Avicenna Medical Blog

Care Management Weekly News Update 1/2/25

Posted by DeAnn Dennis on Thu, Jan 02, 2025 @ 11:45 AM

With large data breaches increasing in healthcare, the U.S. Department of Health and Human Services Office for Civil Rights (OCR) is proposing to modify the HIPAA Security Rule to require health plans, clearinghouses and most providers and their business associates to strengthen cybersecurity protections for individuals’ protected health information. This marks the first time HHS has sought to update the HIPAA Security Rule since 2013.

HHS releases latest round of prescriptions in Medicare rebate program including cancer drugs

The Centers for Medicare and Medicaid Services announced Friday that 64 Part B drugs will have a reduced price for Medicare patients at the pharmacy counter in the first quarter of 2025. CMS said patients may save between $1 and $10,818 per day on co-insurance costs for the Part B drugs included on the list. As part of the Inflation Reduction Act, drug manufacturers must give rebates to the federal government for single source drugs and biological products, including certain biosimilar biological products, whose price increased more than the rate of inflation. The list of discounted drugs changes each quarter.

 

The AHA Dec. 3 released its 2025 Environmental Scan, a resource offering a comprehensive look at key data and insights shaping the health care landscape. It is designed to help hospitals and health systems explore important issues with staff, leaders, boards and community stakeholders. “We are excited to share this valuable tool, which contains data, surveys, trends, thought leadership and educational resources, illustrating some of the top issues facing our field,” said AHA President and CEO Rick Pollack. “The Scan can help you plan for the future within your organization and consider ways our field can move forward together.” 

Gallup’s annual Health and Healthcare poll shows that Americans rate U.S. health insurance coverage below average. Consumers rated the quality of healthcare at its lowest point in the last 24 years of polling. “The current 44 percent of U.S. adults who say the quality of healthcare is excellent (11 percent) or good (33 percent) is down by a total of 10 percentage points since 2020 after steadily eroding each year,” Megan Brenan reports for Gallup News. “Americans rate healthcare coverage in the U.S. even more negatively than they rate quality,” Brenan notes. The report also breaks down partisans’ views of healthcare. 

Insurers and self-funded employers are making significant changes to their GLP-1 drug coverage policies in 2025, reflecting the financial and operational challenges posed by the high-cost medications. Among U.S. adults, 80% say insurers should cover weight loss drugs for adults diagnosed as overweight or obese, according to an August 2023 survey from KFF.  Half of respondents also said insurance should cover the drugs even if it would increase premium costs. Over 42% of U.S. adults (57.4 million) under 65 with private insurance could be eligible for GLP-1 drugs, based on current FDA indications, according to a Sept. analysis from KFF.

 

Tags: Weekly Industry News