MARKET INTELLIGENCE REPORT
Becker’s Healthcare 2/10/2025
· Scott Becker speaks with Jennifer M Worthy, MBA , Executive Vice President of Revenue Optimization at Healthcare Outcomes Performance Company (HOPCo). Jennifer discusses her career in revenue cycle management, key trends like AI in healthcare and authorization reform, and her passion for driving value-based care.
KFF 2/24/2025
· Congressional Republicans and President Trump are in search of trillions of dollars in cuts to mandatory federal spending that could help offset the cost of extending expiring tax cuts. With spending on health programs accounting for a substantial share of federal spending, those programs are an obvious target to achieve overall spending goals in current budget reconciliation discussions.
Modern Healthcare 2/26/2025
· The 2025 plan year marked a turning point for Medicare Advantage, as insurers spooked by unfavorable new regulations, low federal reimbursement, an unexpected rise in medical expenses, a marketing crackdown and pushback from providers, stopped selling policies. Previously, insurers viewed the annual sign-up period as an opportunity to capture as many new members as possible.
· Yet despite the upheaval, the program’s three largest insurers – UnitedHealthcare, Humana and Aetna – maintained their grip on the market although their combined share of policyholders slipped, to 58%, from 59%.
Fox News 2/25/2025
· President Trump signed an executive order directing the departments of the Treasury, Labor, and Health and Human Services to make healthcare prices transparent.
· The order directs the departments to "rapidly implement and enforce" the Trump healthcare price transparency regulations. The departments will ensure hospitals and insurers disclose actual prices, not estimates, and take action to make prices comparable across hospitals and insurers, including prescription drug prices. They will be required to update their enforcement policies to ensure hospitals and insurers are in compliance with requirements to make prices transparent.