This Sunday, the American Hospital Association will convene for its Annual Meeting in DC featuring 50 speakers covering a wide range of topics. It comes at a precarious time for hospitals as Congress begins its budget reconciliation bill process that is expected to include a number of cuts to healthcare spending negatively impacting hospital finances directly. This week also marks the Trump Administration’s 100-day milestone which has seen its popularity decline and economic uncertainty mount.
It’s no surprise hospitals are concerned about their finances. It’s been a priority for many years and they have enjoyed success. Fending off 340B reimbursement cuts and site neutral payments, maintaining prohibitions against physician owned hospitals, enabling horizontal and vertical consolidation to leverage scale in insurer negotiations and supply chain, and limiting reimbursement cuts in Medicare and Medicaid stand out as notable accomplishments. AHA, in collaboration with CHA, FAH, AEH and others have been successful in protecting hospitals against unwelcome regulations and unwanted competition. Its current $30 million campaign against Medicaid cuts demonstrates its broad-based muscle and messaging impact. It’s worked.
Hospitals represent 31% of total health spending—up 10.4% in 2023 vs. total health spending that increased 7.5%. They employ more than half of all physicians in the country and a workforce of 6 million. The majority (69%) are affiliated with multi-hospital systems including one in four now owned by for-profit corporations or private equity funds. And the sector is prominently represented in state and federal policy circles where it has enjoyed considerable success.
I have participated in 5 hospital board strategic planning engagements this month and 11 since the Trump administration began. The accomplishments noted above have not gone without notice, but there’s a strong consensus among Trustees that market conditions have changed and the future for hospitals unknown. Based on my surveys of Trustees in these organizations, the top concerns are these:
- Clinical innovation: how to effectively plan for clinical innovations that change how, where and who provides services (including technology-driven self-care). The disruptive impact of GLP-1, shift of focus to chronic care and usefulness of clinical AI are big unknowns. Notably, trustees assume their organization provides high-quality, evidence-based care whether verifiable or not.
- Competition with private equity funded disruptors: how to effectively compete against or partner with private equity sponsors to expand the scale and scope of near-term opportunities. Can PE be trusted? And which models they fund will emerge as cheaper/better alternatives to hospital services.
- Physician relationships: how to optimize working relationships with referring physicians (independent and employed) to assure utilization and streamline operations. Physicians are disgruntled. They believe their interests are not addressed effectively by hospitals.
- Growth and scale: small and rural hospitals are uniquely vulnerable to risks associated with Medicaid & Medicaid reimbursement cuts, workforce shortages and supply-chain costs. Solutions that enable scale-advantages enjoyed by larger organizations are not accessible and policies (i.e. rural emergency status) impractical.
- Workforce shortages: how to access and keep a workforce adaptable to changes in demand and in the clinical and technology innovations.
- Capital deployment: how to access and deploy capital for near-term technology and facility needs per master site plans while conserving capital due to economic uncertainty (tariffs, reimbursement, et al).
- Payer contracting: how to mitigate reimbursement pressures from Medicare, Medicaid, private insurers and large employers to secure revenues and grow. Trustees do not associate insurers with value-add services to hospitals or patients: they’re seen as a necessary administrative expense.
Transformational change in the U.S. health system is not contemplated by trustees because near-term survival requires their full attention. That’s a view reinforced by the hospital CEO and consistent with their admittedly limited understanding of the entire system.
In hospitals, there’s recognition that their future is not a repeat of the past and acknowledgement that declining trust, affordability and price transparency need more attention. All anticipate the MAGA (Make America Great Again)-MAHA (Make America Healthy Again)-DOGE (Department of Government Efficiency) tri-fecta will damage the short-and-long-term solvency and sustainability of hospitals though the extent is unknown. And all believe their management teams will experience internal pushback and personal stress in addressing each issue.
Final thought:
AHA and its Coalition to Strengthen America’s Healthcare have successfully defended hospitals against unwelcome regulations and disruptive competitors. It has successfully reinforced antipathy toward health insurers and deflected criticism of its prices to forces outside its control i.e. labor costs, drug and supply chain costs, unnecessary regulation, under-payments by Medicare and Medicaid and more.
Each time I engage with hospitals, I am reminded that hospitals play a unique role in communities and in every household. I am constantly impressed by the frontline hero’s that feel called to their role, the faceless support teams that keep the work going and the complexity of hospital operations and repercussions when we fall short. Nonetheless, hospitals are big business and, in the spotlight, as never before.
The issues above are real and the understandable focus of next week’s AHA Annual Meeting. What’s likely long-term for hospitals—their role and focus– and the future of the entire system will get less attention. What’s needed is attention to both.
Paul
Sections in today’s report
- Quotables
- Corporate Healthcare News of Note
- Employers
- Health Economy
- Hospitals
- Insurers
- Physicians
- Polling
- Regulators and Policy
Quotables
On DOGE HHS re-organization, workforce cuts: “The current weakly reasoned reorganization, accompanied by the offhand and contemptuous demolition of much of the workforce of HHS, is as logical as taking three different jigsaw puzzles, throwing out two-thirds of the pieces in each one, and trying to reconstruct the remaining pieces into a new puzzle. In combination, these efforts are likely not only to reduce the ability of HHS to improve the well-being of Americans but to work directly against the Administration’s stated goals of increasing the efficiency and effectiveness of the Department.”
Bill Frist on AI: “Generative AI is transforming healthcare by addressing one of its most persistent challenges: unstructured data. The industry generates a third of the world’s data—growing at 47% annually—but 80% remains trapped in PDFs, faxes, and EMRs. GenAI tools are now making this data actionable, powering automation in clinical documentation, medical coding, prior authorization, and patient communications.
These advancements arrive just as the system faces growing strain—from clinician burnout to negative operating margins. Near-term applications offer clear value, but broader adoption is slowed by infrastructure fragmentation, safety concerns, and the need for cultural change.
Looking ahead, GenAI is poised to reshape the entire healthcare stack: accelerating drug discovery, enhancing diagnostics, and ushering in AI-native infrastructure. While challenges remain, the trajectory is clear. GenAI won’t just make healthcare more efficient—it has the potential to make it more precise, proactive, and patient-centered
The AI Paradigm: A Doctor’s Perspective Home | Substack
The Economy on Gen Z: “In the weeks since, a stock market crash has come along to make things worse. Triggered by sweeping tariffs and investor unease, the downturn has sharply eroded retirement savings and reignited recession fears — hitting hardest just as Gen Xers were supposed to be settling into their peak earning years.
Since the start of April, losses have accelerated, leaving the S&P 500 down more than 11% year to date. The Nasdaq has plunged 17%. Apple (AAPL) stock — once a retirement-plan darling — has plunged more than 21%, dragging IRAs and 401(k)s down with it. And for mid-career workers who have relied on stock-based compensation to build wealth or bridge career shifts, the selloff has been doubly punishing.
This isn’t Generation X’s first system collapse. It might just be the most literal. And for many, it feels like a final insult.”
Generation X has a viral career crisis as stocks and savings tank
Corporate Healthcare News of Note
Walgreens Boots Alliance agreed to pay $300 million to settle allegations that it filled millions of invalid prescriptions for opioids and other controlled substances and illegally billed federal programs such as Medicare for those medications.
HCA Healthcare: Hospital operator beat Wall Street estimates for first-quarter profit on last Friday, as more people underwent elective procedures. The company reiterated its annual profit forecast of $24.05 to $25.85 per share, and said it includes the current and future impacts of policy developments, including the Trump administration’s tariffs on imports. HCA earned a profit of $6.45 per share in the first compared with $5.93 a year earlier and above analysts’ average estimate of $5.76 per share, according to data compiled by LSEG.
HCA Healthcare reaffirms 2025 guidance, beats on Q1 earnings
NC systems compete for hospital building approval: Systems competing to build hospitals in NC, a CON state. Novant-Duke competing against Kaiser-Cone (Risaant) to take advantage of aging population growth and bed shortage.
Certificate of Need North Carolina Novant Health Duke University Cone Health-Moses Cone Memorial Hospital Kaiser Permanente nonprofit hospitals Hospitals Providers
Employers
Lockton National Benefits Survey 2025: 1,817 employers across the U.S. responded to Lockton’s 2025 released April 22, 2025:
“Despite concerns over rising healthcare costs, many plan sponsors remain cautious, focusing on foundational cost-saving strategies that minimize disruption to employees. Sponsors, broadly, are not using more progressive and disruptive tactics such as contracting directly with a health system or hospital, requiring mandatory specialty site-of-care or excluding spouses with access to other coverage.”
Cost-saving strategies self-funded employers are using:
- Use carrier, narrow high-performing networks: 30%
- Utilize reference-based pricing: 6%
- Require specialty medicine to be obtained from a specialty pharmacy: 42%
- Use a spousal surcharge to reduce costs incurred by spouses on plans: 12%
2025 Lockton National Benefits Survey | Lockton
Health Economy
Pitchbook: Current environment for PE investing in healthcare: “Private equity dealmaking in healthcare services slumped in Q1 2025, with estimated deal volume hitting its lowest point since the 2020 pandemic crash. Still, major developments—like Sycamore Partners’ $10 billion take-private of Walgreens Boots Alliance and a spate of PE exits—signal shifting strategies amid economic headwinds and market volatility. Despite persistent challenges, segments like home-based care and musculoskeletal health are gaining traction, and market dislocation may spur deal flow as sellers capitulate on valuation. Read our latest analyst note for a closer look at sector performance, standout deals, and how changing market conditions are reshaping PE dealmaking in healthcare.”
Q1 2025 Healthcare Services PE Update | PitchBook
VMG on deal environment: “In 2024, the healthcare merger and acquisition (M&A) landscape navigated a challenging economic environment marked by persistent inflation, rising interest rates, and global economic instability. Despite these headwinds, the value of health services M&A deals saw a modest increase, rising from $63 billion in 2023 to $69 billion in 2024. This shift highlights that, while the overall volume of transactions has slowed, the value of select deals remains strong. Private equity (PE) firms, facing extended investment holding periods, are under increasing pressure from limited partners to deliver returns. This dynamic may lead to a resurgence in deal activity as these firms look to liquidate investments made during the 2020–2022 period. Major health systems are focused on portfolio optimization and recovering pre-COVID operating margins. More organizations are leveraging technological solutions, particularly artificial intelligence (AI), as a key strategy to maintain profitability. AI continues to attract significant interest, evidenced by a rise in venture capital funding for U.S. health AI startups, which reached approximately $23 billion in 2024. However, in the context of M&A activity, AI primarily serves to enhance operational efficiencies and drives strategic value in transactions. Another key trend that highlights the aim of optimization is the growing interest in vertical integration. Health systems are increasingly acquiring or creating joint ventures with ancillary healthcare services, such as outpatient care centers, post-acute providers, and behavioral health, to create more comprehensive care models, reduce costs, and enhance patient outcomes—all while responding to patient preferences for convenient and accessible care. “
2025 Healthcare M&A Report – VMG Health.pdf
Commonwealth Report: Effects of Potential 2025 Premium Tax Credits Expiration: Key Economic, Employment, and Revenue Losses If Enhanced Premium Tax Credits Expire in 2025
| Year: 2026 | State GDP lost ($ millions) | Total jobs lost (1,000s) | State/Local taxes lost ($ millions) |
| Nonexpansion states | -$22,860 | -194.3 | -$1,269 |
| Expansion states | -$11,231 | -91.3 | -$811 |
| United States total | -$34,090 | -285.56 | -$2,079 |
Commonwealth Fund, The Cost of Eliminating the Enhanced Premium Tax Credits, March 2025
Press Ganey: “Healthcare Employee Experience 2025” takeaways:
- Engagement is declining—And it matters. Engagement declined by 0.02 points in 2024—small but noticeable. Disengaged employees are 1.7x more likely to leave, especially early-tenure staff.
- Turnover improved slightly, but may be poised for a reverse. Turnover dropped from 20% to 18%, but falling engagement—especially among front-line roles—could reverse that trend in 2025.
- Advanced practice providers and physicians are under the greatest strain. APP engagement fell 0.08 points; only 52% feel heard. Physician engagement and alignment also declined, increasing burnout and turnover risk.
- Safety culture has plateaued; concerns about safety are rising. Only 78% of employees believe their organization cares about their safety—a two percentage point drop from last year.
- Perception of teamwork is increasingly important. Strong teamwork boosts outcomes and retention. RNs with low teamwork scores are 1.53x more likely to leave.
- Younger generations are motivated differently. Millennials and Gen Z report lower engagement and higher turnover, valuing career growth, inclusion, and strong leadership.
- Retention is not driven by compensation. Trust, respect, and belonging—not pay—are the strongest predictors of engagement and intent to stay.
What Keeps Healthcare Workers Engaged? New Report Points to Trust and Teamwork | Press Ganey
NORC: Patients’ Trust in Health Systems to Use Artificial Intelligence: NORC surveyed 2039 consumers in the summer of 2023. Results:
“General trust in the health care system, on a scale of 0 to 12 with 12 indicating highest trust, had a mean (SD) score of 5.38. Most respondents reported low trust in their health care system to use AI responsibly (65.8%) and low trust that their health care system would make sure an AI tool would not harm them (57.7%).
This analysis found low trust in health care systems to use AI responsibly and protect patients from AI-related harms. General trust in the health care system, but not health literacy or AI knowledge, was associated with these perceptions…Low trust in health care systems to use AI indicates a need for improved communication and investments in organizational trustworthiness.
Urban Institute: Health Care Spending with and Without Medicaid Expansion FMAP, 2026: Health Care Spending for the Nonelderly by Insurers (Public and Private) and Households, with
(Current Law) and without Medicaid Expansion FMAP, (Federal Medical Assistance Percentage) 2026:
| Current law | No expansion FMAP, all states drop expansion |
Difference | |
| Total health care spending | $2,232.1** | $2,152.2** | $-79.9** |
| Hospitals | $786.6 | $754.7 | $-31.9 |
| Physician practices | $358.7 | $352.2 | $-6.4 |
| Other services | $588.3 | $567.6 | $-20.7 |
| Prescription drugs | $498.5 | $477.6 | $-20.9 |
Urban Institute, March 2025
Hospitals
Chartis: Health System CSO organizational priorities: From a December 2024 survey of 61 health system chief strategy officers serving systems with $1 billion or more revenue: executives In December 2024, we surveyed 61 senior strategy executives at US health systems with an annual revenue of $1 billion or more:
- Ability to recruit physicians: 56%
- Competition from other health systems: 48%
- Organization’s overall financial strength and ability to invest in the future: 41%
- Ability to recruit non-physician clinical workforce (i.e., nurses, allied health): 39%
- Ability to recruit the right leadership talent: 34%
- Organizational ability to execute plans: 25%
- Competition from non-health system entities (i.e., payers, startups, investor-backed entities): 21%
Chartis, Pressures and promise: US health system priorities 2025–2030, February 2025
Cassidy investigates 340B: A new report on the 340B Drug Pricing Program released last Thursday by the chairman of the Senate Health, Education, Labor and Pensions Committee calls for “much-needed” legislative reforms around transparency and oversight of the contentious discount program. Chairman Bill Cassidy, M.D., R-Louisiana, kicked off his investigation in late 2023 as a response to substantial increases in the program’s utilization among providers.
Cassidy said the “investigation underscores that there are transparency and oversight concerns that prevent 340B discounts from translating to better access or lower costs for patients,” and the report outlines potential reforms needed to improve the program to better serve patients.
Fierce Healthcare: Cassidy Backs Greater 340B Hospital, Pharmacy Transparency
AHA Response to Cassidy Report: “In a statement shared with media, AHA President and CEO Rick Pollack said, “The AHA appreciates Senator Cassidy’s leadership on 340B issues. As his report correctly observes, the 340B program was created to help hospitals reach more eligible patients and provide more comprehensive services. Even this investigation — which the report recognizes was ‘limited in scope’ given the variety of 340B hospitals across the country — demonstrates that hospitals use 340B savings to provide financial assistance to low-income patients and to maintain programs that enhance patient services and access to care. In short, 340B is vital in advancing health in communities across the country.
We look forward to reviewing the report in greater detail, discussing it with our 340B members, and working with Senator Cassidy and others to ensure that the 340B program continues to benefit patients and communities, especially those in rural and other medically underserved areas.”
Cassidy releases report calling for reforms to 340B program | AHA News
Fitch: Non-profit hospital financial volatility: Market volatility poses a growing challenge to nonprofit providers’ balance sheets, analysts from Fitch Ratings warned in a pair of research notes published this week.
- “Nonprofits enjoyed steady investment returns in recent years due to strong stock market performance and interest rate hikes, the credit rating agency said. However, the party may be momentarily over, as President Donald Trump’s flip-flopping tariff policies have thrown markets into turmoil.
- Should health systems see their investment income decline, cash on hand could fall nearly 7% from the first half of 2024, hindering health systems’ ability to weather other headwinds including inflation and tight labor conditions.”
Threats to health systems’ investment portfolios shouldn’t be taken lightly…This liquidity acts as a buffer against unforeseen operating challenges that could potentially compress operating margins. From 2020 to 2023, when the markets were strong, investment returns helped add 28 days to providers’ median days of cash on hand and 18 percentage points to the median cash-to-adjusted debt ratio… Health systems carried a median of 220 days of cash on hand during this time. Now, a 25% reduction in investment income could reduce the sector’s median days of cash on hand to 215, while a 75% reduction in investment income could slash median cash on hand to 205.
On Thursday, Fitch said it predicts providers’ credit ratings could also take a hit as a result of the market turmoil. The agency expects to see credit trends deteriorate economy-wide during the second quarter as the trade war heats up, and the outlook for economic growth and inflation worsens.
U.S. Credit Trends to Deteriorate Amid Tariffs and Policy Volatility
Growing market volatility spooks hospital analysts | Healthcare Dive
Insurers
Chartis: Enrollment trends: Original Medicare vs. Medicare Advantage 2020-2025:
| Year | Medicare Advantage Change | Original Medicare Change | Total |
| 2020-2021 | 2.4M | -1.2M | 1.2M |
| 2021-2022 | 2.3M | -1.2M | 1.1M |
| 2022-2023 | 2.0M | -0.7M | 1.3M |
| 2023-2024 | 2.2M | -0.8M | 1.4M |
| 2024-2025 | 1.3M | 0.2M | 1.5M |
Chartis, Medicare Advantage market growth slows amid intensified headwinds, March 2025
Urban Institute Report: Medicaid work requirement impact on states: Researchers analyze policy proposals that would withhold federal funding for adults enrolled in Medicaid expansion who do not report working for at least 80 hours per month or meet exemption criteria, such as being a student, family caregiver, or having a disability. Key Findings
- At least 10,000 adults would lose coverage in nearly every expansion state.
- Coverage losses would be highest in states with large populations like California (1–1.2 million) and New York (743,000–846,000) and would number more than 100,000 in Arizona, Illinois, Indiana, Kentucky, Louisiana, Michigan, New Jersey, North Carolina, Ohio, Pennsylvania, and Washington.
- Researchers say coverage losses could vary widely based on state Medicaid programs’ administrative capacity and how they choose to implement requirements, as well as details of the final federal legislation and regulatory guidance.
Conclusion: “…nearly all people who would lose coverage under a federal Medicaid work requirement are already working, engaged in work-related activities, or meet exemption criteria.”
How Work Requirements Would Affect Medicaid Coverage in Each Expansion State
Related: “… limited real-word experience suggests that Medicaid work requirements don’t promote employment or save large sums of money, but do cause many enrollees to lose coverage, such as what happened in Arkansas in 2018 and 2019. The first Trump administration invited states to implement work requirements, but President Joe Biden adopted the opposite position and courts blocked many state programs.
Using work requirements as a way to save money may also prove difficult because the policy would apply to few people.
There were 26.1 million adults enrolled in Medicaid who do not receive disability benefits or qualify for Medicare as of March, according to an analysis of Centers for Medicare and Medicaid Services data published by the healthcare research institution KFF.
Of those, 44% work full-time, 20% work part-time, and 29% aren’t working because they are students, caring for a family member or are ill. The remaining 8% cite retirement, inability to find work or other reasons for not having a job.
That amounts to just over 2 million people nationwide who would be subject to work requirements under previous proposals and state programs, although many more would have to prove they are working.”
Medicaid work requirement lessons from Arkansas, Georgia | Modern Healthcare
Physicians
Study: Private Equity–Owned Ophthalmology Practices 2014-2022: “Private equity (PE) firms have increased their ownership stake across health care sectors in the US. PE’s focus on short-term profitability may decrease the provision of unprofitable services, reducing access for patients in vulnerable populations. This is a particular concern for certain eye conditions such as retinal detachment, for which access to timely surgery is necessary to prevent irreversible vision loss and for which reimbursement is below cost for the fee-for-service Medicare population. Using a difference-in-differences approach, we examined changes in the provision of retinal detachment repair by 535 physicians in PE-acquired practices and 1,070 matched controls during the period 2014–22. Relative to matched controls, physicians in PE-acquired practices decreased the number of retinal detachment repairs by 19.6% after acquisition. These findings shed light on how PE acquisitions can affect the provision of services that do not present financial opportunities for investors. As nearly 30% of retina specialists are affiliated with PE firms nationally, further investigation into PE’s impact on access for patients is warranted to determine whether PE acquisitions require patients to travel longer distances or have longer wait times, which could have serious effects on patient outcomes.
Private equity (PE) acquisitions of physician practices have increased sharply in the past decade, especially within procedural specialties such as dermatology, ophthalmology, and gastroenterology. PE firms invest in physician practices to generate above-market returns and resell the practice within three to seven years…
Understanding the effect of PE acquisition on patients’ access to care for services that might be unprofitable for investors is of particular salience within ophthalmology, an attractive target for PE firms. PE acquisitions in ophthalmology tripled between 2016 and 2019, with more than 10 percent of ophthalmologists estimated to be working in PE-acquired settings as of 2019…”
Polling
CNN Poll: The latest CNN poll was conducted by SSRS online or by phone from April 17-24 among a random national sample of 1,678 US adults drawn from either a probability-based panel or from a voter file. Results:
“Since March, Trump has seen notable drops in approval from women and Hispanic Americans (down 7 points in each group to 36% among women and 28% among Hispanics). Partisan views of Trump remain broadly polarized, with 86% of Republicans approving and 93% of Democrats disapproving. But among political independents, the president’s approval rating has dipped to 31%, matching his first-term low point with that group and about the same as his standing with them in January 2021.
The poll finds the president underwater and sinking across nearly all major issues he’s sought to address during his time in office, with the public’s confidence in his ability to handle those issues also on the decline…”
Poll: Trump’s approval rating at 100 days in office | CNN Politics
Edelman: 2025 Edelman Trust Barometer: Based on surveys of about 16,000 adults in 16 countries, 2024 to 2025:
- The share among ages 18 to 34 favoring social media medical advice rose from 26% to 38%, while advice from friends or family rose from 32% to 45%.
- 45% of adults age 18 to 34 said they’ve disregarded their health provider’s guidance in favor of information from a friend or family member in the past year — a 13-point increase from the previous year.
- 38% of young adults said they’ve ignored their provider in favor of advice from social media, a 12-point increase from the year before.
- The vast majority of young adults (82%) still said their individual doctor has influenced their health decisions. But one-third of young adults also reported content creators without medical training have influenced their health decisions.
- Some 45% of young adults say the average person can know as much about health matters as trained doctors, a 7-point increase from 2024 survey data.
New York Times/Siena Poll: New York Times/Siena College poll of 913 registered voters conducted from April 21 to 24, 2025:
- 36% think the U.S. is heading in the right direction vs. 53% wrong direction and 11% who aren’t sure.
- 22% think economic conditions are excellent or good vs. 76% who think they’re fair/poor
- 45% says their personal finances are excellent or good vs. 54% who say they’re fair/poor
KFF Poll: Access to Providers in Rural Communities: Percent who say there is not enough of the following in their communities to serve local residents
| Hospitals | Primary care doctors | Specialist doctors | Mental health care providers | |
| Adults overall | 29% | 39% | 48% | 59% |
| Current personal or family connection to Medicaid |
32% | 37% | 50% | 60% |
| Rural residents | 34% | 49% | 71% | 67% |
KFF Health Tracking Poll February 2025: The Public’s Views on Potential Changes to Medicaid, March 2025
Regulation and Policy
Supreme Court on ACA Preventive services coverage mandate: The Associated Press reports that Affordable Care Act’s mandate that health insurers cover preventive care appears likely to survive a legal challenge currently before the Supreme Court based on last Monday’s oral arguments: conservative justices including Amy Coney Barrett and Brett Kavanaugh appeared skeptical of arguments that the ACA’s process for determining which services must be covered by health insurance violates the Constitution. Some justices suggested the case could be returned to the lower court. In any case, a ruling is expected by the end of June.
Physician accreditor executive orders: Last week, President Trump issued an executive order that aimed at the nation’s two medical school and graduate training accreditation organizations (Liaison Committee on Medical Education (LCME) and GMENAC )for their “unlawful discriminatory practices” that compel their institutions to adopt diversity, equity, and inclusion (DEI) standards, which his administration is trying to eliminate. “Reforming Accreditation to Strengthen Higher Education” order stipulates that the Secretary of Education shall “resume recognizing new accreditors to increase competition and accountability in promoting high-quality, high-value academic programs focused on student outcomes.”
CDC Measles update: There have been 884 confirmed cases of measles nationwide so far this year, with cases reported by 29 states, according to the latest data from the Centers for Disease Control and Prevention. There have been 11 outbreaks, and 93% of confirmed cases (820 of 884) are outbreak-associated. The vaccination status of 97% of all cases is classified as “unvaccinated or unknown.”
White House Drug executive order on drug prices: On Tuesday, April 15, President Trump issued an executive order focused on “lowering drug prices by once again putting Americans first.” This lengthy order instructs a range of executive actors to engage in drug pricing-related issues, both on their own and through working with Congress. Many of the directions included in the order will be familiar to those who watched drug pricing policy closely during the first Trump Administration, though the portions of the order relating to the Inflation Reduction Act’s (IRA) Medicare drug price negotiation program are more novel.
“Within 180 days of the date of this order, as appropriate and consistent with applicable law, the Secretary shall publish in the Federal Register a plan to conduct a survey under section 1833(t)(14)(D)(ii) of the Social Security Act to determine the hospital acquisition cost for covered outpatient drugs at hospital outpatient departments. Following the conclusion of this survey, the Secretary shall consider and propose any appropriate adjustments that would align Medicare payment with the cost of acquisition, consistent with the budget neutrality requirement in section 1833(t)(9)(B) of the Social Security Act and other legal requirements
Administration Lays Out Drug Pricing Plan Through Executive Order | Health Affairs
On April 21, 2025, the Supreme Court heard oral argument in Kennedy v. Braidwood Management, Inc. over the constitutionality of a key part of the Affordable Care Act’s (ACA’s) long-standing requirement to cover evidence-based preventive services without cost sharing. Initially filed in 2020 as Kelley v. Azar, this litigation has now spanned three presidential administrations and been defended in court by both Trump administrations and the Biden administration.
