Edward Scheidler retweeted
Friends, the sheer volume of fraud taking place in recent years throughout the world, and in America in particular, is staggering. I heard recently that the high end of federal estimates of the amount of money stolen per year in America is greater than the GDP of Vietnam, the Philippines, or Denmark.
This is a real blight upon our society, made possible, at least in part, by religious disaffiliation.
Since morality is grounded, ultimately, in God, one consequence of disaffiliation is an increase in moral drift, relativism, and indifference.
If we want to protect the common good, we have to recover a moral integrity rooted in the Ten Commandments, the Beatitudes, and the parables of Jesus.
Edward Scheidler retweeted
I encourage everyone to read @DutchRojas, whose analysis of Massachusetts’ healthcare delivery and financing system is excellent.
The great irony? One of America’s most contrived, least competitive healthcare markets is home to @SenWarren and @SenMarkey - two politicians perpetually tilting at the windmills of oligarchy.
When a not-for-profit hospital has a chief investment officer, portfolio managers, and $19 billion under management, one might reasonably ask - Is this a hospital with a hedge fund, or a hedge fund with a hospital?
Follow the money and you’ll find the mission.
Edward Scheidler retweeted
I used to sneak misfits into government meetings. Tiny companies using price data to help patients find cheaper, better care.
Now they’re on stage at HHS and in the footnotes of the Federal Register.
Hospitals hiding prices have a new sheriff to worry about.
Transparency is going mainstream. I'm breaking down the latest developments tomorrow.
Sign up at katytalento.com
Edward Scheidler retweeted
Medicare paid $3,718.37 for teriflunomide. It costs $37 here.
$109.3M wasted in a year of Medicare claims. Taxpayers cover it.
forestparkpharmacy.com, check the price checker, transfer today to save. See ya.
Edward Scheidler retweeted
🚨🚨 Billionaire cancer doctor Patrick Soon-Shiong told Tucker Carlson that nearly every oncologist ignores the one number in your blood test that kills cancer:
“Pick up the phone, call any random oncologist—not to shame them—and say: ‘You do a blood count, right?’ A complete blood count. You take blood and check if you’re anemic or not.”
“And you give chemotherapy and radiation, and you ask: ‘What are you looking for?’ Well, we look to see if you’re anemic, so we can give you this drug made by Amgen called Epogen. We look to see if your platelets have dropped, so we can give you a platelet transfusion. We look to see if your neutrophils have dropped so you don’t get an infection, so we give you Neupogen.”
“Well, the problem is, do red blood cells kill cancer? No. Do platelets kill cancer? No. Do neutrophils kill cancer? No.”
“What kills cancer? Natural killer cells and T cells. So in that blood count, there’s one thing called lymphocytes. Do you look at that? No.”
“The only cell that’s important, that kills cancer, and 99.9% of oncologists will say: ‘We don’t pay any attention to that.’”
Even Tucker couldn’t believe it: “Why, if you’re fighting cancer, would you ignore the one cell that fights cancer?”
“That’s the missing link. That’s the key element in your body.”
Edward Scheidler retweeted
Virginia could make abortion a “constitutional right.”
Question 1 would allow abortion up to birth.
This is what a baby looks like in the third trimester.
This child is not a body part. He or she is not a clump of cells.
This child is a unique and valuable human being worthy of protection.
Vote NO.
Edward Scheidler retweeted
ASPE just released what happened when Medicare cut 340B drug payments in 2018, then restored them in 2022.
Good news for practices that want to be acquired!
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A new analysis from ASPE uses Medicare fee-for-service hospital outpatient claims from 2015–2024 to look at the impact of reducing Medicare drug payments for 340B claims.
In 2018, Medicare changed reimbursement for affected 340B drugs from average sales price (ASP) +6% to ASP −22.5%.
Payment returned to ASP +6% in September 2022 after the new payment rate was invalidated by the Supreme Court for not doing an acquisition cost survey first (now CMS has done that and are trying again with ASP -33.4%).
Here’s what happened, with spending adjusted for inflation:
📈 Before the cut: Total hospital outpatient drug payments increased 32.5% from 2015–2017.
💊 During the cut: Payments for affected 340B drugs increased from $5.8 billion in 2018 to $7.1 billion in 2021 (~22% increase over four years), with most of that growth occurring in 2019.
💰 After the reversal: Payments for those drugs rose from $7.1 billion in 2021 to $10.7 billion in 2023 (~51% over two years). Non-340B drug payments declined over the same period.
These figures exclude the court-ordered retroactive repayments made in 2024.
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The off-campus hospital outpatient results particularly stuck out to me.
Payments for affected 340B drugs increased from $2.8 billion to $3.6 billion between 2021 and 2023, despite fewer claims and a similar number of beneficiaries served.
ASPE argues that the resulting revenue opportunity strengthens incentives for hospitals to acquire practices and expand off-campus since they appear to receive such a strong benefit from the higher 340B payments, which aligns with most of the data for independent practice acquisitions by hospitals.
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Nice to see Drug Channels cited in the report! Reference 10 is the June analysis from Drug Channels.
👉 The 340B Contract Pharmacy Market in 2026: A Maturing Industry Dominated by Big Chains and PBMs drugch.nl/3RHKnRy
Do you expect something similar to happen with the proposed ASP -33.4% reimbursement rate?
🔗 Source: ASPE aspe.hhs.gov/sites/default/f…
Edward Scheidler retweeted
The show is live now get in here!!!! youtube.com/live/0EwGo2BGdnE…
The @ISDUpdate Morning After Recap show will be live today at 11 AM ET.
We’ll talk freshmen running backs, Notre Dame’s upcoming test, and whatever comes up in the chat! Come hang! youtube.com/live/0EwGo2BGdnE…
Edward Scheidler retweeted
Op-ed @statnews by @HHSGov Chief Economist and Chief Regulatory Officer @caseybmulligan:
"A 340B hospital that buys another hospital or a physician practice can register more off-campus clinics and contract pharmacies and capture more spread. Hospital off-campus clinic sites grew from about 7,000 in 2013 to more than 34,000 in 2023, often in neighborhoods that are wealthier and better-insured than that of the parent hospital. Contract pharmacies grew from roughly 1,300 in 2010 to more than 31,000 by mid-2026, dominated by the largest chains.
With greater bargaining power after acquisitions, hospital systems can negotiate higher commercial prices for health care services, which can in turn raise premiums. Newly acquired hospital outpatient sites can also add facility fees to non-drug services. The effects of 340B show up as larger, more expensive hospital systems and a bigger bill for patients, employers, and taxpayers."
Full article: statnews.com/2026/10/08/340b…
340B Program Timeline & Growth
h/t Aiden Lee, Khrysta Dunkel @KhrystaDunkel, Eden Volkov, Sebastian Askar, @caseybmulligan
Edward Scheidler retweeted
New @HHS_ASPE report: Mission vs. Margin: Misaligned Incentives in the 340B Drug Pricing Program
aspe.hhs.gov/reports/misalig…
h/t Aiden Lee, Khrysta Dunkel @KhrystaDunkel, Eden Volkov, Sebastian Askar, @caseybmulligan
@HHSGov @CMSGov @HHSResponse
Edward Scheidler retweeted
This is an INSULT to every Sick American, Physician and Healthcare Worker.
I’m a staunch President Trump supporter and Conservative. I’ve been a Family Physician for 23 years.
2 years in and there has been ZERO real Healthcare Reform.
You even CUT Doctors Pay while making Corporate Healthcare and the AMA WEALTHIER.
Healthcare purchased through Health Insurance is 18% the Economy! Healthcare purchased through Health Insurance costs more than Food, Energy and Military Spending COMBINED.
Healthcare purchased through Health Insurance costs $1 of every $6 you spend EVERY DAY.
It has destroyed our economy. We will never fix Healthcare without a Robust Free Market Medical Care economy.
Edward Scheidler retweeted
DIR fees: money clawed back from the pharmacy weeks or months after the claim was paid and the member walked out. The price on the receipt was never the final price. Nobody at the counter knew that, including the pharmacist.
Edward Scheidler retweeted
𝐒𝐭𝐚𝐧𝐟𝐨𝐫𝐝 𝐇𝐞𝐚𝐥𝐭𝐡 𝐂𝐚𝐫𝐞 𝐫𝐞𝐩𝐨𝐫𝐭𝐞𝐝 𝐭𝐰𝐞𝐧𝐭𝐲 𝐜𝐞𝐧𝐭𝐬 𝐢𝐧 𝐜𝐡𝐚𝐫𝐢𝐭𝐲 𝐜𝐚𝐫𝐞 𝐟𝐨𝐫 𝐞𝐯𝐞𝐫𝐲 $𝟏𝟎𝟎 𝐢𝐧 𝐫𝐞𝐯𝐞𝐧𝐮𝐞.
I keep picturing the two dimes.
When people hear “nonprofit hospital,” I suspect many imagine an institution that makes a substantial effort to help patients who cannot afford their bills.
So look at the actual figure.
Stanford reported $25.5 million in free or discounted care for qualifying patients during its fiscal year ending August 2025. Measured against revenue, that comes to 0.20%.
Stanford also reports community benefits such as Medicaid losses, research and training. Those activities have value. They belong in the discussion.
As does the patient trying to figure out whether the hospital will reduce a bill the family cannot pay.
Twenty cents out of every $100.
Does that match what you expected when you heard “nonprofit”?
Edward Scheidler retweeted
Tough to pay for value when the real prices of medicines are intentionally invisible.
Great discussion at @avbcancercare with @ntlalliancehlth @JaysonSlotnik @PopovianPharmD @AstraZeneca @drjmob
Edward Scheidler retweeted
"Some Medicare patients owe more in coinsurance than the hospital paid for their drug. That arithmetic sounds impossible."
That's #340B in hospitals for you. All about the profits, not the patients.
statnews.com/2026/10/08/340b…
Edward Scheidler retweeted
A new analysis found we spent $244 billion on 340B (2025).
340B drugs accounted for an estimated 26.5% of ALL U.S. net pharmaceutical spending.
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A new BRG analysis estimates that patients and payers spent $244.3 billion on medicines purchased through 340B in 2025.
The estimate includes both the $102.1 billion covered entities spent to acquire those drugs and the difference between acquisition cost and total reimbursement from payers = $142.2 billion in 340B drug margin.
340B margin more than doubled from 2021 to 2025.
Closely aligned with what we found for 340B in Minnesota (blog drugch.nl/4e533DS), commercial and Medicare plans account for the majority (88%) of 340B margin.
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The $142.2 billion is the estimated margin between total reimbursement ($244.3B) and acquisition cost ($102.1B). That margin may be retained by covered entities or paid to contract pharmacies and other partners.
These are estimates, not a comprehensive accounting of reported transactions--the analysis uses assumptions about drug discounts, reimbursement, and payer mix.
There is no comprehensive public reporting on the program’s margin or how it is used, so analytical estimates like these are the best available.
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340B prescriptions represented more than 26% of all U.S. net drug spending in 2025, up from 17.6% in 2021.
At this size, I think it's fair to ask which patients benefit, how much of the margin supports care, and who ultimately receives it.
What data should be required to answer those questions?
🔗 Source: Berkeley Research Group (funded by PhRMA) media.thinkbrg.com/wp-conten…
Edward Scheidler retweeted
“Has 340B's rapid expansion been driven by patient need-or by the market power of large teaching hospitals with greater resources, staffing, and financial reserves?” Check out a white paper from Health Capital Group on how #340B expansion is driven by financial opportunism: 340breform.org/report/health…
Edward Scheidler retweeted
@DrOzCMS I'm going to give you a few of these so you know what to look for. Hospital name is included. ONE CODE - Metabolic Panel. Prices are there. Kind of. Who gets to decide who pays $311 for a metabolic panel or $5.40 for the same panel. Or is the $5.40 for the pathologist to "read it". There's no modifier listed so there's no way to know.
Look closely - how can a standard charge max be higher than the gross charge? Why does Aetna pay way more than cash pay? This is just a partial "chargemaster". What does it tell you?
They're located in Tifton, GA. Let me know when they pay the fine.
While you're at it, could you please determine why they pay an on-staff cardiologist over $2M, several other physicians over 7 figures and an attorney nearly $800K?? Not a big county - not a big hospital (181 beds). The per capita income in that county is less than $30K. The poverty rate is 20%.
Make it make sense. Can you?
Inquiring minds want to know. Do you really want to know or are you just another talking head?
Edward Scheidler retweeted
"Pass-through" is a promise about a noun. Your PBM passes through 100% of what it received. Not what the manufacturer paid. Between those two numbers sit an aggregator, a fee, and a definition your contract left to the other side. Read the noun, not the percentage.
Edward Scheidler retweeted
Employer: "We offer top-tier health insurance! Your monthly premium is only $220."
You: "Great. So if I break my wrist, insurance covers the medical bill?"
Employer: "No. You have a $6,500 individual deductible."
You: "So I pay $2,640 a year in premiums, plus $6,500 out of pocket before insurance pays $1?"
Employer: "Correct. But once you hit $6,500, we cover 80% until you hit your $9,100 out-of-pocket maximum."
You: "So I have to spend $11,740 of my own post-tax money in a single year before I get 100% coverage?"
Employer: "Yes, but it’s pre-tax payroll deductions!"
You: "My take-home pay is $4,200 a month. A single ER visit wipes out nearly 3 full months of my entire net income."
Employer: "That’s why we offer a Health Savings Account so you can save for it!"
You aren't receiving a healthcare benefit.
You are paying monthly access fees for the privilege of self-insuring against medical debt while your corporate employer claims tax write-offs for "providing coverage."