How the Affordable Care Act Drove Consolidation and Moral Injury – and What We Can Do About It

By Wendy Dean, MD - It’s conference season, so I’ve been traveling and speaking a lot about moral injury. Usually, audiences talk about the moral events they face as practitioners. But at a conference in a large city, a nurse I’ll call Jenna shared her experience as a patient having a small benign skin lesion removed from her back. Read Full Article…

HVBA Article Summary

1. Consolidation has eroded physician and patient choice: Jenna’s experience highlights how ACA-driven consolidation and vertical integration have stripped physicians of autonomy and patients of cost-effective care options. Her simple procedure, which could have been done in-office, was instead forced into a hospital setting, drastically increasing cost and time due to system mandates.

2. ACA reforms unintentionally fueled corporatization: While the ACA aimed to improve efficiency and care coordination, it led to increased power for large health systems and insurers. These entities absorbed independent providers, enforced revenue-maximizing mandates, and failed to deliver promised improvements in quality or cost – contributing instead to physician burnout and reduced patient-centered care.

3. Policy changes are needed to restore balance: To counteract these harmful effects, the article calls for repealing the ban on physician-owned hospitals, enforcing antitrust actions, eliminating site-specific payment disparities, and ending facility fees. These reforms aim to reinstate market competition, give practitioners more control, and prioritize patient needs over institutional profits.

Trump signs healthcare executive order that includes a win for pharma companies

By Ahmed Aboulenein - U.S. President Donald Trump directed his health department on Tuesday to work with Congress on revamping a law that allows Medicare to negotiate prescription drug prices, seeking to introduce a change the pharmaceutical industry has lobbied for. Drugmakers have been pushing to delay the timeline under which medications become eligible for price negotiations by four years for small molecule drugs, which are primarily pills and account for most medicines. Read Full Article…

HVBA Article Summary

1. Trump’s order challenges current Medicare negotiation timelines: The executive order pushes back on the Inflation Reduction Act’s 13-year wait for biologic drugs to become eligible for Medicare price negotiation, urging Congress to shorten this window. While Trump can’t change the law by executive order, he tasks HHS Secretary Robert F. Kennedy Jr. with pursuing legislative reform to enable faster cost-cutting measures.

2. Industry resistance to negotiation persists: Drugmakers continue to argue that early negotiation stifles innovation, especially for complex biologics. Despite this, the Trump administration aims to surpass the Biden administration’s initial savings by targeting 15 high-cost drugs—including Ozempic, Wegovy, Ibrance, and Xtandi—in the next round of Medicare price negotiations.

3. Additional reforms seek broader cost alignment: The order also promotes site-neutral payments to eliminate location-based cost disparities, encourages FDA approval of cheaper generics and biosimilars, and expands support for state drug importation programs. These steps aim to boost market competition and make prescriptions more affordable nationwide.

As regulatory landscape continues to shift, retirement & health care benefits evolve

By Alan Goforth - Employee benefits strategies are always changing as companies seek to address the needs of a diverse workforce and recruit and retain the best talent. “As the regulatory landscape continues to shift, employers are responding in kind by evolving their benefits and compensation offerings to best support employees,” according to the 2025 Goldman Sachs Asset Management Retirement Survey & Insights Report. Read Full Article… ^{_{(Subscription required)}}

HVBA Article Summary

1. Retirement plans evolve to meet diverse employee needs and legislative changes: 401(k) plans remain a core benefit, with employers increasingly adding features like Roth in-plan conversions, managed accounts, and lifetime income options. Many are responding to SECURE Act 2.0 with enhanced catch-up contributions and student loan-linked company matches to stay competitive and support financial wellness.

2. Employers balance healthcare cost containment with access and innovation: While 85% of employers have increased premiums, some are introducing no-deductible plans and conditional coverage for GLP-1 drugs tied to structured weight management programs. These moves aim to manage rising costs while expanding access to high-demand treatments.

3. Expanded benefits reflect a holistic approach to employee well-being: From paid caregiver and bereavement leave to PTO conversion options (e.g., student loans, 529 plans), employers are tailoring benefits to support mental health, financial goals, and life stages. Voluntary benefits like legal, pet, and ID theft protection continue to gain traction, alongside core offerings like life and disability insurance.

Trump targets health care costs with executive order on drug price negotiations, hospital payments

By Tara Bannow and Anil Oza - President Trump unveiled a wide-ranging executive order on Tuesday that aims to lower drug prices, boost transparency into fees charged by middlemen, and limit Medicare payments for outpatient services provided by hospitals. Much of the order would require further rulemaking or other actions to have any effect. Read Full Article… ^{_{(Subscription required)}}

HVBA Article Summary

1. Expanding and Restructuring Medicare Drug Price Negotiation: Trump’s executive order builds on Biden-era reforms by expanding Medicare’s drug price negotiation program, originally created under the Inflation Reduction Act. It calls for equal treatment of small-molecule drugs and biologics—extending the negotiation delay for pills from 9 to 13 years—to encourage pharmaceutical investment and innovation. The order also emphasizes improving program transparency and minimizing negative effects on innovation.

2. Lowering Drug Costs Through FDA and Importation Initiatives: The order directs the FDA to streamline generic and biosimilar drug approvals, promote alternatives to animal testing, and expand drug importation pathways from Canada. Despite recent FDA staff cuts, the administration claims it can maintain drug review functions and fulfill these directives aimed at boosting competition and affordability.

3. Addressing Middlemen, 340B Reform, and Site-Neutral Payments: The order mandates broker fee disclosures to expose potential PBM kickbacks, targets abuse in the 340B drug discount program by requiring discounts to be passed to low-income patients, and initiates steps toward site-neutral payment reform to eliminate costly incentives that steer care into hospital-owned outpatient settings.

Lilly weight-loss pill works as well as Ozempic, shares surge

By Deena Beasley and Manas Mishra - Eli Lilly's (LLY.N) experimental pill worked as well as blockbuster drug Ozempic to lower weight and blood sugar in a trial of diabetes patients, and the company said it expects to seek regulatory approvals by the end of the year. Shares jumped 16% as results of the study, the first of several underway on the pill, orforglipron, raised hopes of an effective and easy-to-use treatment reaching a market dominated by weight-loss injections. Read Full Article…

HVBA Article Summary

1. Lilly’s oral weight-loss drug orforglipron outperforms Ozempic in key metrics: In a Phase 3 trial, orforglipron led to nearly 8% body weight reduction in type 2 diabetes patients over 40 weeks—exceeding the weight loss seen with Ozempic’s highest dose. Though its blood sugar-lowering effect (1.3%) is lower than Ozempic’s (2.1%), the trial suggests continued weight loss beyond the study period, strengthening Lilly’s lead in oral obesity treatments.

2. Safety, tolerability, and manufacturing give Lilly an edge: Orforglipron’s safety profile is consistent with other GLP-1 drugs, with manageable side effects such as nausea and diarrhea. No liver-related safety issues were observed, unlike Pfizer’s now-discontinued danuglipron. As a synthetic small molecule, orforglipron can be readily manufactured, potentially ensuring broad access and smooth global rollout.

3. Novo Nordisk under pressure as Lilly advances: With orforglipron showing promising results and Lilly planning regulatory filings for weight loss and diabetes in 2025, investor confidence has shifted. Novo Nordisk’s U.S.-listed shares are down over 50% in the past year, with analysts noting its early advantage in the GLP-1 space is fading amid intensifying competition.

Employee confidence is low amid economic uncertainty—here’s how HR can help

By Mikaela Cohen - Economic uncertainty is in vogue this year. Last month, only 45.2% of employees expressed confidence in their company’s six-month “business outlook,” according to Glassdoor data, down from 55.6% in March 2022. Job insecurities and recession fears have sparked anxiety and lowered confidence, Glassdoor’s lead economist Daniel Zhao told HR Brew, and said employers are key in helping their workers get through this economic uncertainty. Read Full Article…

HVBA Article Summary

1. Employee needs during uncertainty vary: As economic fears grow amid recession forecasts and market volatility, employees are looking to their employers for support. Some may value work as a distraction, while others want open acknowledgment and reassurance from leadership about broader issues.

2. Transparency is now expected from leaders: Post-Covid, workers expect the same level of open, empathetic communication they received during the pandemic. This includes candid updates and a willingness to acknowledge challenges, which can build trust and boost morale during times of uncertainty.

3. HR must foster psychological safety and connection: To meet heightened expectations, HR should prioritize empathy and create safe spaces—like town halls, skip-level meetings, or one-on-ones—where employees can voice concerns. Reinforcing that everyone is navigating uncertainty together helps foster unity and resilience.

Resistance Training + Protein May Lower GLP-1 RA Muscle Loss

By Miriam E. Tucker - Medically supervised resistance training and adequate protein intake may help minimize the loss of lean body mass in people taking glucagon-like peptide 1 receptor agonists (GLP-1 RAs) for weight loss, new data suggest. The findings came from a prospective 6-month study of 200 adults with overweight or obesity who received education on resistance training and protein intake at the time of initiating semaglutide or the dual GLP-1/glucagon-insulinotropic peptide tirzepatide. Read Full Article…

HVBA Article Summary

1. GLP-1 RA treatment combined with lifestyle intervention effectively reduces fat while preserving muscle mass:After six months, participants lost about 13% of their body weight but only 3% of muscle mass, highlighting the effectiveness of combining medication with resistance training and higher protein intake in preserving lean body mass during weight loss.

2. Comprehensive care and body composition monitoring are essential: Experts emphasize the importance of experienced providers guiding patients through obesity treatment, including regular body composition assessments and personalized nutrition and exercise plans, to ensure muscle preservation and long-term metabolic health.

3. Adjunctive therapies may have limited application compared to lifestyle focus: While future drugs may support patients at high risk of sarcopenia, experts agree that nothing replaces the critical role of resistance training and adequate protein intake, which remain foundational for healthy, sustainable weight loss.