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In the first quarter of 2024, annual growth in health care spending exceeded the levels seen before the COVID-19 pandemic. Yet hospital inpatient admissions, on a per capita basis, remained lower than pre-pandemic levels, reflecting a shift to outpatient centers, according to a recent Peterson-KFF Health System Tracker analysis.

As many elective hospitalizations were canceled or delayed at the beginning of the pandemic, health care spending dipped in late 2019 and early 2020. Shortly after that, year-over-year growth in health services spending rebounded to pre-pandemic levels and remained high, with double-digit growth since early 2023. Nursing and residential care facilities spending saw year-over-year growth ranging from 10.0% to 13.4% since the beginning of 2023.

If Medicare Part D covered GLP-1 drugs for obesity, rather than just Type 2 diabetes, it could increase annual spending by $3.1 billion to $6.1 billion, according to a recent Health Affairs study.

The introduction of GLP-1 medications for treatment of diabetes and obesity has reignited the debate over Medicare’s prohibition on covering weight loss medications. In June, the House Ways & Means Committee advanced legislation that would provide a limited pathway for adults 65 and older to get anti-obesity GLP-1s covered by Medicare. The bill has not yet passed the full House.

As CMS firms up plans to collect more granular information from Medicare Advantage organizations on service coverage denials, a timely analysis from KFF finds that their use of prior authorization (PA) surged to over 46 million requests in 2022. This marks a notable increase from the 37 million requests recorded in 2019, reflecting both the growing enrollment in MA plans and the expanding scope of services requiring prior approval. And while several insurers this year have publicized their efforts to eliminate PA requirements, providers say they’re still feeling the burden, and at least one major MA insurer is adding new PA restrictions.

While PA helps control costs and prevent unnecessary utilization, it can introduce potential barriers to timely care and frustrations for providers. Nearly all MA enrollees (99%) are subject to prior authorization for some services, particularly high-cost ones like inpatient hospital stays, skilled nursing facility stays and chemotherapy.

In 2023, the federal government received more than three times as many surprise billing payment disputes it received in 2022, and provider groups continued to win the vast majority of cases while reaping higher payment amounts, according to new CMS data.

The No Surprises Act (NSA), passed in 2021, banned the practice of billing patients for the difference between what their insurer pays and what a provider charges when patients unknowingly receive care from an out-of-network provider. The law also established a Federal Independent Dispute Resolution (IDR) process that out-of-network providers and insurers can use to determine the OON rate that providers should receive if the two parties fail in their own attempts to negotiate.

If Medicare Part D covered GLP-1 drugs for obesity, rather than just Type 2 diabetes, it could increase annual spending by $3.1 billion to $6.1 billion, according to a recent Health Affairs study.

The introduction of GLP-1 medications for treatment of diabetes and obesity has reignited the debate over Medicare’s prohibition on covering weight loss medications. In June, the House Ways & Means Committee advanced legislation that would provide a limited pathway for adults 65 and older to get anti-obesity GLP-1s covered by Medicare. The bill has not yet passed the full House.

Children and adolescents were much more likely to access necessary mental and behavioral health (MBH) services if they lived in states that mandate insurance coverage for mental health care, according to a recent study published in JAMA Network Open.

The study is based on responses from almost 30,000 caregivers of kids and adolescents ages 6 to 17 years with mental and behavioral health conditions in the National Survey of Children’s Health and State Mental Health Insurance Laws Dataset (SMHILD) from 2016 to 2019. The comprehensiveness of state MBH insurance laws was defined by the SMHILD score and categorized as 0 to 2, 3, 4, and 5 to 7.

With policymakers and industry stakeholders increasingly focused on the cost savings opportunities tied to biosimilars, a new Health Affairs study sheds light on some of the factors that influence uptake of these near-copies of pricey biologic medications.

Among almost 200,000 commercial and Medicare Advantage enrollees who newly initiated one of seven biologic drugs with available biosimilar versions — filgrastim, bevacizumab, epoetin alfa, trastuzumab, pegfilgrastim, infliximab and rituximab — the share of people initiating a biosimilar increased from 1% in 2013 to 34% in 2022. Patients who were younger than 18 years were less likely to initiate a biosimilar than other age groups. Meanwhile, enrollees in commercial high-deductible health plans were more likely to use a biosimilar, compared with those in MA plans.

The summer of 2024 is shaping up to be a hotbed of M&A activity among health systems that operate Medicare Advantage plans. While the year kicked off with Point32Health, Inc.’s planned acquisition of Baystate Health’s Health New England, which serves about 12,000 MA members, a flurry of deals announced in recent weeks will further shake up the landscape.

Kaiser Permanente in June unveiled its second Risant Health deal just a few weeks after shoring up its purchase of Geisinger Health, a 10-hospital system that operates one of the largest insurers in Pennsylvania. This time, the MA stalwart set its sights on Cone Health, a system of four hospitals in North Carolina. The health system also operates Triad HealthCare Network, a physician-led ACO, and an MA plan.

Affordable Care Act exchange insurers proposed a median premium increase of 7% in 2025, with most falling between a 0% and 10% increase, according to an analysis by Peterson-KFF Health System Tracker.

Among the 324 ACA exchange insurers across 50 states and Washington, D.C., that were included in KFF’s analysis, proposed premium changes ranged from a drop of -14% to a jump of 51%. And while 50 of the health plans proposed decreasing premiums, 85 requested rate increases greater than 10%.

Here’s how major health insurers’ stock performed in July 2024. UnitedHealth Group had the highest closing stock price among major commercial insurers as of July 31, 2024, at $576.16. Humana Inc. had the highest closing stock price among major Medicare insurers at $361.61.