Morning, Marco — hope the night was manageable. Today's the last day before
Florida's and Medicare's July 1 changes land, so the report leans toward what flips on Wednesday:
your specialty's facing a real Medicare pay cut that SHM is fighting on the Hill, Medicare's
weight-loss-drug program goes live tomorrow (and it's today's Debate), and the Mets keep finding
new ways to lose. Coffee, then pillow.
A · Top Stories
Confirmed-fresh, last 48 hours.
Hospital Medicine · Pay
SHM is fighting a ~7% Medicare cut aimed squarely at hospitalists
This one's about your paycheck and your group's resources. The CY2026 Medicare
Physician Fee Schedule final rule (CMS-1832-F) slashes the practice-expense
portion of payment for services delivered in the facility setting — cutting indirect
PE RVUs in the hospital to roughly half the non-facility rate. Because hospitalists bill almost
entirely facility-based E&M codes, the hit lands disproportionately on you: SHM estimates a
~7% reimbursement cut for the nation's ~50,000 hospitalists. SHM is now leading
a multispecialty push urging Congress to halt that provision before it bites.
(SHM,
CMS)
Action: worth a note at your next group meeting — SHM has a member action
portal for the Congressional ask, and the math directly affects QI, recruitment, and staffing
budgets at hospitalist programs like yours.
Medicare · Clinical
Medicare's GLP-1 Bridge goes live tomorrow — $50/month weight-loss drugs
Starting July 1, eligible Part D beneficiaries can get
Wegovy, Zepbound (KwikPen), or Foundayo for a $50 copay per 30-day supply
through the new Medicare GLP-1 Bridge demonstration — the first time Medicare
has covered these drugs for weight management. It runs through Dec. 31, 2027, sits outside the
normal Part D flow (a central CMS system handles approvals and pays pharmacies), and KFF
estimates ~3.8 million beneficiaries will qualify. Many of your older admits with obesity and
cardiometabolic disease will now have a real outpatient path.
(CMS,
CNN)
Action: this is a discharge-planning lever — flag eligible patients to PCPs
at transitions. See today's Debate for the fiscal fight it's igniting.
Mets
The skid deepens: Mets fall to Toronto, sink to 35–50
No relief in Queens. The Mets dropped a tight one to the Blue Jays
2–1 on June 29, sliding to 35–50 and dead last in the NL
East despite the sport's biggest payroll. It's the same story as the weekend: Andy Green's
interim bench, a clear pivot to seller after the Peterson-to-Cubs trade, and a roster that
can't string wins together. The Aug. 3 deadline now looks like a clearance sale.
(ESPN,
MLB.com)
Talking point: with Lindor and Soto staying put, the trade chatter is all
about which veterans bring back prospects — a long summer of watching the kids.
B · The Debate
One live argument, both sides, no verdict.
Should Medicare pay for weight-loss drugs?
Why it's live: the Medicare GLP-1 Bridge launches tomorrow,
July 1 — the federal government's first coverage of GLP-1s purely for weight management, paid
for by taxpayers and beneficiaries after private Medicare Advantage plans balked at the cost.
With the program live and the price tag still undisclosed, the fight over whether Washington
should be buying these drugs at scale is suddenly very real.
For coverage
Obesity is a chronic disease, and refusing to treat it with the most effective tools
medicine has ever had is the expensive choice, supporters argue. The
Obesity Care Advocacy Network,
whose coordinator Cristy Gallagher called the program a "historic milestone in the fight
against the obesity epidemic," notes the drugs cut heart attacks, strokes, and diabetes
progression — the very complications that fill Marco's inpatient beds. For seniors priced
out at $1,000+/month cash, a $50 copay is the difference between treatment and nothing.
Against
The fiscal exposure is enormous and the savings are oversold, critics counter. The
Congressional Budget Office
pegs broad coverage at roughly $35 billion in new federal spending through 2034 with only
minor offsetting health savings; the Committee for a Responsible Federal Budget
has flagged the same blowout risk. As STAT
reported, CMS still won't say what the Bridge will cost — a hard sell when patients often
regain weight once the drug stops, implying an open-ended tab.
Where it might land: the demonstration is locked in through Dec. 31, 2027 —
its real-world uptake and cost data over the next 18 months will shape whether Congress makes
coverage permanent or lets it lapse.