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The Keckley Report

Is the Health System the Next Target for Campus Unrest?

By May 6, 2024No Comments

Over the weekend, campus unrest was the focus of news coverage nationwide. Israel’s war against Hamas in Gaza is the issue. Opinions about its justification, battlefield tactics and the role played by U.S.’ policies and funding are deeply-felt by sympathizers on both sides while concern for Palestinian civilians and human rights mounts worldwide.

College campuses are prime targets for activism on issues where instigators sense opportunity to advance their agenda. They are home to 18 million in the Gen Z generation. Their youthful predispositions against establishment themes and institutions are easily stoked: in the ‘60’s, it was Vietnam and Civil Rights. Today, it is Israel, especially on campuses where Jewish students are prominent in their student bodies. In this case, students want Boards of Trust to divest holdings in companies that profit from the conflict and Presidents to protect all student groups from biases harmful to their well-being.

I was a college student in Nashville during the era of campus unrest.  I studied social movements in grad school reflecting on those experiences. I remember “Hell no, we won’t go” and “Hey, hey, LBJ: how many boys did you kill today.” And now I find myself pondering how these kids some call privileged will impact institution-rich industries like U.S. healthcare tomorrow.

In my 4Q 2023 Keckley Poll, distinctions between the views of the college-age population and older adults about the health system were surprising: though college age adults use the health system less than others, they share a widespread belief it’s flawed and in need of fundamental change. They believe the profit in healthcare is more important than its caring and they’re open to government policies that might rein in its corporatization.

% Agree vs. % Disagree Adults 18-24  All Adults
The U.S. health system is heading in the right direction. 42/16 28/29
I believe the U.S. health system is fundamentally flawed and in need of major change. 65/5 58/7
The U.S. system puts its profits ahead of patient care. 67/10 60/12
I am confident in my ability to navigate the health system when I have a problem 57/19 52/15
The majority of physicians care more about caring for their patients than making more money. 68/14 70/16
I believe the tax exemption given not-for-profit hospitals is justified by the community benefits they provide. 54/9 55/11
I believe the federal government should impose price controls on hospital services, prescription drugs and insurance premiums 78/0 74/7

My take:

The U.S. system is an unlikely target for campus unrest today but a likely target tomorrow. College student interaction with the health system is episodic: student health is a backstop for their bouts with depression, substance abuse, STIs, chronic conditions and accidents. Insurance and payment are concerns, and impressions from childhood household circumstances flavor their impressions of how the system operates. But what they’re seeing is key: the most heralded organizations in healthcare are associated with their size, financial success and the personal wealth of their executives. In college circles, Wall Street success seems more important than Main Street authenticity, transparency, environmental consciousness, fairness and humility. Like the majority of Americans, their views about the health system are anecdotal and regretfully negative.

Today’s college students are tomorrow’s healthcare workforce. They’re also the consumers who buy our products and services and set the rules by which we operate and compete. While some dismiss their views as exuberant idealists, history teaches student movements have long-term impact on social changes, policies, institutions and how we relate to each other.

The precipitous drop in public trust and confidence in America’s institutions including higher education, big business and the medical system especially among young adults is a red flag healthcare leaders should consider seriously. On college campuses, evidence of discontent with the status quo is in full view whether it’s the value of the degrees they’re pursuing or the foreign policies of the country where they live.

Instead of policies to increase short and near-term profits (and margins) for shareholders and self-interested stakeholders, perhaps the healthcare industry should step back and define the greater purpose it seeks to achieve. It’s unclear to the majority, including college kids.


PS: The Quotables section in this report is illustrative of the stories about the health system consumed outside industry circles including college classrooms and among social activists who seek to challenge the status quo. Some are flattering, some are critical, some are objective and all are important to understanding the social landscape in which the health system operates today. Thanks for reading. And thanks for your ideas and suggestions.


Sections in today’s Report

  • Quotables
  • Care Management
  • Hospitals
  • Insurers
  • Retail Health
  • Workforce


Re: Change Healthcare Congressional Hearing—Sen. Warren-Sir Andrew Witty exchange in Finance Committee: Warren: “By revenue, UnitedHealth is the 11th largest company in the entire world,” she said. “UnitedHealth Group owns the country’s largest insurer, the country’s largest claims processor, the country’s third-largest pharmacy benefit manager, a huge pharmacy chain. It is the largest employer of physicians nationwide or controller with at least 90,000 physicians.”

Witty: “Despite our size, for example, we own no hospitals in America. We do not own any drug manufacturers. We employ less than 10,000 physicians; hospitals across America employ 400,000 physicians. We contract and affiliate with a further 80,000 physicians who voluntarily choose to work alongside our Optum colleagues. We employ less than 1% of doctors in America.”

Lawmakers grill UnitedHealth CEO on Change cyberattack – STAT (

Re: hospital financial hurdles: “As this report clearly highlights, increased expenses, workforce challenges, and growing administrative burden are unsustainable and creating headwinds and obstacles that threaten access to care for millions of Americans. The AHA urges Congress and the Administration to take action to strengthen hospitals and health systems and bolster access to care for all patients and communities.”

Rick Pollack, President & CEO, American Hospital Association Costs of Caring | AHA

Re: medical residency application process complexity, costs: “To apply for residency, medical students need to complete the United States Medical Licensing Examination (USMLE) Step 1 and Step 2, which cost $670 each (and even more for international medical graduate (IMG) students), and to my knowledge, no financial assistance program currently exists…

Based on 2024 fees, if an internal medicine applicant wanted to apply to 35 programs  — the average number of applications submitted by U.S. MD medical students in the 2024 cycle* — it would cost them $734  ($654 ERAS fee + $80 USMLE transcript fee). However, applicants to more competitive specialties such as orthopedic surgery submit about 66 applications, on average, which costs $1,571 ($1,1491 ERAS fee + $80 USMLE transcript fee)…About 50% of medical students  belong to the top quintile of households (≥$130,000 in 2019), and about 24% of medical students belong to the top 5% (≥$248,728 in 2019). The U.S. median household income in 2019 was $68,703 . Only about 5% of medical students were in the lowest household income quintile ($25,600 or below in 2019), and these students disproportionately identify as Black or Hispanic.

Growing up with low socioeconomic status is correlated with a lower likelihood of a student getting accepted into medical school. One study found  that applicants reporting a childhood household income less than $50,000 were 48% less likely to be accepted compared to those who had a childhood household income of $200,000 or greater…”

A Look Inside the Exorbitant Costs of Applying to Residency | MedPage Today

Re: workforce engagement: “According to the most recent Gallup polling, only 23% of people around the world are engaged at work. (While that’s a record high, it’s a pretty dismal one.) A full 59% are not engaged—that is, they “put in the minimum effort required” and are “psychologically disconnected from their employer”—while 18% are highly disengaged and deliberately acting against their organizations’ interests. A recent American Psychological Association survey likewise found woefully negative attitudes among workers: In it 31% were emotionally exhausted, 26% felt unmotivated to do their best, 25% felt “a desire to keep to themselves,” and 19% reported irritability or anger toward colleagues and customers.”

Advice for the Unmotivated (

Re: cost of workforce disengagement: “Gallup has found one clear answer: Change the way your people are managed. In this year’s State of the Global Workplace report, we estimate that low engagement costs the global economy $8.8 trillion. That’s 9% of global GDP — enough to make the difference between success and a failure for humanity. Poor management leads to lost customers and lost profits, but it also leads to miserable lives. Gallup’s research into wellbeing at work finds that having a job you hate is worse than being unemployed — and those negative emotions end up at home, impacting relationships with family. If you’re not thriving at work, you’re unlikely to be thriving at life.”

Insights From the 2023 State of the Global Workplace Report (

Re: CMS quality reporting adequacy: “How can CMS claim to be concerned about quality when failing even to enforce the actual reporting of their mandated quality measures? How can anyone in the “value-based care” business claim to be serious about “value” when mortality is this high and this random? And, no, “your patients” aren’t sicker.  If this is the best that health economy stakeholders can deliver with respect to mortality, then we should stop kidding ourselves about ACO Reach and MSSP and every other “value-based care” program. Rearranging the deck chairs around on the Titanic didn’t save any passengers, and shared savings don’t seem to be saving many lives.”

Hal Andrews, CEO Trilliant Health If Stakeholders Really Care About Quality, It Sure Is Hard to Tell  (

Re: medical device oversight: “Medical device maker Philips said yesterday it will pay more than a billion dollars to settle hundreds of personal injury lawsuits in the U.S. over its defective sleep apnea machines, which have been subject to a massive global recall. The Dutch manufacturer has recalled more than 5 million breathing machines since 2021 because their internal foam can break down, leading users to inhale tiny particles and fumes while they sleep.

Philips’ saga has exposed major challenges in medical device regulation and patient safety monitoring. Its payout also includes medical monitoring claims from patients who used the company’s devices and could experience future complications. “

Philips to pay $1.1B to resolve lawsuits over sleep apnea machines (

Re: FTC antitrust oversight, expanded scope: “Merger antitrust risk used to be relatively easy to gauge, even if most companies weren’t always sure which federal agency would be doing the oversight. Now it’s become a Damocles’ sword hanging over most every major deal…. In the olden days, antitrust regulators focused on deals between companies in the same industry (i.e., vertical mergers) — with a particular focus on negative impacts to consumer welfare or business competition. Scrutiny was expanded to horizontal mergers near the end of President Obama’s administration, with President Trump maintaining that emphasis. President Biden has gone even further, with his FTC chair Lina Khan aiming at private equity consolidation and nascent technologies. Biden’s biggest shift, however, is to consider a merger’s impact on labor…Workers are now the third leg of the antitrust stool, joining customers and competitors, making antitrust risk ubiquitous.”


Re: telehealth status: As the American Telemedicine Association gathers next week for its annual conference, attendees will find plenty to discuss.

Telehealth had its moment in the spotlight with the pandemic, when both the healthcare industry and consumers found they couldn’t live without it. While adoption dropped with the return to in-person care, the general consensus is that telehealth is now a part of the care spectrum. The best evidence of this may be the announcement that both the Joint Commission and the National Committee for Quality Assurance are developing new accreditation standards for virtual care.

ATA Meeting Showcases Telehealth’s Changing Landscape | HealthLeaders Media

Re: Executive pay: “At many of the biggest U.S. companies, CEOs and other executives are getting tens or hundreds of thousands of dollars more in flight benefits than company disclosures suggest. The contrast underscores the gap—already stark with the stock and options that make up the bulk of CEO pay—between the reported costs of executive compensation and the benefit executives receive.

Executive jet use is also under heightened scrutiny after the Internal Revenue Service has announced a plan to audit personal aircraft use by executives and wealthy individuals.

The corporate jet looms large among the perks that the biggest U.S. companies offer their top executives, alongside million-dollar salaries, annual bonuses and slugs of stock or options. Many corporate officers are allowed to take the same jets on vacation, to visit relatives or commute from other homes—and some can fly family and friends—all at company expense.”

Executive Flights on Corporate Jets Worth Millions More Than Reported – WSJ

 Re: integrating primary care and public health: “With a new shared understanding of the definition of population, the integration of primary care and public health can foster an effective collaboration that understands that the health of a population is not simply a product of functionality or funding of health care services. Rather, it includes the conditions in which people are born, grow, live, work, and age, and encompasses inequities in power, money, and resources.20 The emphasis on SDoH supports the important role of primary care. With a greater emphasis on health equity, family physicians stand poised to serve as leaders who understand the role of SDoH and the impact of climate change, seeing its effects in the patients and communities they serve.21 Within this role, family physicians should continue leveraging available technologies, including telehealth, patient portals, and even social media to reduce their carbon footprint and provide multiple access points for patients to meet a variety of needs in their community. “

Integration of Primary Care and Public Health (Position Paper) | AAFP


Care Management

Study: CPC+ and mental health association: Researchers analyzed CMS ’Comprehensive Primary Care Plus (CPC+) demonstration project association with access to mental health and substance use services from 2018 to 2022. Results:

“Among patients diagnosed with OUD, compared with patients attributed to non-CPC+ practices, attribution to a CPC+ practice was associated with filling more prescriptions for buprenorphine prescriptions…Among patients diagnosed with depression or anxiety, attribution to a CPC+ practice was associated with more prescriptions for buprenorphine prescriptions per patient per quarter). Findings of this cohort study suggest that individuals with an OUD who received care at a CPC+ practice filled more buprenorphine and anxiolytics prescriptions compared with patients who received care at a non-CPC+ practice. As the Centers for Medicare & Medicaid Innovation invests in advanced primary care demonstrations, it is critical to understand whether these models are associated with indicators of high-quality primary care.”

Access to Mental Health and Substance Use Treatment in Comprehensive Primary Care Plus | Health Policy | JAMA Network Open | JAMA Network

Covid vaccine complications: “The Covid vaccines, a triumph of science and public health, are estimated to have prevented millions of hospitalizations and deaths. Yet even the best vaccines produce rare but serious side effects. And the Covid vaccines have been given to more than 270 million people in the United States, in nearly 677 million doses

As of April, just over 13,000 vaccine-injury compensation claims have been filed with the federal government — but to little avail. Only 19% have been reviewed. Only 47 of those were deemed eligible for compensation, and only 12 have been paid out, at an average of about $3,600.

Some scientists fear that patients with real injuries are being denied help and believe that more needs to be done to clarify the possible risks….

Federal officials and independent scientists face a number of challenges in identifying potential vaccine side effects…

There is no central repository of vaccine recipients, nor of medical records, and no easy to way to pool these data. Reports to the largest federal database of so-called adverse events can be made by anyone, about anything. It’s not even clear what officials should be looking for.”

Thousands Believe Covid Vaccines Harmed Them. Is Anyone Listening? – The New York Times (

Study: colonoscopy costs: Unadjusted and adjusted average reimbursement for GI procedures dropped by 7% and 33%, respectively, from 2007 to 2022. Reimbursements for colonoscopy and biopsy decreased by 38% during that period. Related:

  • The average cost to undergo a colonoscopy in the U.S. in 2024 is $1,608, Breakdown: Facility fee: 59%, Gastroenterologist: 23%, Anesthesia: 16%, Lab fees: 2%
  • S. hospitals’ facility fees for colonoscopy procedures covered by private health insurance are an average of 55% higher than facility fees billed by ASCs.

Changes in Medicare Reimbursement for Common Gastroenterolog…: Official journal of the American College of Gastroenterology | ACG (

USPTF modifies breast cancer screening guidance: Last Tuesday, the US Preventive Services Task Force (USPSTF) finalized a recommendation that women at average risk of breast cancer should start receiving biennial mammography screenings once they turn 40 reversing a 2009 task force recommendation that raised the age from 40 to 50. Their rationale: increased prevalence of breast cancer in younger women.

Recommendation: Breast Cancer: Screening | United States Preventive Services Taskforce (

DOJ marijuana access policy change: “The Justice Department on Tuesday said it had recommended that federal restrictions on marijuana become a whole lot chiller. And while it is not clear that lobbying from Democrats like Fetterman has played any role, the move was the latest step by the Biden administration to liberalize the nation’s cannabis policy — something his allies believe comes with an obvious political upside when more than two-thirds of Americans support legalization of the drug

Biden, a suit-wearing president who is more statesman than stoner, has become something of the pot president. It could elevate his standing specifically with young voters, who support rescheduling, or reclassifying, marijuana as a less serious drug, as well as with supporters of changes to criminal justice laws.”

On Politics: Joe Biden, pot president? – – Mail (



Kaufman Hall: April hospital performance: Key Takeaways

  • Margins and other key performance indicators declined slightly in March. While hospitals performed relatively well in the first quarter of 2024, declines in volume and associated revenue in March may signal more challenges ahead.
  • Hospital outpatient revenue fell 5% in March, reflecting the competitive challenges of providing outpatient care.
  • Increases in bad debt and charity, along with increases in days A/R, pose challenges and opportunities for hospitals’ revenue cycles and overall collections.

National Hospital Flash Report: April 2024 | Kaufman Hall

Study: price differences in hospitals:” Our analysis provides detailed insights into the rate differences between nonprofit and for-profit health systems, highlighting significant variations in negotiated rates across ownership types and markets. Contrary to common belief, for-profit health systems do not consistently have higher negotiated rates. In competitive markets, for-profit institutions represented both the lowest and highest average rates compared to nonprofit institutions in certain regions, with negotiated rates ranging up to 3.4X for MS-DRG 871 (sepsis) in the Northeast market.

A core thesis of our research, dating back to the 2021 Trends Shaping the Health Economy Report and earliest editions of The Compass, is that healthcare is local. There are countless local factors that impact healthcare markets, including reimbursement rates. Healthcare pricing is influenced by hospital competition, payer dynamics, patient demographics and regulatory frameworks, among other factors. Once again, our analysis underscores the importance of localized approaches to healthcare research, particularly in understanding price disparities between nonprofit and for-profit organizations.”

Exploring Reimbursement Differences Between Nonprofit and For-Profit Health Systems – Trilliant Health

Axios: Hospital funding: “Hospitals’ business models are being upended by fundamental changes within the health care system, including one that presents a pretty existential challenge: People have far more options to get their care elsewhere these days.

  • Oliver Wyman recently predictedthat under the status quo, hospitals will need to reduce their expenses by 15-20% by 2030 “to stay viable.”
  • Boston Consulting Group last year projectedthat health systems’ annual financial shortfall will total more than $200 billion by 2027, and their operating margins will have dropped by 10 percentage points. To break even in 2027, a “typical” health system would need payment rate increases of between 5-8% annually — twice the rate growth over the last decade, according to BCG. If the load is borne solely by private insurers, hospitals will need a 10-16% year-over-year increase.

Between the lines:This is the lens through which to view health systems’ spree of mergers and acquisitions, which have increasingly drawn criticism from policymakers, regulators and economists as being anticompetitive… A big bonus of outpatient care is that it’s supposed to be cheaper. But when hospitals charge more for care than an independent physician’s office would have, or they tack on facility fees, costs don’t go down…. Realitycheck:Hospitals account for 30% of the country’s massive health spending tab, and they’ll have to be at the forefront of any real efforts to contain costs. They’re also anchors in their communities and are powerful lobbyists, which helps explain why Congress has struggled to modestly reduce what Medicare pays hospital outpatient departments.”

Axios Vitals: Dying hospital model April 26, 2024



Study: consolidation: “In recent years, there has been concern among policymakers about increasing consolidation in the U.S. health care system. One particular concern is that consolidation of health systems and hospitals (including physician practice acquisition) has reduced competition, leading to higher prices and potentially reduced benefits for patients.

Indeed, the worry has grown sufficiently that in 2023, the Federal Trade Commission and the U.S. Department of Justice released draft merger guidelines for the health care sector, seeking to promote transparency for employers and consumers, strengthen antitrust enforcement, and initiate reimbursement reform.1 In addition, 36 bills regarding the consolidation of health systems — ranging from contractual affiliation notifications to certificate of need reviews — were enacted across 24 states in 2023.2 Federal proposals to create a new agency or task force to monitor, oversee, and intervene in health care markets have also been discussed.3 To further promote competition in health care markets, the U.S. Department of Health and Human Services recently named its first chief competition officer.4

Overall, our data show that the largest health systems have, on average, a combined 43.1% of the market share (as measured by total inpatient hospital discharges) in each state, while the top three large-group insurers hold an average of 82.2% of the market share in each state...

This increased consolidation of insurers suggests that policymakers’ exclusive focus on regulating provider consolidation is problematicInsurer consolidation has resulted in lower prices (or charges), but the impact on reimbursements to providers is unclear. Importantly, there has not been evidence of reduced premiums for patients and some studies have found evidence that insurer consolidation increases premiums.

Insurers are also increasingly acquiring physician practices at a rate higher than hospitals and health systems are acquiring physician practices. Private equity and other physician groups have acquired the largest share of physicians in the last five years (65% and 14% of all physician practice acquisition deals in the United States, respectively). Health insurers acquired the third most (11%); one insurer, Optum, now employs over 10% of all practicing physicians in the United States.

Further regulation of health system consolidation should specifically analyze costs and reimbursements/payments in addition to prices/charges, and must take into consideration the impact of consolidation in the insurer market, which may have more deleterious effects on patients when it comes to the availability of services and providers, out-of-pocket costs, and quality of care. Providers and suppliers outside of traditional health systems are also highly concentrated (e.g., dialysis providers and electronic health record vendors) at the national level and may raise the cost of episodes of care. Courts and regulators seeking to level the playing field in health care markets should examine how consolidation of both insurers and providers of health care services within states, regions, and nationally (as well as within specific MSAs) may affect access, cost, and quality of care.”

Why Market Power Matters for Patients, Insurers, and Hospitals | Research and Action Institute (

Insurer CEO compensation: UnitedHealth Group’s Andrew Witty became the highest-paid CEO among the major health insurers last year, but his total compensation paled in comparison to Oscar Health CEO Mark Bertolini. Witty’s total 2023 compensation was $23.5 million, up 12.8% from a year earlier, driven by gains in stock and option awards.

It came during a year in which UnitedHealth Group’s net earnings rose 13.8% to $32.4 billion as revenues increased 14.6% to $371.6 billion. Its UnitedHealthcare insurance unit saw growth in Medicare Advantage enrollment, to 7.7 million members, and its Optum health services division became the largest employer of physicians.

Witty’s $23.5 million came before UnitedHealth Group stumbled into the spotlight following a cyberattack on its Change Healthcare subsidiary in February, a breach that has affected its finances and reputation. The company in April reported a first-quarter net loss of $1.2 billion and said it expects costs related to the cyberattack will total as much as $1.6 billion this year.

The total compensation for CEOs of the major publicly traded payers — UnitedHealth Group, Centene, Cigna Group, CVS Health, Elevance Health, Humana and Molina Healthcare — averaged $20.6 million in 2023, up 5.7% from 2022, according to a Modern Healthcare review of company proxy statements filed with the Securities and Exchange Commission. Elevance Health CEO Gail Boudreaux received the highest salary at $1.6 million.

UnitedHealth’s Andrew Witty leads CEO compensation in 2023 | Modern Healthcare

Study: MA vs. FFS Medicare: Inovalon analyzed utilization in matched samples of pre-65 adults from 2018-2023 pre-Medicare of Medicare FFS and MA enrollees. Results:

  • “The unmatched samples columns present outcomes for the original, unmatched cohorts, and show particularly striking differences in terms of inpatient related quality outcomes such as readmissions, consistent with higher quality under MA. FFS has 3.6 times higher rates of 30-day readmissions compared to MA. FFS also has 1.6 times higher rates of potentially avoidable hospitalizations overall, with 2.5 times higher rates for acute conditions and 1.3 times higher rates for chronic conditions
  • For some measures such as readmissions, the quality advantage of MA over FFS widens even further upon matching with 3.8 times higher rates in FFS compared to MA. After matching, FFS still shows 1.7 times higher rates of avoidable hospitalizations overall.
  • We find that MA has 24% fewer preventable hospitalizations relative to FFS. The reduction is especially concentrated among preventable acute-related hospitalizations, for which we see a 59% reduction, which is highly statistically significant. Preventable chronic hospitalizations are also 8.6% lower under MA. We additionally find 70% fewer 30-day all-cause readmissions, after adjusting for any differences that existed prior to Medicare enrollment, a result which is also highly statistically significant. “

FINAL-INS-23-2164-Harvard-Campaign-White-Paper-2.pdf (

CVS reports Medicare Advantage losses: Last Wednesday, CVS Health announced the launch of a 3–4-year cost containment effort in its Medicare Advantage division (Aetna) after reporting a $900 million higher-than-anticipated medical costs in 1Q2024 2024., CVS Health net income declined 47.5% to $1.1 billion, or $0.88 per share, during the first quarter as revenue increased 3.7% to $88.4 billion.

Aetna’s medical loss ratio rose from 84.6% to 90.4% as the insurer experienced higher Medicare Advantage utilization and lower scores from the star ratings quality measurement program.

Aetna membership grew 5.1% to 26.8 million, fueled by a 24% jump in Medicare Advantage enrollment to 4.2 million. Aetna reported the biggest rise in Medicare Advantage sign-ups among its peers during 2024 open enrollment. Revenue for the insurance segment increased 24.6% to $32.2 billion.

CVS Health reviews strategy amid Aetna’s Medicare Advantage costs | Modern Healthcare



AAMC: Physician workforce racial composition 2021 vs. 2036 (projected)

Race 2021 2036 (projected)
White 65% 56%
Asian 20% 26%
Hispanic 6.1% 7.4%
Black/African-American 5.8% 6.1%
Multiple Race, non-Hispanic, American Indian 2.7% 3.8%

AAMC (Association of American Medical Colleges), The Complexities of Physician Supply and Demand: Projections From 2021 to 2036, March 2024


Retail Health

CVS launches specialty pharma venture:: “Most shoppers are familiar with CVS Health’s CVS 0.40%increase; green up pointing triangle many private-label products, from women’s daily multivitamins to heart-healthy trail mix. There is a reason CVS and other retailers place those products prominently on their shelves: Store brands are more profitable for them because they offer higher margins. Now CVS is deploying that same approach to the much more profitable business of blockbuster prescription drugs. The move already seems to be paying off and spreading to other managed-care organizations, like Cigna Group, with major repercussions for manufacturers of lower-cost biosimilar products. These are cheaper versions of biotech drugs made from living cells, which are far more complicated to make than traditional pills.


Last year, CVS Health launched a venture called Cordavis, a unit that will partner with drug manufacturers to commercialize these biosimilar drugs. Many such drugs have been coming off patent in recent years, representing a massive opportunity for middlemen such as CVS that stand between drugmakers and patients. CVS says the biosimilars market in the U.S. is projected to grow from less than $10 billion in 2022 to more than $100 billion by 2029.”

Coming to a CVS Near You: A Store Brand Monoclonal Antibody – WSJ

Study: OTC weight control supplement label accuracy: Researchers analyzed whether select dietary supplements marketed online for weight loss from companies advertising military discounts are accurately labeled according to the Supplement Facts listed ingredients, whether they contain any ingredients prohibited for use in the military, and to qualitatively describe the products’ label claims.

In this case series, 30 dietary supplement products marketed for weight loss were selected and purchased in June 2023 from 12 online companies advertising military discounts. Data were analyzed from July to August 2023. Findings:

“Of the 30 products tested, analysis showed that 25 had inaccurate labels. Of these, 24 had ingredients listed on the label that were not detected (misbranded); 7 had hidden components not present on the label, some of which would be considered adulterated; and 10 had substances on the DoD Prohibited Dietary Supplement Ingredients List either on or hidden from the label. All products were rated as risky when applying the OPSS Scorecard.”

Label Accuracy of Weight Loss Dietary Supplements Marketed Online with Military Discounts | Public Health | JAMA Network Open | JAMA Network



ShiftKey survey: nurses: Nursing platform solution provider ShiftKey conducted a survey of Findings:

shared with The Hill found that

  • 86%of women in the field — including nurses, nurse practitioners, physician assistants and technicians — reported experiencing burnout, with 64% saying they were at risk of burning out “right now.”
  • 66% of male health care workers said they have experienced burnout and 55% said they were at risk of burning out right now.
  • Female nurses were also more likely to say they have considered leaving the field, with 53% saying so compared to 32% of their male counterparts

Burnout is rampant among female health care workers. Here’s why | The Hill

BLS Workforce Wages: March 2024: Highlights:

  • Compensation costs for civilian workers increased 1.2%, seasonally adjusted, for the 3-month period ending in March 2024; Wages and salaries increased 1.1 % and benefit costs increased 1.1% from December 2023.
  • Compensation costs for civilian workers increased 4.2% for the 12-month period ending in March 2024 and increased 4.8% in March 2023. Wages and salaries increased 4.4% for the 12-month period ending in March 2024 and increased 5.0% for the 12-month period ending in March 2023. Benefit costs increased 3.7% over the year and increased 4.5% for the 12-month period ending in March 2023.
  • Compensation costs for private industry workers increased 0.6% for the 12-month period ending in March 2024. Inflation-adjusted wages and salaries increased 0.8% for the 12 months ending March 2024. Inflation-adjusted benefit costs in the private sector increased 0.1 percent over that same period. Within private industry by bargaining status, compensation costs increased 5.3% for union workers and 3.9% for nonunion workers for the 12-month period ending in March 2024. Wages and salaries increased 6.3% for union workers and 4.1% for nonunion workers for the 12-month period ending in March 2024. Benefit costs increased 3.8% for union workers and 3.6% for nonunion workers for the period ending in March 2024.

U.S. Bureau of Labor Statistics (

DOL: March Jobs report: Employers added 175,000 positions in April, the Labor Department reported Friday, undershooting forecasts. The unemployment rate ticked up to 3.9%.

A less torrid expansion after the 242,000-job average over the prior 12 months isn’t necessarily bad news, given that layoffs have remained low and most sectors appear stable “Health care added 56,000 jobs in April, in line with the average monthly gain of 63,000 over the prior 12 months. In April, employment continued to increase in ambulatory health care services (+33,000), hospitals (+14,000), and nursing and residential care facilities (+9,000). Employment in social assistance increased by 31,000 in April, led by a gain in individual and family services (+23,000). Social assistance had added an average of 21,000 jobs per month over the prior 12 months.”

Employment Situation Summary – 2024 M04 Results (

U.S. Job Market Eases, but Hiring Remains Firm – The New York Times (