TrustWorks On Call: Regressive Next Chapter in Health

Behind the Headlines

Unpacking the forces driving healthcare's biggest stories.

1. 500+ hospitals warned over price transparency compliance.

The Trump administration sent letters this week to 519 hospitals warning that they are out of compliance with price transparency regulations; more hospitals are expected to receive these letters soon.
Most hospitals received a warning notice, which opens a 90-day window to correct minor deficiencies, but some were served a Corrective Action Plan request, which requires submitting a concrete plan to correct more substantial deficiencies within 45 days.

TrustWorks Take: More Americans now say healthcare affordability is a “very big problem” than any other economic issue. The Trump administration’s response to voters’ concerns has been to help people find the best deals, instead of providing subsidies. Price transparency is one plank in that messaging platform, and drug pricing deals are another. These letters coincided with the announcement that TrumpRx added 160 more drugs to its platform, bringing the total number of drugs it offers coupons for to over 800. Unfortunately, neither is likely to move the needle on affordability anytime soon.

Price transparency was supposed to allow consumers to shop around for care, which could spark competition among providers that drives down prices. However, the complexities of healthcare services and insurance benefits have made it difficult for consumers to act directly on this information, even when it is posted accurately. Instead, hospital price transparency data is proving most useful to brokers for optimizing network designs, and some hospital leaders fear it is giving insurers an edge in contract negotiations. Still, health systems should look for their own strategic benefits to price transparency, beyond mere legal compliance. For example, market intelligence on what your competitors are charging can be used in your own pricing strategies.

2. 2026 Measles cases have nearly matched last year’s total.

The number of confirmed measles cases in 2026 surpassed 2,000 in the first week of June, with the count rapidly approaching last year’s confirmed total of 2,228, which made it the worst year of measles outbreaks since 1992.
Utah in particular has struggled to contain its ongoing measles outbreak, which started last year in an anti-vaccine, fundamental religious community, before spreading to more secular, vaccine-skeptical communities, whose interest in “alternative health” and “wellness” has led them to favor unregulated supplements and remedies over vaccines and traditional medicine.
The US is now considered “highly likely” to lose its measles elimination status when it is officially reevaluated this November.

TrustWorks Take: As the KFF piece on Utah puts eloquently, “medical professionals [are] now on the front line of America’s regressive next chapter in health history, one in which dangerous and preventable diseases return.” Vaccines provide a “scientific solution” for measles, but we lack a “societal solution” to the declining trust in vaccines and the medical system. Only 88.6 percent of Utah's kindergartners have received the MMR vaccine, far below the 95 percent threshold required for herd immunity.

It is no coincidence that one of the anti-vaccine movement’s champions is now the Secretary of Health and Human Services (HHS). Secretary Kennedy has reportedly devoted the vast majority of his focus to food and (anti-)vaccine policy, while neglecting HHS’ other mandates, including the viral outbreaks his anti-vaccine advocacy efforts have helped unleash. The leadership vacuum at HHS stems from his inattention to key issues, including Medicare and Medicaid, as well as the preponderance of acting directors serving in their roles because Kennedy has yet to designate permanent replacements. The measles outbreak is only one of many ways that his leadership is letting the American public down.

3. ASCO 2026 touts wave of cancer breakthroughs.

During the first week of June, the American Society of Clinical Oncology (ASCO) held its annual meeting, where the world’s leading cancer researchers shared their best work, including a daily pancreatic cancer pill in phase three trials that doubles survival time, an injection that effectively targets head and neck cancers, and various ways to boost the immune system’s natural abilities to fight cancers.
One topic that made headlines outside of trade press was the collection of findings, based only on observational studies so far, that suggest taking GLP-1 drugs may reduce the incidence and progression of various cancers, including lung, breast, colorectal, and liver.

TrustWorks Take: That the five-year relative all-site cancer survival rate has improved from 49 percent in the 1970s to 70 percent in the last decade is one of the great medical triumphs of our time, and the continuation of this progress is still on display at ASCO’s annual meeting. However, this progress comes at a very literal cost, as oncology drugs comprise almost half of the specialty drug market, a rapidly growing contributor to overall healthcare spending. The US spent $99B on oral- and clinician-administered anti-cancer therapies in 2023, and that spending is projected to rise to $180B by 2028.

GLP-1 drugs potentially adding cancer prevention to their ever-growing list of promising clinical applications could pose an interesting quandary for employers. GLP-1s are currently one of the primary drivers of employers’ healthcare cost hikes, and they are responding by backing out of GLP-1 coverage for obesity. However, they will face increasingly difficult decisions on how to handle coverage as the label expands. GLP-1 drugs are expensive, but not relative to biologic cancer treatments and other specialty pharma. Instead, the cost problem they create comes from their broad demand, which continues to grow with the discovery of more therapeutic benefits.

Beyond the Whiteboard

Visualizing key trends from the healthcare industry

All Talk, No Action on Healthcare
This week, Congress passed its annual budget reconciliation package that boosts immigration enforcement by another $70B, after using that legislative vehicle cut Medicaid spending by $1T over a decade last year. That means Congress is all but officially done passing meaningful legislation for the year, and healthcare has been left to the wayside. The only bills left in contention are annual appropriations to fund the government by October 1, but recent precedents in election years suggest Congress will pass stopgap measures to maintain current funding levels until after the midterms. This includes the House Appropriations Committee’s recently passed measure to ban Medicare from implementing the WISeR prior authorization model, which would only become law once HHS is funded for 2027. Congressional action on Trump’s Great Healthcare Plan, pharmacy benefit manager reform, site neutrality, and any other smaller priorities will have to wait until the next Congress, which is likely to produce a divided government, should Democrats take the House or Senate. With Congress looking out at years of potential gridlock, the regulatory agenda of the Trump administration will bear the load of healthcare policymaking.

Dialing In

Sharing insights from our work with clients

The Problem with Trying to Innovate Physician Compensation
During an initial planning call to redesign a large multispecialty group’s physician compensation plan, we were asked to bring “whatever is new or innovative” in the physician comp space to the table. This group had switched from national to regional benchmarks two contracts ago, and greatly expanded non-productivity incentives in their last contract, so the group’s CFO wanted to stay ahead of the curve. He went on to ask, “How do we get our next contract to be the industry’s gold standard?”

Wanting to know what other groups are trying is important due diligence, but the framing I found myself pushing back on is the idea that there is some perfect compensation model waiting to be discovered. There will never be a one-size-fits-all approach because compensation must be tailored to the dynamics of your group and its market. What you need is consistency, transparency, and mutually beneficial incentive alignment such that your physicians benefit when the group succeeds, and vice versa. If you can synchronize those outcomes, offer market-competitive compensation, and fit compensation holistically within your overall strategy, your comp plan becomes your own gold standard, even if another group could not replicate its success.

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Regressive Next Chapter in Health