President-elect Trump's picks for CDC, FDA, surgeon general: 31 notes FYI- a really good summary.
About health insurance/insurers
Most American workers satisfied with employer-provided health coverage “A new nationwide poll finds that a strong majority of Americans receiving health care coverage through work — about 180 million people — are satisfied with their current employer-provided plans (75%) and prefer to get their coverage through an employer rather than through the federal or state government (74%).”
UnitedHealthcare beats CMS in Medicare Advantage star ratings lawsuit “UnitedHealthcare has prevailed in its lawsuit against CMS regarding the methodology used to calculate its 2025 Medicare Advantage star ratings.
The lawsuit, filed Sept. 30 in the U.S. District Court for the Eastern District of Texas, revolved around the inclusion of a single disputed customer service phone call in the agency's calculations.
Judge Jeremy Kernodle ruled that CMS must "recalculate Plaintiffs' 2025 star ratings without consideration of the disputed call and shall immediately publish the recalculated star ratings." The court found that CMS had acted "contrary to its own guidelines" when evaluating the phone call, which was marked as "unsuccessful" despite evidence showing it lasted over eight minutes and connected to a call center representative.”
12 payers recently fined by states FYI
How much each state has spent to expand Medicaid “States spend nearly $40 billion annually on expanded Medicaid coverage under the ACA, according to KFF.
Medicaid is financed by the federal government and the states based on per capita income. The federal funding share varies from 50% to 74%, depending on the state. The ACA expanded Medicaid eligibility in 2014, and the federal government has paid for 90% of expansion costs since 2020.”
Expansion costs range from $3.23B (California) to $960K (Sound Dakota).
Attributing Racial Differences in Care to Health Plan Performance or Selection “In this cross-sectional study, we found substantial variation across MMC [Medicaid managed care] plans in racial differences in health care that was largely an artifact of selection bias. These findings highlight the difficulty of measuring a plan’s impact on health equity while underscoring that health care disparities remain large in Medicaid. Although these findings suggest that initiatives to adjust payments to MMC plans based on health equity measures may have unintended consequences, they also demonstrate a pressing need for well-designed policies to measure and address inequities in Medicaid.”
About hospitals and healthcare systems
Geisinger performs 1st shoulder surgery with 'lifetime guarantee' “Wilkes-Barre, Pa.-based Geisinger performed the first reverse shoulder replacement surgery in the world with a guarantee for the full cost of care throughout the patient's lifetime.
The surgery and lifetime guarantee are in partnership with Medacta Group SA, a Swiss company specializing in innovative and sustainable solutions for joint replacement, sports medicine and spine surgeries…”
About the public’s health
Study provides more positive data for Paxlovid use in high-risk patients with COVID-19 “Overall, the analysis showed that Paxlovid “significantly reduced” times to sustained alleviation (13 vs. 15 days; HR = 1.27; P < 0.0001) and resolution through day 28 (16 vs. 19 days; HR = 1.2; P = 0.0022). Treatment with Paxlovid also reduced the number of COVID-19related medical visits by 64.3% and reduced the number of patients needing these visits (2.3% vs. 8.4%).”
New Clinical and Public Health Challenges: Increasing Trends in United States Alcohol Related Mortality “During the last 20 years there have significant increases of about 2-fold in US alcohol-related mortality. Clinical challenges are increased by interrelationships of risk factors, especially overweight and obesity and diabetes.”
State Reported Efforts to Address Health Disparities: A 50 State Review “This analysis focuses on current state efforts, many of which were implemented during or after 2020, to address health disparities and advance health equity based on a review of publicly available materials from all 50 states and DC. In addition, case study interviews were conducted with 14 stakeholders in three states (California, North Dakota, and Michigan) to increase understanding of the factors contributing to success of these state initiatives, lessons learned, and potential implications for other states.”
About healthcare personnel
MD-Granting Medical Schools in the US, 2023-2024 FYI. Annual report from the AMA