Reporter Bob Herman examines the booming business — and secretive inner workings — of the U.S. health care industry. | June 23, 2025 Check out STAT+ | | --- | | | | --- | | Sponsored By   | | --- | | By Bob Herman Reporter, Health Care Inc. Writer | | --- | | Jeff Bezos and Lauren Sánchez apparently are getting married this week in Italy, and these types of “super-weddings” can easily cost tens of millions of dollars. My wife and I got married almost 14 years ago, and we must have missed out on the technology to have $500,000 holographs of deceased relatives to wish us well. | | --- | | congress Hospitals are scrambling on Senate GOP bill Rogelio V. Solis/AP The Senate version of President Trump’s tax-cut bill would slash Medicaid enrollment and funding even more than the House version. Hospitals — which stand to lose hundreds of billions of dollars over the next decade — now are lobbying heavily to stop the Senate version from moving forward, my colleagues Daniel Payne and John Wilkerson report. In the House bill, Republicans were less harsh on Medicaid provider taxes, which is a financial maneuver to draw down more federal money for hospitals. The House bill also would grandfather “state directed payment arrangements,” another lucrative mechanism that has allowed hospitals to get paid a lot more for treating Medicaid patients. The Senate bill would take a bigger hatchet to those hospital funds. Two hospital lobbyists involved in congressional meetings told Daniel and John they believe enough Senate Republicans are uncomfortable with the bill in its current form that it will ultimately change, even with additional funding for rural hospitals.  A large irony in all of this: Even if hospitals get lawmakers to sign onto the House version, millions of people still would lose their health insurance. But hospitals’ revenue would be a bit more protected. Read more from Daniel and John, who are following this critical piece of legislation closely. unitedhealth Don’t be shredding your stuff, Semler  The California Public Employees’ Retirement System has an ongoing lawsuit against UnitedHealth Group, claiming UnitedHealth’s top leaders lied to investors about the company’s allegedly illegal business practices and profited from large stock sales tied to the lack of disclosure around those practices. My colleague Tara Bannow spotted a new filing in the case: CalPERS has served the medical device firm Semler Scientific with a “preservation subpoena” so the company keeps documents that CalPERS believes may help its case. CalPERS wants all the information between Semler and the Department of Justice, which has investigated Semler for potential fraud claims. But it also wants “all documents and communications with UnitedHealth concerning the QuantaFlo device,” according to a separate legal filing. That includes how many QuantaFlo devices UnitedHealth bought or rented from Semler, how UnitedHealth intended to use the device, and “communications with UnitedHealth concerning the DOJ investigation.”  Here’s a small teaser: Watch our website this week, or follow me on social media for updates. My colleagues and I will be publishing a story that dives deep into Semler — a company that had pledged to detect artery disease early, but now has pivoted to cryptocurrency speculation after Medicare’s multibillion-dollar pot of money dried up. Here’s our story from last year on the ties between Semler and UnitedHealth. medicare advantage The high commission CMS announced updated 2026 commissions for Medicare brokers, and those who steer people into Medicare Advantage plans are going to get a big raise. Agents and brokers will get $694 for signing up new Medicare Advantage enrollees and $347 for renewing people’s plans — both are 11% higher than 2025 commissions. Agents and brokers will get $114 for helping new traditional Medicare enrollees pick a prescription drug plan and $57 for renewing someone’s Medicare drug plan — just 5% and 4% higher than this year’s rates.  What does this mean? Brokers again will have major financial incentives to herd people into MA plans, even if those plans may not be the best fit for those Medicare beneficiaries. | | --- | --- | | | --- | --- | by the numbers Reality check on Medicare Advantage Medicare Trustees' report I’m not going to get into the “Medicare solvency date” discrepancy with the new Medicare trust fund report that came out (the trustees said Medicare won’t be able to pay 100% of benefits starting in 2033, three years sooner than they estimated last year and a whopping 19 years sooner than the Congressional Budget Office analysts recently predicted ¯\\\_(ツ)\_/¯ ).  Instead, I want to focus on this chart about Medicare Advantage plans. It’s filled with acronyms and numbers, but all you need to know is this: Over the past couple years, MA insurers have attempted to scare older adults and policymakers into thinking Medicare was getting cut. In reality, they were still pouring a lot of taxpayer dollars into supplemental benefits in 2024 and 2025 to attract people into their plans — more than any year prior to 2023. hospitals Government price-setting, credit positive? I’m a sicko and enjoy reading what the credit rating agencies have to say about their nonprofit hospital clients. Let’s just say it’s unusual to see praise for government regulation. But that was the case last week when S&P Global Ratings rated the debt of MedStar Health, a hospital system in Maryland with more than $8 billion of annual revenue.  Maryland has a longstanding waiver from the federal government to set hospital prices equally among public and private health insurers. S&P’s credit connoisseurs ultimately think this setup has been a good thing for hospitals like MedStar, saying it “reduces the burden of uncompensated care and eliminates market power issues from health plan negotiations.”  “In our opinion, the global budget arrangement under the Maryland system offsets risk related to declining volumes and provides additional support to the rating with a stabilized and more predictable revenue base,” S&P’s credit analysts wrote. | | --- | --- | More around STAT | | --- | | | | --- | | | | --- | | | | --- | | Check out more exclusive coverage with a STAT+ subscription Read premium in-depth biotech, pharma, policy, and life science coverage and analysis with all of our STAT+ articles. | | --- | --- | Industry odds and ends Boston Children’s Hospital is opting out of the big national antitrust settlement against Blue Cross Blue Shield plans and is suing the insurance companies on its own, according to a new lawsuit filed last week. Another one for monopoly and duopoly watchers: Markets that are dominated by DaVita and Fresenius “have much higher commercial prices for dialysis,” a large team of economists and researchers found in a new study published in JAMA Health Forum. Ascension has officially acquired Amsurg, the division of the bankrupt Envision Healthcare that controls 250 surgery centers, for roughly $3.9 billion, Eliza Ronalds-Hannon and Michelle Davis of Bloomberg report. Surgery centers are profitable facilities, and the nonprofit Ascension is willing to shell out $15.6 million per surgery center to turn things around and make its bondholders happier. In other surgery center news, Surgery Partners declined the takeover offer from the private equity arm of Bain Capital, which is Surgery Partners’ largest shareholder. Bain Capital said in a filing that it will continue to talk with Surgery Partners and others about potential mergers or any other “corporate transaction.” Ohio Attorney General Dave Yost officially signed off on General Catalyst’s acquisition of Summa Health, which will convert the nonprofit hospital system to a for-profit, with some extra terms and conditions (such as increasing the purchase price from $485 million to $500 million). For a refresher on what the venture capital firm wants to do with Summa, and some of the inherent tension involved, read this from my former colleague Mohana Ravindranath. This interesting LinkedIn post is a case study in why hospital price transparency often feels like an empty solution (and why facility fees in hospital-owned clinics have gotten out of control). This person’s son had a nasal cauterization in a clinic owned by Essentia Health, a nonprofit hospital system based in Minnesota. The procedure turned out to be more than three times as expensive as the self-pay/cash rate at the hospital. In 2018, the Children’s Hospital of Philadelphia and Orphion Therapeutics, a small biotech, started talking about how to collaborate on a gene therapy to treat a rare disorder that causes blindness in kids. The collaboration has imploded into a nasty legal dispute. Last year, Orphion, which is now shuttered, accused a top CHOP scientist of violating their agreements by starting a competing biotech. CHOP fired back in countersuit last week, alleging Orphion never made necessary payments. The Meme Ward | | --- | --- | # Thanks for reading! More next week.  | | --- | | ![](https://marketing.statnews.com/hs-fs/hubfs/email-templates/signatures/signature-bob-herman.png?noresize&upscale=true&width=400&upscale=true&name=signature-bob-herman.png) | | --- | --- | Enjoying Health Care Inc.? 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