Medicare Advantage Still Deceiving, Trillion-Dollar Medicaid Cuts Panic Hospitals, BUCA+ Plots Market Domination

Hey all,

Happy Tuesday! Reading today’s rundown is another tale of the business of healthcare eroding the care itself. After all, who needs accessible, affordable care when there are quarterly earnings to protect? That’s why we’re building ZorroRX to shrink the healthcare industry and increase the amount of care delivered.

Enjoy the rundown!

Jacob Brody (Co-Founder & CEO, ZorroRX)

(Health Care Un-covered) and (Medicare Advantage Advertising

Wendell Potter argues that if the Trump administration and Robert F. Kennedy Jr. want to stop deceptive health care marketing, they must also crack down on misleading Medicare Advantage (MA) ads. These commercials hide critical facts about restricted networks, prior authorizations, and high out-of-pocket costs, even as insurers profit massively from taxpayer-funded programs. With over 650,000 MA ads aired during the 2022 enrollment season alone, Potter argues that stronger ad standards are urgently needed to protect seniors. Full Article.

(STAT News) Hospitals Brace for Medicaid Cuts

Hospitals across the U.S. are convening “war rooms” to plan for nearly $1 trillion in Medicaid cuts over the next decade, with leaders weighing service reductions, consolidations, and efficiency measures as they face what some describe as an “existential crisis.” The cuts, expected to push nearly 10 million Americans off coverage, are forcing struggling systems to consider scaling back pediatric, behavioral, and women’s care, while stronger systems eye consolidation, AI adoption, and expansion opportunities amid industry upheaval. One lever many hospitals are looking to in order to stay afloat is maximizing their use of the 340B drug discount program. Full Article

(FierceHealthcare) BUCA+ To Grow Market Share over Next Decade Amidst Headwinds

A new Morningstar analysis projects that the six largest insurers—Aetna, Centene, Cigna, Elevance Health, Humana, and UnitedHealthcare—will cover 56% of Americans by 2034, up from 41% in 2014, driven by competitive scale and government outsourcing to private operators. However, rising medical-loss ratios, post-pandemic care surges, regulatory scrutiny of Medicare Advantage billing, and potential reforms to pharmacy benefit managers pose significant financial and policy challenges that could dampen profitability. Many of these companies may strug