July 2025 will be the month U.S. healthcare leaders recognize as the industry’s modern turning point. Consider…
- On July 4, the One Big Beautiful Bill Act was signed into law setting in motion $960 billion in Medicaid cuts over the decade and massive uncertainty among those most adversely impacted—low income and under-served populations dependent on public programs, 8 to 11 million who used now-suspended marketplace subsidies to buy insurance coverage, and hundreds of state and local health agencies left in funding limbo.
- On July 15, the Bureau of Labor Statistics reported the June Consumer Price Index rose .3% bumping the LTM to 2.7% (lower than LTM of 3.4% for medical services). Prices have edged up.
- On July 31, President Trump issued an Executive Order to 17 drug companies ordering them to reduce prices on their drugs by September 29 or else. And CMS issued final rules for FY2026 Medicare payments to hospitals, rehab and other providers reflecting increases ranging from 2.5-3.3% effective October 1.
- And on the same day, the Bureau of Labor issued its July 2025 jobs report that showed a disappointing net gain of 73,000 jobs plus downward revisions for May and June of 258,000 sparking Wall Street anxiety and President Trump to call the results “rigged” before firing BLS head Erika McEntarfer. Note: healthcare added 55,000 in July—the biggest of any sector and more than its 42,000 average monthly increase.
Collectively, these actions reflect rejection of the health industry by the GOP-led Congress. It follows 15 years of support vis a vis the Affordable Care Act (2010) and pandemic recovery emergency funding (2020-2021). In that 15-year period, the bigger players got bigger in each sector, investment of private equity in each sector became more prevalent, costs increased, affordability for consumers and employers decreased, and the public’s overall satisfaction with the health system declined precipitously.
For the four major players in the system, the passage of the “big, beautiful bill” was a disappointment. Their primary concerns were not addressed:
- Physicians wanted relief from annual payment cuts by Medicare preferring reimbursement tied directly to medical inflation. And insurer’ prior authorization and provider reimbursement was a top issue. Status: Not much has changed though adjustments are promised.
- Hospitals wanted continuation of federal Medicaid funding, protection of the 340B drug purchasing program, rejection of site-neutral payment policies, higher Medicare reimbursement and relief from insurer prior authorization frustrations. Status: Medicaid funding is being cut forcing the issue for states. CMS payment increases for 2026 are lower than operating cost increases. Insurers have promised prior-auth relief but details about how and when are unknown. And Congress posture toward hospitals seems harsh: price transparency compliance, safety event reporting, and cost concerns are bipartisan issues.
- Insurers wanted sustained funding for state Medicaid and Medicare Advantage programs and federal pushback against drug prices and hospital consolidation. Status: Congress appears sympathetic to enrollee complaints and anxious to address insurer “waste, fraud and abuse” including overpayments in Medicare Advantage.
- Drug companies oppose “Most Favored Nation” pricing and want protections of their patents and limits on how much insurers, pharmacy benefits managers, wholesalers, online distributors and other “middlemen” earn at their expense. Status: to date, little action despite sympathetic rhetoric by lawmakers. Status: to date, Congress has taken nominal action beyond the Inflation Reduction Act (2022) though 23 states have passed legislation requiring PBMs, insurers and manufacturers to disclose drug prices and 12 states have established Prescription Drug Affordability Boards to monitor prices.
My take:
The landscape for U.S. healthcare is fundamentally changed as a result of the July actions noted above. It is compounded by public anxiety about the economy at home and global tensions abroad.
These July actions were a turning point for the industry: responding appropriately will require fresh ideas and statesmanship. Transparency about prices, costs, incentives and performance is table stakes. Leaders dedicated to the greater good will be the difference.
Paul
References cited in this report are sourced from citations below. Sections in today’s report:
- Quotables
- Economy
- Hospitals
- Insurers
- Prescription Drugs
- Public Health
- Regulators
Quotables
Miller on price transparency: “If we look at the last OIG [Office of Inspector General] report , we saw that 37 out of 100 hospitals complied with the two major components of the rule.
To fix that problem, we should routinely audit large health systems — with a focus on tax-exempt institutions — and then we should couple this with implementation of penalties and publicization of non-compliance. Think the ‘Walk of Shame’ from ‘Game of Thrones.'”
Brian Miller, Hopkins hospitalist and member of the Medicare Payment Advisory Commission (MedPAC) testifying at the Senate HELP committee July 31, 2025. How to Make Healthcare Affordable? Senators’ Suggestions Vary Widely | MedPage Today
Historian Tomes on system reform: “No market solution has arisen for the most critical determinant of poor health and health care outcomes in the United States: extreme income inequality. Countless studies indicate that poverty is the most important health risk factor that Americans face. Yet a market-driven health care system offers limited incentives to lower that risk; little profit can be made by preventing or treating poverty-induced illnesses.
U.S. health care needs a new business model. Many physicians resist the pressures to pursue economic goals at patients’ expense, spending countless hours convincing pharmacy benefit managers and insurance companies to cover necessary care. But only more collective physician and patient action will help medicine find a more equitable, sustainable model.
Meanwhile, the Trump administration appears intent on blowing up our fragile health care system in the name of an unrestrained “free market” and corporate profiteering. Many people will suffer if the system collapses completely, but perhaps a more sustainable health care system can be built from the rubble.”
A Gilded Age for Patients? The Broken Promises of Profit-Driven Medicine | New England Journal of Medicine August 2, 2025
CMS on new Interoperability Framework: “We’re done waiting. The CMS Interoperability Framework is a call to action for health data networks that want to move faster – to make what should already work, actually work by voluntarily meeting the CMS Interoperability Framework criteria to be listed as a CMS-Aligned Network.
This is a voluntary blueprint for modern health data exchange that puts patients and providers first. It is open, standards-based, and market-friendly, so that the industry can stop theoretical debates and start delivering real results. CMS is offering shared infrastructure and clear criteria, and we’re inviting any network – big or small – that’s ready to lead.
This effort is not intended to create new regulatory burdens. Just alignment, execution, and momentum. Come one, come all.
The Interoperability Framework has two parts: the criteria that define data sharing principles and the different categories of participants, such as networks, EHRs, providers, payers, and digital health products. All participants should understand the framework criteria overall and consult the participant-specific sections for the requirements applicable to their role.”
Keckley Note: The July 31 announcement by CMS included 60 organizations that support the framework including 7 health systems (AtlantiCare, Bon Secours Mercy Health, Cleveland Clinic, Froedtert ThedaCare Health Inc, Intermountain Health, Providence, Sanford Health) along with Amazon, United Health Group, Epic, Oracle Health and others. Notably, none of the 7 hospital systems is investor-owned.
Interoperability Framework | CMS
Health Affairs on Medicare Advantage Growth: “Compelling evidence demonstrates that Medi-care substantially overpays private plans, dis-torts choice for beneficiaries, and has a funda-mentally uneven playing field for MA and traditional Medicare. Yet reforming MA generates staunch opposition from insurance companies and their proponents, who argue that lower MA payments harm beneficiaries by reducing benefit generosity. Despite limited evidence supporting their contention (studies have found that reducing MA payments has modest effects on benefits), MA plans use lobbying and litigation to block reform.
In addition to traditional Medicare having substantially less generous benefits, the current system fundamentally distorts competition among MA plans. Despite some insurers not up coding while others upcode by 50%, Medicare applies a uniform percentage reduction to plan capitation, causing half of plans (with 15% of enrollees) that upcode relatively little to lose money while plans that aggressively upcode generate billions of dollars in windfalls that fuel consolidation. Between 2008 and 2024, the MA market share of the three largest insurers (two of which are among the most aggressive upcoders) rose from 32%to 59%. Reforming the upcoding adjustment from a uniform reduction to an amount based on each insurer’s actual upcoding would reduce or eliminate windfalls from aggressive upcoding…
The answer to the policy question of how many enrollees remain in MA not for the extra benefits and lower out-of-pocket and premium costs, but because they are effectively foreclosed from Medigap if they switch to traditional Medicare during open enrollment, is unknown. Overpayments in 2025 equal approximately 10% of total Medicare spending, benefiting only enrollees in MA plans. In addition to increasing taxpayer costs, overpaying MA increased Part B monthly premiums by $13 billion for 2025. Without reform, the trends of increasing MA and declining traditional Medicare enrollment will continue and likely accelerate as the disparity between benefits and enrollee costs in traditional Medicare and MA widens, fueled by rising overpayments from favorable selection and upcoding. “
Inside The Meteoric Rise of Medicare Advantage July 30, 2025
Milbank on Big Beautiful Bill: “This month, Congress passed HR1/OBBBA, which is estimated in the next decade to cause 16 million Americans to lose coverage and add $3.4 trillion to the federal deficit. The health of Americans will suffer as a result — especially for those who are poorer, sicker, live in rural settings, and are members of racial and ethnic minority groups with higher rates of Medicaid enrollment. The bill will also create significant burdens for state governments that will have to administer more complicated programs on tighter budgets.
The role of state health policy leadership will be increasingly important as the federal government retrenches.”
NEJM Editor on Medical Journalism: “With Robert F. Kennedy Jr., the health and human services secretary, threatening to bar government scientists from publishing in our journals in favor of in-house, government-run publications, this moment demands a clear reminder of why the current system exists. Just as democracy depends on a free and independent press to hold power accountable, medical progress depends on independent journals to vet, challenge and advance science without political interference.
Scientific progress is not abstract. It touches all of us directly and often profoundly. But it reaches patients safely only through a system built to test ideas, expose flaws and communicate results with care.”
Eric J. Rubin is editor in chief of the New England Journal of Medicine and the NEJM Group. Kirsten Bibbins-Domingo is editor in chief of JAMA and the JAMA Network
Opinion | Medical journals are critical to Americans’ health – The Washington Post July 21, 2025
Beckers on Medicare anniversary: “July 30, 2025, marks the 60th anniversary of Medicare and Medicaid, which have grown to cover about 140 million people combined, including older adults, people with disabilities and low-income families. Medicare insures more than 68 million people, while 71 million are enrolled in Medicaid.
That safety net is under pressure. Millions of Americans are projected to lose their health insurance in the coming years due to Medicaid cuts and ACA reforms outlined in The One Big Beautiful Bill Act, which President Donald Trump signed into law July 4. The Congressional Budget Office estimates the legislation will increase the number of uninsured Americans by 10 million by 2034…
Cuts to Medicaid, the expiration of the ACA’s enhanced premium tax credits at the end of 2025, and threats of Medicare reductions are placing millions of Americans’ coverage and access to care at risk.”
Slubowski on Trinity strategy, physician partnerships: “We have focused on growth in home care and our medical groups. We’re expanding our freestanding ambulatory surgery centers and imaging. We’re doing virtual visits as well. That’s where healthcare is going — it’s ambulatory, it’s home, it’s virtual. Our strategy is across all 26 states. Of course, it varies by state depending on the population, the existence of other competitors and our ability to partner with physicians in those communities. We have the overarching plan, but we then translate it into what needs to happen specifically in each state we serve.
We have had many deals with physicians to do ambulatory surgery. We have 41 ambulatory surgery centers where we have controlling and minority interests. Our ownership percentages vary. Some are new, and some are existing surgery centers we’ve had the opportunity to partner with. We’ve built our own staff to support this effort.
The reality is, if we’re not open to partnerships with physicians beyond employment or other joint ventures, they’re going to do practice on their own. They’re going to find other partners. It’s important for us to have that capability to serve in partnership with them.”
Trinity Health’s Mike Slubowski invests in ambulatory centers – Modern Healthcare
Economy
Study: Projected Savings from Reducing Low-Value Services in Medicare: Researchers estimated the utilization and potential savings achievable by reducing 47 low-value services used by Medicare beneficiaries for the period 2018-2020. Findings:
“Based on claims of 3.7 million beneficiaries, Medicare annually spent $3.6 billion across 2.6 million cases of the 47 low-value services between 2018 and 2020, with an additional $800 million annually paid from out-of-pocket payments. The top 20 services accounted for 95% of total annual spending ($4.2 billion of $4.4 billion). Five USPSTF grade D services among these were responsible for 59% ($2.6 billion), with chronic obstructive pulmonary disease and bacteriuria screening being the costliest. Four of the top 5 most frequently provided services were low-value imaging for conditions such as plantar fasciitis, headache, syncope, and low back pain.”
Cleveland Fed report: “New-tenant rent inflation rose sharply during the COVID-19 pandemic, subsequently falling. Concomitantly, consumer price index (CPI) tenant rent, which measures rent increases for both new and continuing renters, rose more gradually and, after falling somewhat, has remained elevated. To illustrate why CPI rent inflation has remained elevated, we combine a measure of new-tenant rents and annual renter mobility rates to create a simulated CPI tenant rent inflation measure. We use this simulation to define a “rent gap” that represents the difference between actual CPI tenant rent inflation and rent inflation we would observe if every tenant experienced new-tenant rent inflation. This gap has declined since hitting its peak at the end of 2022 but remains high, implying that existing rents for continuing renters may still be notably below new-tenant rent levels and that rent inflation may remain elevated. However, the future path remains uncertain because it depends on future mobility rates, future passthrough rates, and future new-tenant rent inflation…. Our baseline forecast implies that CPI rent inflation will remain above its prepandemic norm of about 3.5% until mid-2026. Our alternative forecasts highlight both upside and downside risks to this forecast.”
New-Tenant Rent Passthrough and the Future of Rent Inflation
Bureau of Labor July jobs report: Friday, the BLS released its July jobs report surprising some and prompting the President to say the numbers are “rigged” and firing the BLS’ long-time Highlights:
- The U.S. added a seasonally adjusted 73,000 jobs in July, the Labor Department reported Friday, below the gain of 100,000 jobs economists polled by The Wall Street Journal had expected to see.
- Revisions cut down the jobs growthoriginally reported for May and June by a combined 258,000. That left May as having added just 19,000 jobs and June just 14,000.
- Total nonfarm payroll employment changed little in July (+73,000) and has shown little change since April. Over the month, employment continued to trend up in health care and in social assistance. Federal government continued to lose jobs.
- In July, health care added 55,000 jobs, above the average monthly gain of 42,000 over the prior 12 months. Over the month, job gains occurred in ambulatory health care services (+34,000) and hospitals (+16,000).
- Social assistance employment continued to trend up in July (+18,000), reflecting continued job growth in individual and family services (+21,000).
- The unemployment rate rose slightly to 4.2% from 4.1%. The number of people unemployed for 27 weeks or longer increased to 1.83 million from 1.65 million in June.
Employment Situation Summary – 2025 M07 Results
New York Times: Stock Market jitters: “Data showing cracks in the U.S. labor market and President Trump’s newest barrage of tariffs shook investors around the world, weighing on stocks, the dollar and more. After months of rallying and periods of relative calm, stocks tumbled on Friday as fresh economic data reflected unexpected signs of weakness in the labor market and President Trump announced steep new tariffs against some of America’s largest trading partners. The S&P 500 ended the day down 1.6%, capping one of the index’s worst weeks since Mr. Trump wrought chaos across the global trading system when he unveiled his first round of steep tariffs in April. The benchmark fell 2.4% for the week.
Stock Market Posts Worst Week in Months on Renewed Economic Fears – The New York Times
CMS: Projected Health Expenditures, selected calendar years 2022-33
| Year | National health expenditures (NHE) per capita* | Personal health care (PHC) expenditures per capita* |
| 2022 | $13,617 | $11,299 |
| 2023 | $14,570 | $12,297 |
| 2024 | $15,610 | $13,237 |
| 2025 | $16,570 | $14,051 |
| 2027 | $18,247 | $15,450 |
| 2033 | $24,200 | $20,559 |
* In billions
CMS via Health Affairs, June 25, 2025
Hospitals/Health systems
Modern Healthcare: Increasing hospital operating costs: “Rising healthcare costs and declining reimbursement rates are forcing hospitals to rethink how they operate and deliver care.
High pharmaceutical, labor and administrative expenses coupled with looming Medicaid and Medicare cuts mandated by the new tax law are dragging hospital finances. As a result, providers are implementing new technology, tweaking their staffing models and retooling supply chain operations to try to eke out savings before reimbursement reductions and an expected decline in Medicaid enrollment hit, health system executives said.”
Rising costs, Medicaid cuts drive hospitals’ efficiency overhaul – Modern Healthcare
HHS OIG report: Under-reporting of harmful events: “Hospitals did not capture half of patient harm events in their incident reporting or other surveillance systems Hospitals miss opportunities to learn from and reduce harm when their incident reporting or other systems fail to capture harm events. Our review found that these systems did not capture 49%of harm events that occurred among hospitalized Medicare patients in October 2018…. When hospitals missed patient harm events, it was often because staff did not consider them to be harm or, as staff explained, it was not standard practice to capture them. Hospitals did not capture many of the harm events in their incident or other reporting systems, largely because they used narrow definitions of patient harm. Hospital staff did not consider 46% of missed events to be harm… In addition to narrow definitions of patient harm, hospital staff reported not capturing harm events because they were difficult to distinguish from the patient’s underlying disease (20%) or because the event occurred after the hospital discharged the patient (4%).
Hospitals Did Not Capture Hald of Patient Harm Evens, Limiting Information Needed to Make Care Safer OIG July 2025
Study: online reviews of healthcare facilities: “A total of 1,099. 901 online reviews from 138,605 facilities were identified over the 7-year study period. Among these, nearly one-half (46.3%) were negative and one-half (50.1%) were positive, with a median (IQR) rating of 4 (1-5) stars. The word “not” was most correlated with negative ratings (r = 0.31; 95% CI, 0.31–0.32), whereas “and” was most correlated with positive ratings (r = 0.35; 95% CI, 0.35–0.36). Among 200 topics, the strongest negative correlations involved payment issues (r = 0.25; 95% CI, 0.25–0.25) and poor treatment (r = 0.24; 95% CI, 0.23–0.24); the strongest positive correlations involved kindness (r = 0.32; 95% CI, 0.32–0.32) and anxiety relief (r = 0.32; 95% CI, 0.32–0.32).
In this cross-sectional analysis, negative patient experiences frequently centered on quality of communication and administrative issues. Negative feedback centered on unmet expectations, whereas positive reviews emphasized supportive staff interactions. Incorporating real-time online-review data into existing quality-improvement frameworks—such as patient experience dashboards or service recovery protocols—could help clinicians, administrators, and policymakers identify emerging concerns, monitor patient sentiment, and tailor interventions that enhance patient-centered care across diverse health care settings.”
Online Reviews of Health Care Facilities | Health Policy | JAMA Network Open | JAMA Network
Trilliant analysis: CMS phase-out of Inpatient Only List (IPO): “CMS’s proposal to phase out the IPO list beginning in 2026 would remove 285 mostly musculoskeletal procedures from inpatient-only designation. This shift could accelerate outpatient migration of surgical volume, as seen when inpatient total hip arthroplasty volume declined 35.8% the year after its 2020 removal. If finalized, the policy will have financial and operational implications for hospitals, particularly those dependent on high-margin inpatient procedures.”
McKinsey report: Value-based specialty care: Patients requiring specialty care account for a growing share of healthcare spending. In 2023, direct specialty spending on orthopedics, oncology, cardiology, women’s health, behavioral health, and nephrology reached 38% of total medical spending. Total cost of care (TCOC) for patients seeing specialists in these six areas accounted for 68% of total commercial and Medicare spending in 2023…
..While more than half of original Medicare members are under a value contract with their primary care physician, VBC covers only about 28%of patient lives in nephrology, 20% in orthopedics, and 5% or less in the other highest-spending specialties, such as cardiology, oncology, women’s health, and behavioral health.7
Value creation in US healthcare: Reducing specialty costs | McKinsey
Kennedy suspends employee vaccination: Friday, Health and Human Services Secretary Robert F. Kennedy, Jr. announced additional repeals of federal policy that financially rewarded hospitals for reporting staff vaccination rates.
“Medical decisions should be made based on one thing: the wellbeing of the person – never on a financial bonus or a government mandate.” said Secretary Kennedy. “Doctors deserve the freedom to use their training, follow the science, and speak the truth-without fear of punishment.”
The policy, established under the Biden administration’s Centers for Medicare & Medicaid Services (CMS) inpatient payment rule, tied hospital reimbursement to staff vaccination reporting. The data was published on CDC’s National Healthcare Safety Network as a tool for public shaming, not public health.
HHS, CMS Eliminate Financial Pressure Tied to Hospital Staff Vaccination Reporting Aug. 1, 2025
Study: factors associated with the use of outpatient surgery: “In this cross-sectional study of 456 954 participants, variations in the use of outpatient surgery were associated primarily with geographic location. Lower frequency of outpatient surgery at hospitals in the Northeast and Pacific Coastal regions was not explained by patient- or hospital-related factors…
The likelihood of outpatient surgery varied significantly by hospital census division for all 10 operations (eg, MIS salpingo-oophorectomy range, 29.6%-58.8%; P < .001). Variation in hospital census division contributed most to outpatient surgery for 8 of 10 operations compared with other patient and hospital characteristics “
Variations in the Use of Outpatient Surgery | Health Policy | JAMA Network Open | JAMA Network
Sullivan Cotter Report: Executive Compensation: Per Modern Healthcare’s 2025 Executive Compensation Survey based on Sullivan Cotter data. Highlights:
- Total cash compensation is rising: Total cash compensation, which includes base salaries and annual incentives, grew 7% at hospitals and health systems in this year’s survey, an increase from 6.5% in the previous year. Median base salaries rose 4.4%, compared with 3.8% a year ago. The growth stems in part from higher performance-based incentives for quality, patient experience, cost efficiency and other measures that reflect stronger operational performance across the industry. Incentive plans paid out about 10% more on average than the prior year.
- Operational and strategic roles are more important than ever: Median base salaries for chief operating officers at health systems rose 11%, while median total compensation increased 13%. The largest systems — those with annual revenue above $3 billion — saw the biggest jump in COO median total compensation, at 21%. Median base salaries for chief strategy officers grew 8% at health systems, while total compensation grew 13%.
- Executive turnover remains a challenge: Almost 80% of health systems reported the same or increased executive turnover from a year ago, and 91% reported the same or increased recruiting activity
Sullivan Cotter https://sullivancotter.com/surveys/health-care-management-and-executive-compensation-survey/
Insurers
Forbes: United updates 2025 outlook: On Tuesday, UnitedHealth updated its 2025 outlook, which includes revenues of $445.5 billion to $448 billion, net earnings of at least $14.65 per share and adjusted earnings of at least $16 per share…
In the company’s second quarter, UnitedHealthcare’s “consolidated medical care ratio of 89.4% increased 430 basis points year-over-year.” That compares to 85.1% in the year earlier period and well below the ratio in the lower 80th percentile where health insurers like to be.
Despite a new financial outlook that missed Wall Street’s expectations, UnitedHealth’s total revenues rose to $111.6 billion in the quarter from $98.8 billion in the year-ago period. Net income was $3.4 billion, or $3.74 a share, compared to $4.2 billion, or $4.54 a share in the year ago quarter…”
UnitedHealth Reports $3.4 Billion Profit and Sees 2026 Earnings Growth July 29, 2925
Related: Fitch downgrades UHG: Fitch affirmed UnitedHealth Group’s “AA-” rating July 30 but revised the company’s outlook to negative from stable. Fitch said the revision reflects new information disclosed by UnitedHealth during its second quarter earnings call held July 29.
“The company provided guidance on its significantly diminished operating performance for the remainder of 2025, which suggests that it will meet its financial leverage downgrade sensitivities for the year, with a partial recovery expected in 2026,” Fitch said.
Fitch Revises UnitedHealth’s Outlook to Negative; Affirms IFS Ratings at ‘AA-‘
MACPAC: Per the Medicaid and CHIP Payment Access Commission’s (MACPAC) July brief: The number of Medicaid beneficiaries using home- and community-based services (HCBS) has increased in recent years, reaching over 2.5 million individuals – while the number of beneficiaries utilizing institutional long-term services and supports (LTSS) declined.
HCBS use increased by 2.6% of all Medicaid beneficiaries from 2019 to 2021, The number of beneficiaries using institutional long-term services and Supports (LTSS), meanwhile, declined from 1.8 million in 2019 to 1.5 million in 2021.
To draw its conclusions, MACPAC analyzed HCBS use and spending patterns for Medicaid fee-for-service HCBS users from 2010 to 2013, identifying trends in HCBS within specific demographics.
MACPAC
Prescription Drugs
White House calls on Drug companies to lower prices: Last Thursday, President Trump asked 17 major pharmaceutical companies to take steps to cut U.S. drug prices within the next 60 days. He threatened to “deploy every tool in our arsenal to protect American families from continued abusive drug pricing practices” if companies refuse to comply. He asked for each company to commit to his several goals by Sept. 29.
On Truth Social on Thursday, Trump posted individual letters he sent 17 drugmakers: AbbVie, Amgen, AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly, EMD Serono, Genentech, Gilead, GSK, Johnson & Johnson, Merck, Novartis, Novo Nordisk, Pfizer, Regeneron, and Sanofi.
“The letters come after Trump in May signed an executive order reviving a controversial plan, known as the “most favored nation” policy, that aims to slash drug costs by tying the prices of some medicines in the U.S. to the significantly lower ones abroad. It was Trump’s latest effort to try to rein in U.S. prescription drug prices, which are two to three times higher on average than those in other developed nations – and up to 10 times more than in certain countries, according to the Rand Corp., a public policy think tank.”
Trump asks drugmakers to cut U.S. prices within 60 days
JD Power: Retail pharmacy satisfaction: Customer satisfaction with chain drug stores lags well behind mail-order and supermarket pharmacies and big box retailers that fill prescriptions, per J.D. Power. Supermarket pharmacies scored the highest for customer satisfaction, earning an average of 715 on a 1,000-point scale, per J.D. Power.
- Mass merchandiserslike Walmart and Sam’s Club had an average satisfaction score of 706. Mail-order pharmacies scored 697.
- Chain drug store satisfactionwas up slightly from last year but still lags far behind the other pharmacy types with an average satisfaction score of 643.
- Grocery stores and mass merchandisers outscored chain pharmacies on metrics like having enough staff, being able to quickly fill prescriptions and easy ordering.
Chain Drug Store Closures Create Big Opportunities for Supermarkets, Mass Merchandisers and Online Pharmacies, J.D. Power Finds July 29, 2025 https://www.jdpower.com/business/press-releases/2025-us-pharmacy-study
Public Health
SAMSHA Report: Substance abuse in 2024: “Among people aged 12 or older in 2024, 58.3 % (or 168.0 million people) used tobacco, vaped nicotine, used alcohol, or used an illicit drug in the past month; 46.6% (or 134.3 million people) drank alcohol in the past month; 16.7% (or 48.0 million people) used a tobacco product in the past month; 9.6% (or 27.7 million people) vaped nicotine in the past month; and 16.7% (or 48.2 million people) used an illicit drug in the past month. Estimates for tobacco use, nicotine vaping, alcohol use, or illicit drug use are not mutually exclusive because respondents could have used more than one type of substance (e.g., tobacco products and alcohol) in the past month.”
FDA announced opioid labeling change: Friday, the U.S. FDA announced labeling changes to all opioid pain medications to better emphasize and explain the risks associated with their long-term use. These changes follow a public advisory committee meeting in May that reviewed data showing serious risks—such as misuse, addiction, and both fatal and non-fatal overdoses—for patients who use opioids over long periods.
FDA Requires Major Changes to Opioid Pain Medication Labeling to Emphasize Risks | FDA
Study: Association between social determinants of health (SDoH) and long COVID: “Among 3787 participants, 418 (11%) developed long COVID. After adjustment for demographic characteristics, pregnancy, disability, comorbidities, SARS-CoV-2 severity, and vaccinations, financial hardship, food insecurity, less than a college education, experiences of medical discrimination, skipped medical care due to cost, and lack of social support were associated with increased risk for long COVID. Living in ZIP codes with the highest (vs. lowest) household crowding was also associated with greater risk.
Participants with social risk factors at the time of SARS-CoV-2 infection had greater risk for subsequent long COVID than those without. Future studies should determine whether social risk factor interventions mitigate long-term effects of SARS-CoV-2 infection.”
Regulators
CMS issues 2026 final payment rules: Last week, CMS released final rules for payments starting October 1: :
- Hospital Inpatient Prospective Payment System reflect a 3.3% increase in the market basket based on expensesminus a 0.7% productivity adjustment.
- Long-term care hospitals will get a 2.7% reimbursement increase.
- Hospice providers got a 2.6% payment update. The regulation also requires that face-to-face encounter attestations must include signatures and dates from the clinicians present.
- Inpatient psychiatric hospitals are set for a 2.5% Medicare rate hike. CMS also eliminated quality metrics for health equity and COVID-19 vaccination rates.
- Medicare payments for inpatient rehab facilities will rise 2.6%.
FY 2026 Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) Final Rule — CMS-1833-F July 31, 2025 https://www.cms.gov/newsroom/fact-sheets/fy-2026-hospital-inpatient-prospective-payment-system-ipps-and-long-term-care-hospital-prospective-0
FY 2026 Skilled Nursing Facility (SNF) Prospective Payment System Final Rule (CMS-1827-F) July 31, 2025 https://www.cms.gov/newsroom/fact-sheets/fy-2026-skilled-nursing-facility-snf-prospective-payment-system-final-rule-cms-1827-
