Chaotic work environment: 40%
- Too many bureaucratic tasks: 30%
- Lack of teamwork: 25%
- Lack of shared values with leadership: 22%
- No control over workload: 20%
- EHR workflow inhibits efficiency: 17%
- Aggressive patients: 15%
- EHR workflow inhibits quality patient care: 13%
- Lack of training: 11%
- Lack of autonomy: 10%
Klas Research via Healthcare Dive, August 2024
Key stat:“…almost two-thirds of nurses (62%) experience burnout. It’s especially common among younger nurses, with 69% of nurses under 25 reporting burnout.”
Nurse Burnout: What Is It & How to Prevent It | ANA (nursingworld.org) April 2024
