View of U.S. Healthcare Quality Declines to 24-Year Low “Americans' positive rating of the quality of healthcare in the U.S. is now at its lowest point in Gallup’s trend dating back to 2001.
The current 44% of U.S. adults who say the quality of healthcare is excellent (11%) or good (33%) is down by a total of 10 percentage points since 2020 after steadily eroding each year. Between 2001 and 2020, majorities ranging from 52% to 62% rated U.S. healthcare quality positively; now, 54% say it is only fair (38%) or poor (16%).
As has been the case throughout the 24-year trend, Americans rate healthcare coverage in the U.S. even more negatively than they rate quality. Just 28% say coverage is excellent or good, four points lower than the average since 2001 and well below the 41% high point in 2012.”
How Trump could roll back Biden-era healthcare regulations “One avenue for quick recissions of federal rules is through the Congressional Review Act (CRA). The lesser-known federal law enacted during President Bill Clinton’s term allows Congress a short window to overturn final rules with the support of the president.”
The article is a great review of how this Act would work after Trump takes office.
Trends to Watch in 2025 [From The Business Group on Health “The following trends represent areas of focus for employers and other industry stakeholders throughout 2025:
About health insurance/insurers
The Effects of Not Extending the Expanded Premium Tax Credits for the Number of Uninsured People and the Growth in Premiums From the CBO: “CBO estimates that, relative to extending the tax credits, not extending them—either for a year or permanently—will increase the number of people without health insurance. The agency expects some people will exit the marketplaces and become uninsured because of higher out-of-pocket costs for health insurance premiums.
Without an extension through 2026, CBO estimates, the number of people without insurance will rise by 2.2 million in that year. Without a permanent extension, CBO estimates, the number of uninsured people will rise by 2.2 million in 2026, by 3.7 million in 2027, and by 3.8 million, on average, in each year over the 2026-2034 period.
Anthem Blue Cross Blue Shield reverses plan to limit anesthesia coverage “One of the country’s largest health insurers is facing backlash from doctors and government officials over its decision to no longer pay for anesthesia care if a surgery or procedure goes beyond a time limit.
Anthem Blue Cross Blue Shield insurance announced in early November that it planned to change how it evaluates billed time on professional claims for anesthesia services next year and deny any claims for anesthesia services that exceed that time limit.
The change was set to apply to members in Connecticut, New York and Missouri. A spokesperson for the company said in a statement that Anthem had decided not to proceed with the change following what the company claimed was ‘widespread misinformation.’”
Older Adults in U.S. Struggle with Health Care Costs More Than Those in Other Nations “Among the key findings:
•Out-of-pocket costs are high. Nearly one in four older adults in the U.S. spent at least USD 2,000 out of pocket on health care last year. In contrast, less than 5 percent of older adults in France and the Netherlands spent that much. Switzerland was the only survey country where older adults reported spending more.
•Older adults are delaying care because of costs. Delaying medical treatment can worsen health conditions. Although less than 10 percent of older adults across countries reported skipping needed care or forgoing medical treatment because of costs, older Americans did so at the highest rate. One-third of older U.S. adults facing cost-related barriers reported being in fair or poor health.
•People are skipping dental care. One in five older adults in the U.S., Australia, and Canada skipped needed dental care because of costs. By comparison, 5 percent or fewer of older adults in the Netherlands and Germany went without dental care.
Spending was 27% More for People who Disenrolled from Medicare Advantage than for Similar People in Traditional Medicare Key Takeaways
Medicare spent 27% more, on average, for people who were covered by traditional Medicare after disenrolling from Medicare Advantage than for people who were continuously covered by traditional Medicare, after adjusting for differences in health status and other characteristics. This is a difference of $2,585 in Medicare spending per person, on average, between the two groups in 2022.
Differences in Medicare spending between people who disenrolled from Medicare Advantage and beneficiaries continuously in traditional Medicare varied by health condition, ranging from 15% for people with pneumonia to 34% for people with diabetes. For example, among people with certain cancers, Medicare spending was 28% ($4,907) higher, on average, among those who disenrolled from Medicare Advantage than among people continuously covered by traditional Medicare.
Differences in Medicare spending between people who disenrolled from Medicare Advantage and those continuously in traditional Medicare increased with age for Medicare beneficiaries ages 65 and over. For example, among people ages 85 and over the difference was 46% ($7,113) compared to 25% among people ages 65 to 69 ($1,843).
Differences in Medicare spending between people who disenrolled from Medicare Advantage and beneficiaries continuously in traditional Medicare were larger among Black (55%, $5,203) and Hispanic (54%, $4,434) beneficiaries than White beneficiaries (25%, $2,464).
People dually-eligible for Medicare and full Medicaid benefits who disenrolled from Medicare Advantage had spending that was 61% ($9,435) higher than their counterparts who were continuously in traditional Medicare, while the difference in spending for Medicare beneficiaries who do not receive Medicaid was 20% ($1,684).
Skilled nursing facility spending accounted for the largest share of the difference in average Medicare spending per person between people who disenrolled from Medicare Advantage and those continuously in traditional Medicare (34%), followed by outpatient hospital spending (23%), and inpatient hospital spending (20%), with some variation by chronic conditions and other beneficiary characteristics.”
About hospitals and healthcare systems
Buying across borders: 5 systems acquiring hospitals in a new state FYI
National Hospital Flash Report “Key Takeaways
1. Overall, October data show continued stability. Revenue, average length of stay, and other indicators show stable performance.
2. Outpatient revenue continues to grow. Revenue growth has been steady over the past few years, indicating a shift in how patients seek care.
3. Discharges per calendar day increased compared to the previous month. This has led to a decrease in overall expenses on a volume adjusted basis, though supplies and drug expenses continue to grow.
About pharma
Novo Holdings wins EU blessing for Catalent buy “Novo Nordisk's controlling shareholder, Novo Holdings, has secured European Commission approval for its $16.5-billion acquisition of Catalent, a move that some say could dramatically reshape the CDMO landscape—and potentially limit manufacturing options for competing pharmaceutical companies.”
The deal involves Novo Holdings acquiring Catalent and subsequently selling three manufacturing sites to Novo Nordisk for $11 billion, positioning the Danish drugmaker to expand production of its popular obesity and diabetes treatments
About the public’s health
Increases in U.S. life expectancy forecasted to stall by 2050, poorer health expected to cause nation’s global ranking to drop “Key takeaways:
The U.S. is forecasted to fall in its global rankings below nearly all high-income and some middle-income countries.
Drug use disorders, high body mass index, high blood sugar, and high blood pressure are driving mortality and disability higher across the U.S.
Future scenarios for health outcomes identify the states that are forecasted to gain ground, face stagnation, or grow worse.
Scientific evidence underscores the urgent need to prioritize public health to prevent the economic consequences of sickness, disabilities, and premature mortality in the U.S.”
About healthcare IT
David O. Sacks, future White House AI Czar, likely to favor startups and 'thoughtful' regulation “Sacks is reportedly a close confidant of Elon Musk, who will also hold a special advisory role to the White House on cutting government spending.
Sacks founded a venture capital firm in 2017 called Craft Ventures. He was also a pivotal player at PayPal in the early 2000s. Sacks is a lawyer by training and hosts the weekly podcast ‘All In’ about the technology industry.”
About healthcare technology From ECRI: “Top 10 Health Technology Hazards for 2025 The List for 2025
1. Risks with AI-Enabled Health Technologies
2. Unmet Technology Support Needs for Home Care Patients
3. Vulnerable Technology Vendors and Cybersecurity Threats
4. Substandard or Fraudulent Medical Devices and Supplies
5. Fire Risk in Areas Where Supplemental Oxygen Is in Use
6. Dangerously Low Default Alarm Limits on Anesthesia Units
7. Mishandled Temporary Holds on Medication Orders
8. Infection Risks and Tripping Hazards from Poorly Managed Infusion Lines
9. Skin Injuries from Medical Adhesive Products
10. Incomplete Investigations of Infusion System Incidents”
About healthcare personnel
Clinician Turnover 2024 “KLAS Arch Collaborative is—for the first time—asking clinicians who report plans to leave their organization where they intend to go. This report examines the cost of clinician turnover, how burnout and the EHR experience affect staff retention, and best practices from organizations who have improved their clinicians’ satisfaction and reversed turnover trends…
[For example]: Since 2019, the risk of clinician turnover has steadily increased. In 2024, nearly half of nurses and physicians are classified as at risk. Of these at-risk clinicians, 21% of nurses and 13% of physicians actually leave…
This turnover results in steep costs for organizations—the average cost of turnover for a nurse and physician respectively is $56,300 and $500,000–$1,000,000.”
The Future of Primary Care: Traditional and Nontraditional Models Continue to Evolve A great overview from Bain. For example: “By 2030, 30% of primary care could be delivered by nontraditional providers, with strong growth from payer-owned providers and enabled primary care providers.”
Aya Healthcare to Acquire Cross Country Healthcare for Approximately $615 Million in Cash “ya Healthcare and Cross Country Healthcare today announced that they have entered into a definitive agreement whereby Aya will acquire Cross Country for $18.61 per share in cash in a transaction valued at approximately $615 million. The all-cash transaction represents a premium of 67 percent to Cross Country’s closing price on December 3, 2024, and a premium of 68 percent to the volume-weighted average trading price for the 30-day trading period ended December 3, 2024.
Aya and Cross Country offer complementary, tech-enabled workforce solutions across the continuum of care.”
