Note: Due to technical site problems, yesterday’s blog was not transmitted. Appologies.
Read today’s Kaiser Health News
In other news:
Estimated Impact Of Medically Tailored Meals On Health Care Use And Expenditures In 50 US States: Medically tailored meals (MTMs) can reduce health care use among high-risk patients with diet-related conditions. However, the potential impact of providing coverage for MTMs across fifty US states remains unknown…Assuming full uptake among eligible people, MTMs were net cost saving in the first year in forty-nine states, with the largest savings seen in Connecticut ($6,299 per patient). The exception was Alabama, where MTMs were cost-neutral. The number of treated patients needed to avert one hospitalization ranged from 2.3 (Maryland) to 6.9 (Colorado). These findings can inform state-level policy makers and health plans considering MTM coverage through state-specific strategies.
States with the highest, lowest health equity scores FYI. The results are not obvious.
Internal budget document reveals extent of Trump’s proposed health cuts:
The proposal would reduce the more than $47 billion budget of the NIH to $27 billion — a roughly 40 percent cut. It would consolidate NIH’s 27 institutes and centers into just eight. Some of its institutes and centers would be eliminated, including the National Institute on Minority Health and Health Disparities and the National Institute of Nursing Research.
Many of NIH’s institutes would be fused. A National Institute on Body Systems, for example, would absorb three separate institutes: the institute focused on heart and lung diseases; the institute focused on diabetes, kidney and digestive disorders; and a third focused on muscle, skeletal and skin diseases.
A new, $20 billion agency named the Administration for a Healthy America would be created. AHA would include many pieces of other agencies that are being consolidated — such as those focused on primary care, environmental health and HIV.
AHA would have $500 million in policy, research and evaluation funding to be allocated by Kennedy to support “Make America Healthy Again” initiatives, including a focus on chronic childhood diseases. But many specific programs would be eliminated under AHA, according to the document, including programs focused on preventing childhood lead poisoning, bolstering the health-care workforce, advancing rural health initiatives and maintaining a registry of patients with amyotrophic lateral sclerosis, or ALS.
The proposal would fund the Food and Drug Administration at a level that allows it to continue to collect drug and medical device fees from the industries the agency regulates. Unless the agency is funded at a certain level, the FDA’s ability to use these funds, which help expedite safety reviews for devices, drugs and other products, would be limited.
The proposal would cut the CDC’s budget by about 44 percent, from $9.2 billion to about $5.2 billion, and would eliminate all of the agency’s chronic disease programs and domestic HIV work. The chronic disease programs being eliminated include work on heart disease, obesity, diabetes and smoking cessation.
Rural programs formerly under the Health Resources and Services Administration appear to be hard-hit. The rural hospital flexibility grants, state offices of rural health, rural residency development program and at-risk rural hospitals program grants are listed as eliminations under AHA.
Money for the Head Start program, which provides early child care and education for low-income families and is funded by HHS’s Administration for Children and Families, would be eliminated. “The federal government should not be in the business of mandating curriculum, locations and performance standards for any form of education,” the document says.
About health insurance/insurers
Supreme Court to hear challenge to ACA rule requiring free preventive care, cancer screenings: or a decade and a half, Americans have been guaranteed that no matter their health insurer, certain preventive care like cancer screenings are free of charge. That’s because an Affordable Care Act provision has required insurers to fully cover services given an A or B recommendation by an expert task force.That may soon change. On Monday, the U.S. Supreme Court will hear a challenge to this statute in the case of Kennedy v. Braidwood Management. Either way the court decides, legal and medical experts told STAT, the ruling could have profound ramifications for the future of preventive health care in the United States.
In a related article: Use of No-Cost Preventive Services Jeopardized by Kennedy v Braidwood: This cross-sectional study presented a detailed, comprehensive assessment of ACA-mandated no-cost preventive service use potentially jeopardized by Braidwood and future challenges. Among ESHI enrollees in 2018 aged 18 to 64 years, nearly 1 in 3 (and nearly half of women) received no-cost preventive services from 2018 to 2022 covered under the ACA mandate but threatened by Braidwood. While results varied across states, proportions were higher than 20% in every state.
UnitedHealth cuts earnings guidance amid rising Medicare Advantage costs: UnitedHealth Group posted nearly $6.3 billion in net income during the first quarter of 2025, but the company reduced its year-end earnings outlook amid rising use of physician and outpatient services among its Medicare Advantage membership and “unanticipated changes in the profile of Optum Health members.”
UnitedHealth stock decreased 20% on the morning of April 17 following “an overall performance that was frankly unusual and unacceptable,” CEO Andrew Witty told investors. In its earnings report, the company also cited “a greater-than-expected impact to current and new complex patients from the ongoing Medicare funding reductions enacted by the previous administration.”
About hospitals and healthcare systems
10 Things to Know About Rural Hospitals FYI. One reason this study is important is that “Rural hospitals account for about one third of all community hospitals nationwide and at least a third of all hospitals in most states.”
About pharma
Eli Lilly’s 1st GLP-1 pill shows favorable results in late-stage trial:Eli Lilly completed a phase 3 trial for its weight loss drug, orforglipron, which showed promising results in evaluating its safety and efficacy for adults with Type 2 diabetes and inadequate glycemic control.
The once-daily oral GLP-1 receptor agonist significantly reduced blood sugar and body weight in adults with Type 2 diabetes and had a safety profile consistent with injectable therapies, according to an April 17 news release from the drugmaker.
Comment: If the results hold up, this medication could replace the injectables in its class, probably at lower cost.
Trump Seeks to Lower Drug Prices Through Medicare and Some Imports: President Trump signed an executive order on Tuesday outlining a series of actions intended to lower drug prices, including helping states import drugs from Canada.
The policies were more modest than proposals to reduce drug prices that Mr. Trump offered in his first term.
And one of his new directives could increase drug prices. It calls for the Trump administration to work with Congress to change a 2022 law in a way that could defang a negotiation program meant to reduce Medicare’s spending on commonly used or costly drugs.
Such a change has the potential to increase costs for the government, because it would most likely delay the existing timetable for some drugs to become eligible for Medicare price cuts.
Arkansas first state to ban PBMs from owning pharmacies: Arkansas has become the first state to ban pharmacy benefit managers from owning pharmacies after Gov. Sarah Huckabee Sanders signed House Bill 1150 into law April 16.
The legislation, sponsored by state Rep. Jeremiah Moore and state Sen. Kim Hammer, prohibits state pharmacy permits from being issued to PBMs beginning Jan. 1, according to an Jan, 16 press release from the governor’s office.
About healthcare IT
Evolving Remote Monitoring: An Evidence-Based Approach to Coverage and Payment Not all remote monitoring programs are effective. Look at page 9of this report for a summary of evidence.
About healthcare personnel
40% of nurses eye exit by 2029: 5 findings from NCSBN’s new workforce report Worth skimming the report’s main findings.
About health technology
Device maker that helped UnitedHealth collect billions offers to settle fraud claims with DOJ United used a device from this company to document decreased peripheral blood flow-allowing the company to claim a higher patient severity and get more Medicare Advantage payments.