EFI Welcomes Jonathan Levin, MPH, PhD

---

• “Bullshit” — The New Way Health Giants Hide Billions (Hunterbrook)
• What to Ask About a Hospital (CHIR)
• Anthem’s 62% Profit Margin in Federal Employees Health Benefits Contract (Healthcare Uncovered)
• First-Year Rural Health Fund Awards Range From Less Than $100 Per Rural Resident in Ten States to More Than $500 in Eight (KFF)
• Indiana to Bid $68B in Medicaid Contracts This Summer (IBJ)
• IU Health Awards $3.7M in Grants for Infant, Maternal Health Support (Inside IN Business)
• FDA Grants Speedy Approval to Eli Lilly’s Weight-Loss Pill for Obesity (IBJ)

Save the Date: All-Stakeholder Year-in-Review, Dec. 3

EFI members are invited for a very special All Stakeholder meeting on December 3rd for a private screening of The Tenderness Tour film. It’s a beautiful story of award-winning activist, Richard Propes, a cancer-survivor, double amputee with spina bifida, traveling through Indiana on a ‘Tenderness Tour,’ to raise awareness about the issues of the medical debt crisis in Indiana and the United States. Richard Propes traveled 150 miles across Indiana in 2024 for the Tenderness Tour raising over $100,000 to eliminate debt for Indiana families.

EFI member Jenni Nolan, who founded Clear Healthcare Advocacy, is featured in the film and will be joined by Andie Redwine, the film’s director.

IMBD Page
Movie Website

If you are an EFI member and haven’t received a calendar invitation for the meeting please contact Sara Otte.

---

Recap: September 10th All-Stakeholder Meeting

What does it take for employers to get real value from our health care system? That question guided our discussions at our September All-Stakeholder Meeting, where we explored three critical areas shaping employer health care strategy: prescription drug affordability, fiduciary risk and responsibility, and partnering for value. 

The key takeaway: employers have more leverage than they think.

By applying new laws, transparency tools, and fiduciary principles, you can drive real accountability and value. Future meetings will build on these insights, and new resources are being developed to help employers put them into practice.

Thank you to everyone who attended and contributed to such thoughtful dialogue! Download the slides.

---

A turning point in health care for employers and patients

Fueled by EFI’s data and advocacy, Indiana took bold steps to curb sky-high hospital prices and strengthen accountability. From banning hidden facility fees to requiring fair pricing and fiduciary oversight, these wins place Indiana at the forefront of national health care reform. Read the op-ed >

Employers

• Health care costs are soaring. Blame insurers, drug companies — and your employer (NPR)
• The Price Increases That Should Cause Americans More Alarm (KFF)
• Heartland Highlight: Longtime Hoosier activist tackles medical debt in new documentary (Indy Star)
• Beyond The Bill: The Hidden Economic Toll Of High Commercial Provider Prices (Health Affairs)
• A New Car vs. Health Insurance? Average Family Job-Based Coverage Hits $27K (KFF)
• GLP-1s, cancer care are driving higher employer health care costs in 2026 (STAT)
• Large employers forecast ‘daunting’ 9% hike in healthcare costs next year (Healthcare Dive)
• The ‘quiet alarm bell’ on U.S. health costs: Employers are backed into a corner, and workers are paying the price (Fortune)
• Employer health care expenses expected to soar next year (CFO)
• Medical debt tops $2 billion for Hoosiers. Experts say it’s likely higher (WFYI)

---

Policy

• Medicaid work requirements delayed until 2027 following federal action (Indiana Capital Chronicle)
• As Insurers Struggle With GLP-1 Drug Costs, Some Seek To Wean Patients Off (KFF)
• 340B rebate pilot tees up healthcare industry firestorm (Modern Healthcare)
• Consumer groups, debt collectors clash in medical debt hearing (Indiana Capital Chronicle)

---

Other healthcare:

• Braun on hospital costs: we can do better (WANE)
• How Indiana is driving down its hospital costs (Governing)
• Indiana’s nonprofit hospitals reported more than $1 billion in profits (Indy Star)
• Where private equity deals stand in 2025 (Modern Healthcare)
• When hospitals buy physician practices, prices go up (Indiana Capital Chronicle)
• Physician pay declines despite rising workloads: report (Modern Healthcare)
• Optum acquires 200-provider medical group (Becker’s)
• Urban hospitals increasingly poaching rural funds (Becker’s)
• Parkview Health to build $150M hospital in Lebanon (IBJ)
• Parkview Health plans $200M hospital, office building in West Lafayette (IBJ)
• UnitedHealth paid AARP $9B to sell Medicare products (AXIOS)
• Trump Demands That Drugmakers Lower Some of Their U.S. Prices by September (New York Times)

Sept 10 All – Stakeholder Member Meeting

This meeting will feature Antonio Ciaccia, President of 3 Axis Advisors and a nationally recognized expert in healthcare drug pricing and policy. Antonio will provide an overview of the current industry players, drug pricing trends, and opportunities to address drug affordability. 

Karen Handorf, J.D., a Full Professor of the Practice at Center on Health Insurance Reforms (CHIR) and an ERISA attorney, will provide an update on the latest employer lawsuits and discuss strategies for mitigating risk through fiduciary oversight and contracting.

To round out the meeting, Jessica Brooks-Woods, CEO of the National Association of Benefits and Insurance Professionals, will join me on stage to discuss how employers can work with their brokers and consultants to drive drug affordability and accountability.

Please contact Sara Otte, sara@employersforumindiana.org for any meeting questions.

---

Get to know the new CEO!

The EFI Team is thrilled to welcome Randa Deaton as our new President and CEO. Take a few moments to get to know her with the below quick Q/A!

What drew you to the Forum and what project or initiative are you most excited to work on? 

I could not be more excited and honored to join EFI; I consider it one of the most influential and impactful state employer coalitions in the country. After working for many years in this space in Kentucky and at a national level, I am most excited to be working and collaborating with employers in my home state of Indiana to drive improved health care affordability and quality on behalf of Hoosier workers and families.

What inspired you to pursue a career in this industry, and how has your journey shaped your perspective on healthcare?

My passion for improving health care comes from both my personal and professional experiences over the last two decades. As part of my role in benefit strategy at Ford Motor Company, I was charged with engaging and collaborating with peer businesses in Greater Louisville to improve healthcare quality and affordability; here I learned the power of collective impact to drive improved transparency, accountability, and health outcomes. I also spent over a decade as a caregiver to a family member with a serious illness, and here I learned what exceptional and accessible care looks and feels like and its extraordinary impact on individuals and families. I believe we should all be working together to ensure access to exceptional care that optimizes outcomes.

What are some of your favorite activities or hobbies outside of work?

My husband and I love to travel, camp, watch sports, and hang out with our adult sons. We spend half the year weekend camping (or glamping) at Indiana State parks with friends and family hiking, biking, and sitting around the fire. The other half of the year is spent at IU football and basketball games cheering on the Hoosiers – a family tradition from both of our families. 

---

Texas Employers for Affordable Healthcare / Houston Business Coalition on Health

Texas Employers for Affordable Healthcare / Houston Business Coalition on Health

PODCAST: Listening In (With Permission): LINK

Andréa Caballero (Catalyst for Payment Reform) talks with Chris Skisak, Executive Director of Texas Employers for Affordable Healthcare and the Houston Business Coalition on Health, to explore how Texas employers are fighting back against hospital consolidation, opaque contracts, and rising healthcare costs.

---

Hospitals:

• Construction On $4.3B Downtown IU Health Hospital Complex Nears Halfway Mark (IBJ)
• Ascension Enters Agreement To Acquire Amsurg Outpatient Centers (Modern Healthcare)
• IU School of Medicine Opens New $230M Education and Research Building (IBJ)
• 2025 Scorecard on State Health System Performance (Commonwealth Fund)
• Community Health Network President Bryan Mills Announces Retirement After Four Decades of Service (CHN)
• Ascension St. Vincent Celebrates Blessing, Ribbon Cutting of Lucas Family Brain and Spine Hospital (Ascension)

---

Policy:

• Scott Signs Bill Capping Drug Prices at Vermont Hospitals (Seven Days)
• Why One State Banned Corporate Ownership Of Doctors’ Offices (Modern Healthcare)
• What Health Care Provisions of the One Big Beautiful Bill Act Mean for States (NASHP)
• 2025 State Legislative End-of-Session Recap (CAHPR)
• Reining in Hospital Prices (US of Care)
• HHS Report Marks A Potential A Turning Point In Health Care Competition (Health Affairs)

---

Pharmacy:

• Prices For Obesity Drugs Fall, But Affordability Still Out Of Reach For Many (IBJ)

---

Public Health / Patients:

• Indiana’s Overall Child Well-Being Improves, With High Rankings In Economic And Education (ICC)
• Indiana Health Department Reports Potential Record-Low Infant Death Rate In 2024 (ICC)
• Doulas, Once a Luxury, Are Increasingly Covered by Medicaid — Even in GOP States (KFF)
• Surprise Medical Bills Were Supposed To Be a Thing of the Past. Surprise — They’re Not. (KFF)

---

Insurers:

• Health Insurers Promise To Improve Coverage Reviews That Prompt Delays, Complaints (IBJ)
• Insurers Vow To Make Prior Authorization For Treatment Easier. What That Means. (Washington Post)
• Indiana Chamber Will No Longer Have Anthem As Provider For Small-Business Health Coverage (IBJ)

---

Provider / Physician:

• An Attack on the Medical Establishment Buried in an 1,800-Page Regulation (NYT)
• Hospitals Scoop Up Physician Practices, Driving Prices Up (Axios)

---

Other:

• Price Changes: January 2000 to December 2024 (LinkedIn)

Employers:

• Podcast: No Extra Care, Just Extra Cost: Facility Fees with Patricia Kelmar (CPR)
• Survey: 36% of Employers Now Cover GLP-1’s for Weight Loss and Diabetes (BenefitsPro)

---

Hospitals:

• Podcast: Hospital Consolidation Across Geographic Markets with Katie Gudiksen and Brent Fulton (CPR)
• Making Hospital Tax Breaks Work for Communities (Lown Institute)
• Nonprofit Hospitals Are Quiet Quitting Their Charitable Missions (The Well News)
• 100 Rural Hospitals Have Closed Labor and Delivery In 5 Years: Report (Beckers)
• FTC, Indiana AG Urge Rejection of HCA, Union Health Merger (Beckers)
• Beyond Cost Shifting: Market Power as the Key Driver of Hospital Prices (ERIC)

---

Pharmacy:

• Roche Diagnostics Hopes New Self-Collection HPV Test Will Expand Screening for Cervical Cancer Risk (IBJ)
• The 25 Most Expensive Hospital Drugs (Becker’s)

---

Public Health / Patients:

• 29 Million Americans Can’t Afford Health Care, Highest Number Since 2021 (Benefits Pro)
• In U.S., Inability to Pay for Care, Medicine Hits New High (Gallup)
• Podcast: Winning a Two-Year Fight Over a Bogus Bill (An Arm and A Leg)
• Preserving Young Patient’s Hair Prompts IU Surgeons’ Invention (IBJ)

---

Policy:

• How Much Will That Surgery Cost? Hospital Prices Remain Largely Unhelpful. (KFF)
• Braun’s ‘Make Indiana Healthy Again’ Plan Tightens Food Stamp Requirements, Examines Hoosier Nutrition (IBJ)
• Indiana Lawmakers Send Hospital Pricing Legislation to Braun (IBJ)
• States Take The Reins on Insurance Reform (Politico)

---

Other:

• Improving Price Transparency Data: Recommendations From Practice (Health Affairs)

Interested in past meeting topic or presentation? All past EFI All-Stakeholder Meeting presentations are freely and publicly available here. Check out top of mind healthcare topics today!

Texas Employers for Affordable Health Care

Webinar: Employer Health Care Data Field Guide

When: April 17, 2025 at 1pm ET

Registration: Link

Overview: During this webinar, the Employer Health Care Data Field Guide will be unveiled. The Guide is a one-of-a-kind roadmap for navigating the complexities of healthcare data access. The Guide’s author, Chris Deacon will guide attendees through its content including:

•  Making the Most of the Data
• The Importance of Healthcare Data for Plan Sponsors
•  Fiduciary Duty of Plan Sponsors
•  Primer on Laws & Regulations
•  How to Get the Data, including letter templates and responses to TPA objections

---

National Alliance of Healthcare Purchaser Coalitions

Download The Resource: PBM Misalignment Initiative: Final Report

Overview: The National Alliance PBM Misalignment Initiative investigates and addresses misalignment between employers and their pharmacy benefit management (PBM) service providers. 

Building on the 2023 PBM Playbook and other related resources, this final report provides an overview of the current PBM landscape, examines factors driving misalignment, and identifies actionable steps employers can take to improve PBM practices and prices.

---

Employers:

• Transparency and Accountability: The Path to Meaningful Health Care Pricing Reform (ICC)
• Even ‘Good’ Employers Face Rising Risk of Lawsuits Over Health Plan Costs (Benefits Pro)
• New Tools to Health Employers Ensure Compliance with Mental Health Parity and Addiction Equity Act Released (National Alliance of Healthcare Purchaser Coalitions)

---

Hospitals:

• Indiana System Signs Definitive Agreement to Acquire 19th Hospital (Beckers)
• Indiana Hospital Merger Would Lead to Higher Health Care Prices and Job Losses (Yale)

---

Insurer:

• UnitedHealth to Reimburse Pharmacies More for Brand-Name Drugs (Modern Healthcare)
• UnitedHealth Group PBM to Cut Some Drug Reauthorization Requirements (Modern Healthcare)

---

Private Equity:

• State Spotlight: New Massachusetts Law Enhances Oversight of Private Equity in Health Care (CHIR)

---

Pharmacy:

• Medicare Part D Spending on 10 Diabetes Drugs Hit $35.8B in 2023 (MedCity News)
• Novo Nordisk Launches Lower-Cost Wegovy, Following Eli Lilly Into Direct-to-Patient Sales (MedCity News)

---

Policy:

• State Leaders Downplay Concerns of Possible Federal Medicaid Cuts (IBJ)
• Indiana Lawmakers Seek To Forbid Hospital Monopolies, But One Merger Fight Remains (KFF Health News)
• Senate Committee Advances Hospital Price Bill, But Expects More Changes (IBJ)
• Power, Money and Finger-Pointing: Gov. Braun Picks a Side in Muddy Health Care Price Fight (Indy Star)

---

Other:

• What Does the Future Hold for Public Health Funding? (ICC)
• Time for More Changes to Hoosier Hospitals (Indiana Capital Chronicle)
• Americans Borrow Estimated $74 Billion for Medical Bills in 2024 (Gallup)
• John Arnold’s Top Three Health Care Reforms (AV)

Interested in past meeting topic or presentation? All past EFI All-Stakeholder Meeting presentations are freely and publicly available here. Check out top of mind healthcare topics today!

Midwest Business Group on Health

Webinar: Empowering Employers: Experts Weigh in on CGM Technology, Benefits, and the Need for Choice

When: March 4, 2025 from 2-3:30pm ET

Registration: Link

Overview: If the question is, “What’s today’s game changer in diabetes management?” The answer can be summarized in just three letters — CGM. This free session will explore how Continuous Glucose Monitoring (CGM) can provide the data needed for individuals to make behavior changes and improve glucose control. Learn what industry experts recommend when it comes to health plan coverage of CGMs and how this technology can benefit individuals living with diabetes, types I and II. This webinar will offer valuable insights into harnessing the power of CGMs to transform how diabetes is managed at your organization.

---

National Alliance of Healthcare Purchaser Coalitions

In Person Conference: 2025 Health Policy Summit

When: March 6, 2025 in Washington, DC

Overview: The Purchaser Business Group on Health and the National Alliance of Healthcare Purchaser Coalitions will co-host the 2025 Policy Summit.

---

Employers:

• Employers Increasingly Promote Wellbeing To Workers (IBJ)
• Meet America’s Best Large And Midsize Employers 2025 (Forbes)

---

Hospitals:

• Guardian Journalists Show The Harm Of Hospital’s High Prices (AHCJ)
• New 100-Bed Hospital With Maternity Services Coming To Hamilton County. Here’s Where (IndyStar)
• Indiana System Revives Bid For HCA Hospital (Beckers)
• Community Health Partnership Will Build 2 Behavioral Health Centers, Adding 240 Beds (IndyStar)

---

Private Equity:

• Increases In Physician Professional Fees In Private Equity–Owned Gastroenterology Practices (Health Affairs)
• Variation In Hospital Salary Expenditures And Utilization Changes After Private Equity Acquisition, 2005–19 (Health Affairs)
• Changes in Patient Care Experience After Private Equity Acquisition of US Hospitals (JAMA)

---

Pharmacy:

• Kroger Health Reunites With Express Scripts (Modern Healthcare)
• Drug Costs and Their Impact on Care: Insights from Medicare Patients and Providers (Commonwealth Fund)

---

Policy:

• Indiana Lawmakers Toyed With Health Care Cost Bills For Years. Is This The Year For Change? (IndyStar)

---

Other:

• From Laggard To Leader: Why Health Care In The United States Is Failing, And How To Fix It (Health Affairs)
• Understanding Health Care Price Variation: Evidence From Transparency-In-Coverage Data (Health Affairs)
• Bringing Hospital Care to Patients’ Homes (Washington Post)

Feb 14 Meeting

All Forum members are invited to our Forum All Stakeholder meeting on February 14th from 9:00 – 11:30am ET. Snacks will be provided and the full agenda can be found here.

If you are a Forum member and did not receive an invite, please contact Sara Otte at sara@employersforumindiana.org.

Midwest Business Group on Health

Webinar: Empowering Employers: Experts Weigh in on CGM Technology, Benefits, and the Need for Choice

When: March 4, 2025 from 2-3:30pm ET

Registration: Link

Overview: If the question is, “What’s today’s game changer in diabetes management?” The answer can be summarized in just three letters — CGM. This free session will explore how Continuous Glucose Monitoring (CGM) can provide the data needed for individuals to make behavior changes and improve glucose control. Learn what industry experts recommend when it comes to health plan coverage of CGMs and how this technology can benefit individuals living with diabetes, types I and II. This webinar will offer valuable insights into harnessing the power of CGMs to transform how diabetes is managed at your organization.

Employers:

• Purdue Remains No. 1 For Second Year in Healthiest Employers of Indiana (Purdue)

---

Hospitals:

• Commercial Inpatient Hospital Price Growth Driven by System Affiliation and Nonprofit-Status Hospitals (HCCI)
• A Busy Hospital M&A Period Continues (Beckers)
• Indiana Hospital to Rebrand After Joining Deaconess Health (Beckers)

---

Providers & Physicians:

• Three of Indiana’s Leading Independent Orthopedic Practices Announce Merger to Form OrthoIndiana (OrthoIndy)

---

Private Equity:

• Growth of Private Equity and Hospital Consolidation in Primary Care and Price Implications (JAMA)

---

Pharmacy:

• 6 Drugs Now in Shortage (Beckers)
• Where Smaller PBMs are Headed this Year (Modern Healthcare)
• Lilly Acquires Scorpion Therapeutics in Deal Worth up to $2.5B (IBJ)
• FTC Releases Second Interim Staff Report on Prescription Drug Middlemen (FTC)
• Largest Pharmacy-Benefit Managers Hiked Up Drug Prices, FTC Says (WSJ)

---

Policy:

• Indiana Nonprofit Hospitals Sitting on Billions of Dollars Worth of Net Assets, Legislator Says (IBJ)
• FTC Updates Merger Reporting Rules: 5 Things to Know (Beckers)
• Braun Signs Executive Orders on Abortion Records, Health Care Costs (ICC)

---

Public Health

• Biden Administration Moves to Ban Medical Debt From Credit Scores (NYT)

2024 Year-in-Review

Thank you for another productive year of meetings, discussions, collaboration, and networking! 

To explore highlights of the past year, including key meetings, projects, and initiatives, check out our 2024 Year in Review presentation.

If you missed a meeting or need to revisit any materials, visit our website for links to all of our past slide decks and resources.

---

Refreshed Data in Sage Transparency

On December 17th Sage Transparency was updated with data from RAND 5.1 (see the next section for details), CMS Hospital Quality and Patient Experience Star Ratings, CMS Hospital Readmission Penalties, and Quantros Hospital Quality Reliability Scores.

---

Recent Presentations

In November, Gloria Sachdev was invited to present for the following organizations where she shared market and policy ideas to advance transparency, affordability, and competition:

• November 12th: National Association of Health Data Organizations
• November 20th: Georgetown University
• November 22nd: Connecticut Office of Health Strategy

On December 10th, RAND Corporation released an update to round five of its employer-led price transparency study. This update incorporates additional claims data and refinements to their original analysis. Highlights include:

• In 2022, employers and private insurers paid an average of 254% of what Medicare would have paid for the same inpatient and outpatient hospital services at the same facilities (including both facility charges and related professional claims).
• State-level median prices have remained stable across the past three study rounds: 254% of Medicare in 2018 (Round 3, 2016–2018 data), 246% in 2020 (Round 4, 2018–2020 data), and 253% in 2022 (Round 5.1 — this study, 2020–2022 data).
• The new data includes trends in emergency service pricing at the state and national levels between 2018 and 2022.

Use the link below to download the updated report and supplemental data.

Each year, we are proud to honor outstanding individuals and organizations who are working to improve our healthcare systems. Please join us in congratulating both recipients on this well-deserved recognition. These trailblazers are truly making an impact and inspiring change across the country!

2024 EFI Dave Kelleher Leadership Award

Schweitzer Engineering Labs

Pamela Colley, Senior Public Affairs Manager
Chris Foutch, Senior Finance Supervisor

The amazing team at Schweitzer Engineering Labs (SEL) was awarded the 2024 Dave Kelleher Leadership Award for their dedication to advancing healthcare price transparency. SEL has demonstrated exceptional leadership through various initiatives, including establishing direct contracting, addressing price variations, leveraging claims data to eliminate hidden fees, and optimizing prescription drug management. Their support of market and policy initiatives that align payments with the value of services sets an example of the leadership this award celebrates.

---

2024 Healthcare Innovation Award

Mark Cuban

Mark Cuban was awarded the 2024 Healthcare Innovation Award for his groundbreaking work with the Mark Cuban Cost Plus Drug Company, PBC. His transparent, no-nonsense approach to prescription drug manufacturing and pricing is revolutionizing the healthcare industry. By eliminating traditional middlemen like PBMs, Cost Plus Drugs has enhanced transparency and fostered trust among consumers and employers by providing access to safe, affordable medications.

---

Employers:

• US Employers Prioritize Wellbeing but Miss the Mark with Employees (WTW)
• Small Businesses Search for Affordable Health Care (Matter of Fact)
• Why the U.S. Healthcare System is so Much Worse than its Peers (Harvard Business Review)

---

Hospitals:

• Is Hospital Market Concentration Related to Medical Debt? (Urban Institute)
• Virtual Hospital-at-Home Could Offer Alternative to CMS Waiver (Modern Healthcare)
• Indiana Hospitals Pull Merger Application After Pushback Over Monopoly Concerns (KFF)
• 25 Largest Health Systems by Hospital Beds (Beckers)

---

Providers & Physicians:

• Fact Sheet: Nursing Faculty Shortage (AACN)
• The Bad News Behind the Rise in Locum Tenens (MedScape)
• OrthoIndy and Indiana Hand to Shoulder Center Announce Alignment (OrthoIndy)

---

Conglomerates:

• Justice Department Sues UnitedHealth Over Amedisys Deal (Beckers)

---

Insurance:

• UnitedHealth Pays its Own Physician Groups Considerably More than Others, Driving Up Consumer Costs and its Profits (STAT)

---

Pharmacy:

• Same Drug, 2,200 Different Prices (WSJ)
• U.S. Patent Office Pulls Controversial Rule to Curb Pharma Patent Abuse (STAT)
• How a Duty To Spend Wisely on Worker Benefits Could Loosen PBMs’ Grip on Drug Prices (KFF)

---

Policy:

• CY 2025 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS)
• New York Targets PBMs with New Transparency, Competition Rules (Modern Healthcare)
• Reporting of Health Care Entity Mergers and Acquisitions (IN.gov)
• Make America Healthy Again: 6 Healthcare Positions of RFK Jr. (Beckers)
• Hospital Payment Cap Simulator (Brown University)

---

Public Health

• Seven Key State-Level Strategies for Supporting Community-Level Harm Reduction (NASHP)
• States Ranked by Preterm Birth Rates (Beckers)
• The Maternity Care Project

---

Other Healthcare News

• View of U.S. Healthcare Quality Declines to 24-Year Low (Gallup)
• Everyone’s Mad at Health Insurers, But ‘There’s Plenty of Blame to Go Around’ (TradeOffs)
• It’s a Big Thing: Medical Spread Pricing. So, Let’s Talk About Contract Transparency, With Cynthia Fisher (Relentless Health Value)

Upcoming Meeting

Mark your calendar for our EFI Member All-Stakeholder Meeting November 12th, from 1:00 – 5:00pm ET! The Agenda is below and a calendar invite will be sent to members in early October.

1. Welcome and EFI Year in Review
2. Value Based Payments: What is it?
3. Indiana All-Payer Claims Database (APCD) Demonstration
4. Panel Discussion: Improving Access to Maternal and Infant Care
5. Awards / Closing
6. Networking Cocktail Hour

---

Vice President Job Opening

The Forum seeks a highly organized Vice President to support our membership, education, and research efforts. The VP will work in tandem with the Forum’s CEO and Director of Business Operations to improve the value received by employers and patients for their health care expenditures. This role reports to the CEO. For more information go here. If interested in the position, please send a resume to Sara Otte at sara@employersforumindiana.org.

---

Presentations

In October, Gloria Sachdev was invited to give presentations regarding market and policy ideas to advance transparency, affordability, and competition to the following organizations:

• October 28th: Center on Health Insurance Reforms at Georgetown University
• October 30th: Catalyst for Payment Reform

The 26th KFF Annual Employer Health Benefits Survey was released on October 9, 2024. The survey examines trends in employer-sponsored health coverage, including premiums, employee contributions, cost-sharing provisions, offer rates, wellness programs, and employer practices. This year, employers were also asked about their provider networks, abortion coverage, family building benefits, coverage for GLP-1 agonists as well as programs for lower-wage workers. The survey includes 2,142 interviews with non-federal public and private firms. Learn more about the report in these Wall Street Journal and Health Affairs articles.

Investigative journalist George Joseph’s released a report on October 17th revealing troubling insights into Parkview Health System. Despite being headquartered in the nation’s most affordable city, Parkview’s hospital prices rank among the highest in the country. Full report here. A follow up article was then released on October 24th with Hoosier employers, families and lawmakers weighing in on Indiana’s healthcare market. Read the follow up report here.

This report uncovers many of the deep-rooted inefficiencies that exist across the U.S. healthcare system including:

• The harmful effects of health system consolidation;
• aggressive billing practices;
• lack of transparency;
• high and variable pricing;
• cost shifting to commercial payers; and
• inequitable access to care.

When large systems dominate the market, the lack of competition leads to unchecked price hikes, leaving patients and employers without options. To ensure healthcare is affordable and accessible, we need meaningful reform that holds healthcare systems accountable.

National Alliance of Healthcare Purchaser Coalitions

In Person Conference: Manifesting a New Destiny: Employers Creating the Future of Healthcare

Agenda: Link

Date: November 18th – 20th

Registration: Link (EFI has a limited number of free registration codes. If you are an Employer Member of EFI and interested in attending this event, please contact Sara Otte at sara@employersforumindiana.org.)

Overview: The Annual Forum will take place in Arlington, VA, November 18-20, 2024. This event brings hundreds of employers, business coalition leaders, and healthcare stakeholders to discuss successful strategies and emerging trends in healthcare value; health policy; and benefits, wellbeing and health equity.

---

Employers:

• Third Annual Conference Tackles the Cost of Hospital Care (City and State NY)
• 32BJ Health Insights 2024 Conference, The Price of Power: Confronting the Hospital Affordability Crisis (32BJ Health Insights)
• Employers Require More Health to Improve Health-Care Affordability (Bloomberg Law)
• Rising Health Care Prices are Driving Unemployment and Job Losses (Yale)
• A Five-Lever Framework For Pres (Benefits Magazine, pg 40)
• ICHRAs vs. Self-Funded Plans: Choosing the Best Health Benefits Solution for Your Employees (The Alliance)

---

Hospitals:

• Methodist Hospital to Come Tumbling Down After IU Health Opens New Hospital (IBJ)
• IU Health Breaks Ground on Fort Wayne Hospital (Inside Indiana Business)
• Days of Cash on Hand at 35 Health Systems (Beckers)
• The $37.4 Billion Tilted Playing Field For Nonprofit Hospitals (Forbes)
• Parkview’s Pricing Again Comes Under Scrutiny (Journal Gazette)
• Ascension to Open $200M Indiana Women and Infants Hospital (Beckers)
• IU Health Bloomington Hospital Pays for Some Patients to Transfer to Bedford (IN Public Media)
• Shining a Light on Corporate Hospital Systems’ Role in Driving America’s Healthcare Cost Crisis (Hospital Watch)
• Indiana Hospital Association Names Longtime Health Care Leader as New President (IBJ)

---

Providers & Physicians:

• Marathon Health Expands Network to 720 Locations (IBJ)
• Draft for Public Review and Comment: Principals for Alternative Payment Models (CPR)
• Health Care Administrators: A Call for Equal Transparency and Accountability (KevinMD)
• 11 Providers Being Acquired by Payers (Beckers)

---

Conglomerates:

• Exclusive: CVS Explores Options Including Potential Break-Up, Sources Say (Reuters)
• CVS Lays Off 400+ at Aetna Headquarters (Beckers)
• UnitedHealth Posts $6.1B Profit in Q3 (Beckers)
• Meet UnitedHealth’s Executive Team (Beckers)
• Elevance Health to Make $11.9M Expansion in Indianapolis, Add 230 Jobs (IBJ)
• Elevance Posts $1B Profit in Q3, Lowers Earnings Forecast (Beckers)
• Kroger Sells Specialty Pharmacy Unit to Elevance (Beckers)

---

Insurance:

• Patient Safety Experts Want Progress on Quality Measure Alignment (Modern Healthcare)
• Aetna Launches Deductible-Free Plan: 5 Notes (Beckers)
• Biden Administration Proposes a Rule to Make Over-The-Counter Birth Control Free (NPR)
• “Not Medically Necessary”: Inside the Company Helping America’s Biggest Health Insurers Deny Coverage for Care (ProPublica)
• Labor Department, UnitedHealth Settle Alleged Emergency Claims Issues (Beckers)

---

Pharmacy:

• Why Your Pharmacy Experience Is Miserable (Time)
• State Insulin Copay Caps (American Diabetes Association)
• What Went Wrong at CVS? (The Week)
• How Would Authorizing Medicare to Cover Anti-Obesity Medications Affect the Federal Budget? (CBO)
• Cell and Gene Therapy Approvals Drive Paradigm Change in Manufacturing (Pharmaceutical Technology)
• A Free Drug Experiment Bypasses the US Health System’s Secret Fees (Bloomberg)
• Walgreens to Close 1,200 Locations as Retail Sales Decline (Washington Post)
• Walmart Plans to Deliver Prescriptions Nationwide in as Little as 30 Minutes (CBS News)
• A Report in Response to the Executive Order on Lowering Prescription Drug Costs for Americans (CMS)
• FDA Authorizes Marketing of First Home Flu and COVID-19 Combination Test Outside of Emergency Use Authorities (FDA)

---

Policy:

• Feds Back Healthcare Workers in Noncompete Lawsuit (Modern Healthcare)
• Lawmakers Scrutinize “Black Box of State PBM Spending” (ICC)
• How State Policy Makers Can Tackle Medical Debt: Lessons From North Carolina (Health Affairs)
• FTC Objection to Proposed Terre Haute Hospital Merger Centers on Controversial State Law (Indiana Lawyer)
• Key Committee to Vote on Maryland Drug Affordability Board Plan (WYPR)

---

Public Health

• In Landmark Move, EPA Requires Removal of All U.S. Lead Pipes in a Decade (Washington Post)
• 2024 Health of Women and Children Report (America’s Health Rankings)

---

Other Healthcare News

• Medicare Plans Are Making Big Changes for 2025. Here’s How to Navigate Them. (WSJ)
• Healthcare Executive Pay Jumps 4.6%: 5 Notes (Beckers)
• An Epic Dystopia: How a Near-Monopoly Gained Control of Most of the Nation’s Electronic Medical Records, to the Detriment of Medical Practice and Doctor Morale (The American Prospect)
• The Incursion of Profit-Enhancing Middlemen In US Health Care (Health Affairs)