“Big Beautiful Bill” will likely lead to massive changes
The recently enacted tax and spending bill is expected to reverse many of the health coverage gains of the Biden and Obama administrations. The cuts will affect physicians and other providers, hospitals, patients and almost everyone involved in health care delivery. Linked below are resources to help you sort out what it means for you. (KFF News; Modern Healthcare; Advisory Board; Becker’s Hospital Review; text of the bill)
Insurers pledge to streamline prior authorizations, but…
Last month, UnitedHealth, Cigna and over 40 other insurers announced plans to simplify prior authorizations. While they promise to eliminate some requirements by 2026 and improve communication, providers are likely to remain skeptical due to unmet past commitments, MGMA’s Anders Gilberg told Modern Healthcare. Insurers also pledged to honor prior authorizations from previous plans for 90 days. By 2027, they say they intend to adopt a common technology standard and respond to 80% of electronic requests in real-time.(Modern Healthcare)
CMS launches AI-driven prior authorization test, sparking concerns
CMS has launched the Wasteful and Inappropriate Service Reduction, or WISeR, Model to test whether advanced technologies like AI can streamline prior authorization in traditional Medicare. Targeting services prone to misuse—such as skin substitutes and nerve stimulators—the model will run in six states, excluding emergency and inpatient-only care. While CMS says it wants to reduce fraud, critics warn it could delay care and increase administrative burden. They argue it contradicts efforts to scale back prior authorization. The move raises concerns about tech firms reviewing cases without direct patient care experience. (MedPage Today)
Practice Transformation
Study: Clearer team roles cut physician inbox burden
A University of Michigan study published in the Journal of General Internal Medicine found that clarifying team roles and message routing protocols significantly reduced physician inbox burden—without added technology or costs. At an academic internal medicine clinic, the intervention led to a 16% drop in messages per full-time physician and a 65% decrease in cc messages. By using workflow tools and clearly assigning responsibilities, the team improved message management through a scalable approach requiring no EHR customization or additional staff. (Medical Economics; Journal of General Internal Medicine)
Paper calls for end of Benadryl use
A paper in the World Allergy Organization Journal recommends moving away from diphenhydramine (Benadryl) due to safety concerns and abuse potential. Many experts advocate for second-generation antihistamines like cetirizine, loratadine and fexofenadine, which offer equal or better efficacy with fewer side effects. The authors argue diphenhydramine poses a greater public health risk and should no longer be widely prescribed or sold over the counter, calling its continued use outdated in light of safer alternatives. (MedPage Today; World Allergy Organization Journal)
Evidence & Innovation
Joint Commission to overhaul standards
The Joint Commission is revamping its accreditation standards. “Accreditation 360: The New Standard,” is a major overhaul of its healthcare accreditation process, marking the most significant update since 1965. The initiative removes 714 hospital requirements (building on a 2023 effort that cut 400) and introduces outcome-based measures to improve patient safety. The streamlined approach is designed to clarify expectations for accredited facilities and make standards more transparent. All accreditation standards will be publicly accessible and searchable online. (Fierce Healthcare; Joint Commission)
Policy Solutions
PGx testing eases patient concerns but highlights education gaps
A study in the Journal of Personalized Medicine found that patient concerns about preemptive pharmacogenomic (PGx) testing—particularly regarding insurance risks and medication costs—dropped significantly after receiving results. Among 5,000 patients surveyed, 25.5% initially feared insurance issues and 30.1% worried about medication costs; both concerns declined post-testing. However, those unsure about understanding PGx results remained confused afterward, and trust in physicians’ ability to interpret the data fell slightly. The findings emphasize the need for improved patient education and provider communication to maximize PGx testing’s benefits in personalized care. (Journal of Personalized Medicine)
