Industry News: Volume 3, Issue 16

How US primary care compares to other wealthy nations

By Kelly Gooch – Among 10 high-income countries, the U.S. trails its peers in access to and continuity of primary care, according to a study released March 28 by the Commonwealth Fund.

The study compares the state of primary care in the U.S. with nine other high-income nations: Australia, Canada, France, Germany, the Netherlands, New Zealand, Sweden, Switzerland, and the United Kingdom. Findings are based on data from the Commonwealth Fund’s 2022 International Health Policy Survey of Primary Care Physicians and the 2023 International Health Policy Survey of adults age 18 and older.

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End of Internet Subsidies for Low-Income Households Threatens Telehealth Access

By Sarah Jane Tribble – For Cindy Westman, $30 buys a week’s worth of gas to drive to medical appointments and run errands.

It’s also how much she spent on her monthly internet bill before the federal Affordable Connectivity Program stepped in and covered her payments.

“When you have low income and you are living on disability and your daughter’s disabled, every dollar counts,” said Westman, who lives in rural Illinois.

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Mental health care is hard to find, especially for people with Medicare or Medicaid – With rates of suicide and opioid deaths rising in the past decade and children’s mental health declared a national emergency, the United States faces an unprecedented mental health crisis. But access to mental health care for a significant portion of Americans — including some of the most vulnerable populations — is extremely limited, according to a new government report released Wednesday.

The report, from the Department of Health and Human Services’ Office of Inspector General, finds that Medicare and Medicaid have a dire shortage of mental health care providers.

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CMS final rule on broker comp, health equity could shake up Medicare Advantage

By Noah Tong – Centers for Medicare & Medicaid Services finalized a host of actions ranging from broker compensation, health equity, mental health, supplemental benefits and biosimiliars, in the Contract Year 2025 Medicare Advantage and Part D final rule Thursday night.

Technical experts and industry execs warned the changes will be consequential for MA plans.

“Yesterday’s 2025 Final Rule was one of the more impactful that I can recall in my two-plus decades in the industry,” said Sean Libby, president at BeneLynk. “It is clear that MA plans need a roadmap for health related social needs and health equity.”

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By Eric Wicklund – Telehealth programs may be great for connecting patients to their doctors, but new research suggests it isn’t closing the gap on diagnostic tests and referrals.

A new study posted in the Journal of the American Medical Association (JAMA) by researchers from several notable health systems finds that diagnostic loop closures for colonoscopies, cardiac stress tests, and dermatology referrals were worse for patients after virtual visits than for those patients seeing their doctor in-person.

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As Republicans Wrestle With IVF, the Biden Administration Expands Benefits

By Michelle Andrews – While Republican lawmakers try to walk a fine line on in vitro fertilization — expressing support for the popular procedure, even as some of their supporters argue life begins at conception — the federal government expanded fertility benefits for millions of workers this year, including up to $25,000 a year for IVF.

Many employers have embraced fertility benefits in recent years to attract and keep workers. In 2023, nearly half of companies with at least 500 employees covered IVF, according to benefits consultant Mercer’s annual employer survey.

The federal government — the largest employer in the country — now offers enhanced IVF coverage in about two dozen of its health plans, according to the Office of Personnel Management, which administers them.  

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More Patients Are Losing Their Doctors — And Trust in the Primary Care System

By Lynn Arditi, The Public’s Radio – First, her favorite doctor in Providence, Rhode Island, retired. Then her other doctor at a health center a few miles away left the practice. Now, Piedad Fred has developed a new chronic condition: distrust in the American medical system.

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