Trump pulls US out of WHO, a move condemned by public health experts

By Anastassia Gliadkovskaya - In an executive order signed on the eve of his inauguration, President Trump pulled the U.S. from the World Health Organization. Withdrawal from the United Nations health agency is possible after a one-year notice. Read Full Article…

HVBA Article Summary

1. Global Health Security at Risk: Public health experts, including former CDC director Tom Frieden, warned that a U.S. withdrawal from WHO would severely compromise global health surveillance and pandemic preparedness. As the largest donor to WHO, the U.S. plays a critical role in tracking health threats worldwide, and reducing this support could weaken efforts to prevent future health crises.

2. International Reactions and Concerns: Germany’s health minister and other global health organizations, such as the Association for Professionals in Infection Control and Epidemiology, expressed concern over the U.S. decision, emphasizing that withdrawing from WHO could undermine international cooperation in combating global health emergencies and infectious diseases.

3. Criticism of WHO's Handling and U.S. Discontent: The U.S. order criticized WHO's management of the COVID-19 pandemic, claiming the organization lacked necessary reforms and independence from political influence. Additionally, there was dissatisfaction with the financial contributions expected from the U.S., arguing they were disproportionate compared to other large countries, such as China.

Trump officials pause health agencies’ communications, citing review

By Lena H. Sun, Dan Diamond, and Rachel Roubein - The Trump administration has instructed federal health agencies to pause all external communications, such as health advisories, weekly scientific reports, updates to websites and social media posts, according to nearly a dozen current and former officials and other people familiar with the matter. Read Full Article… ^{_{(Subscription required)}} 

HVBA Article Summary

1. Pause on Communications Across Health Agencies: Following the inauguration of the new administration, staff at key Department of Health and Human Services agencies, including the FDA, CDC, and NIH, were instructed to halt external communications. This pause affects several critical reports and data releases, including CDC’s Morbidity and Mortality Weekly Reports (MMWR), health alerts, and updates on public health data.

2. Uncertainty Over the Duration and Scope of the Pause: While the directive to pause communications was expected during a presidential transition, many health officials expressed confusion over its wide-ranging scope and unclear duration. The pause has raised concerns about potential delays in urgent public health messaging, such as updates on disease outbreaks, drug approvals, and public health advisories.

3. Possible Reasons Behind the Pause: Some officials believe the pause is a temporary measure to allow the new administration to review and understand the vast flow of information coming from these agencies. While others fear the move could mirror previous attempts to control agency communications, as seen during the Trump administration’s handling of the CDC during the COVID-19 crisis. Concerns may arise if the pause extends beyond a few weeks.

Trump Appoints Acting Secretary for Department of Labor

By Remy Samuels - President Donald Trump on Tuesday named Vince Micone acting secretary of labor, while his nominee for the position, former Representative Lori Chavez-DeRemer, R-Oregon, awaits Senate confirmation. Read Full Article… 

HVBA Article Summary

1. Micone's Appointment as Acting Secretary of Labor: Micone steps into the role of Acting Secretary of Labor (DOL) while Chavez-DeRemer undergoes the Senate confirmation process. Prior to this, Micone served as deputy assistant secretary for operations within DOL's Office of the Assistant Secretary for Administration and Management, overseeing a staff of over 770 employees and handling key administrative functions.

2. Sonderling's Nomination as Deputy Labor Secretary: Trump has nominated Keith Sonderling, former Equal Employment Opportunity Commissioner, to serve as Deputy Secretary of Labor. Like Micone, Sonderling is awaiting Senate confirmation.

3. Micone's Background and Leadership: Before joining the DOL, Micone was executive director for enterprise services at the U.S. Department of Commerce and held roles across several federal agencies. He also co-chairs the Combined Federal Campaign, which has raised over $770 million for nonprofit organizations under his leadership.

Employer group sues to stop Biden rules that ‘overstep’ existing mental health parity law

By Lynn Cavanaugh - On Friday, just days before President Trump was inaugurated, The ERISA Industry Committee, which represents 100 large employers, sued the Labor Department over Biden administration final rules aimed at ensuring mental health treatment is covered on par with other medical care, like cancer and heart disease. Read Full Article… ^{_{(Subscription required)}} 

HVBA Article Summary

1. The Lawsuit Challenges New Final Rules: The ERISA Industry Committee (ERIC) filed a lawsuit against the U.S. Department of Health and Human Services, Treasury, and the Department of Labor, arguing that the Biden Administration’s Final Rule regarding mental health and addiction parity exceeds regulatory authority and violates the Fifth Amendment’s due process clause, as well as the Administrative Procedure Act.

2. Concerns Over Compliance and Impact on Employers: ERIC claims the Final Rule, effective January 1, 2025, is "arbitrary and capricious" due to vague and complex regulations that could make it difficult for employers to comply in time, ultimately threatening the affordability and quality of health benefits offered to employees.

3. Mixed Support for Mental Health Goals: While ERIC supports the goals of the Mental Health Parity and Addiction Equity Act, it argues that the new rules, particularly around preauthorization and provider payment requirements, could undermine access to quality mental health care and the ability for employers to provide comprehensive coverage.

Why costly gene therapy is top of mind for benefits administrators

By Dr. Nancy Klotz - Gene therapy, a revolutionary approach to treating disease by modifying a person's genes, is one of the most transformative developments in healthcare today. In certain cases, it can offer a cure for an otherwise deadly or debilitating disease, but it's also one of the most expensive treatments available. Read Full Article… ^{_{(Subscription required)}} 

HVBA Article Summary

1. Rising Costs and Impact on Health Plans: Gene therapy, while potentially lifesaving, is extraordinarily expensive, ranging from hundreds of thousands to millions of dollars per dose. As the number of people receiving gene therapy is expected to grow significantly by 2034, health plan sponsors must prepare for the financial burden of covering these high-cost treatments while maintaining quality care for members.

2. Coverage Considerations for Gene Therapy: Given the high cost and rarity of gene therapy, health plans should clearly define coverage policies, specifying which treatments are covered (e.g., only FDA-approved therapies) and under what conditions. It’s essential to have processes in place to handle new therapies as they emerge and to explore cost containment options like treatment caps and stop-loss insurance.

3. Cost Containment Strategies: Health plans can mitigate the financial risks of covering gene therapy by utilizing stop-loss insurance, which provides reimbursement for catastrophic claims, and implementing case management to ensure appropriate, outcomes-based care. Proactive planning and the development of tailored strategies will help manage costs without compromising the effectiveness of treatments for members.

Not enough hospitals are testing their predictive AI models for accuracy, bias, study finds

By Dave Muoio - Many U.S. hospitals using predictive models are not evaluating their tools internally for accuracy, and fewer still are evaluating them for potential biases, according to a study published in the most recent edition of Health Affairs. Read Full Article…

HVBA Article Summary

1. In-house development and evaluation trends: Hospitals that develop their own AI tools are more likely to evaluate the accuracy and bias of their predictive models locally. This contrasts with hospitals using models from Electronic Health Record (EHR) vendors, who are less likely to conduct these evaluations, potentially exposing patients to inaccurate or biased models.

2. Disparities based on hospital type: Critical access hospitals, rural hospitals, and those serving marginalized populations are less likely to use AI models, highlighting a growing digital divide. This disparity risks exacerbating inequities in healthcare, as these hospitals may not access AI benefits at the same rate as higher-margin hospitals and academic centers.

3. Local evaluation as a key to safety and fairness: Local evaluation of AI models is crucial for ensuring patient safety and fairness, particularly for hospitals serving diverse or disadvantaged patient populations. The research calls for increased transparency from AI developers and targeted interventions to support hospitals' capacity for local evaluations, to prevent a “rich-get-richer” scenario in healthcare AI adoption.

'It reminds me of Bitcoin': Healthcare execs split on ICHRAs

By Noah Tong - Individual coverage health reimbursement arrangements, or ICHRAs, are either the future of health coverage or merely a blip on the radar, depending on who you ask. ICHRAs allows employers to offer workers tax-free money to buy insurance through the Affordable Care Act (ACA), rather than being told to select a plan. Read Full Article…

HVBA Article Summary

1. Flexibility and Adoption Challenges: ICHRAs offer flexibility for consumers by allowing health benefits that are not tied to employment, making them ideal for businesses with workers across state lines. However, brokers remain hesitant due to limited provider networks, and adoption is slow in certain regions like Arizona, where there is skepticism from employers and challenges in administration.

2. Regional Variation in Adoption: ICHRA adoption varies significantly by region. Urban areas, particularly those with ACA plans, see more uptake, while rural areas with fewer insurance options are less inclined. States like Colorado and Pennsylvania are seeing traction, while regions like the Northeast face challenges due to lack of data sharing among providers.

3. Future of Group Insurance and Political Landscape: The rise of ICHRAs may signal the eventual decline of traditional group insurance, as younger generations prefer personalized healthcare plans and businesses seek cost-effective solutions. Political support for ICHRAs remains bipartisan, with potential for future legislation to support or expand these plans, despite challenges in maintaining political neutrality.