The Gist Healthcare Podcast Wednesday, November 5, 2025
Nov 5, 2025
Explore the latest Medicare pay bump for physicians and its implications for healthcare providers. Dive into the impending merger between Kimberly-Clark and Kenvue, valued at $48 billion. Discover the legal battle as Pfizer takes on Novo Nordisk over an obesity startup. Additionally, uncover the concerns surrounding Tylenol lawsuits related to pregnancy claims. Don't miss discussions on new efficiency adjustments in healthcare policies and paused health IT procurement due to recent shutdowns.
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Medicare Pay Rise With Major Offsets
- CMS finalized a 2026 physician fee schedule boosting Medicare rates by roughly 3.3–3.8% depending on provider type.
- The increase is offset by a new negative 2.5% efficiency adjustment and other targeted policy changes like MIPS stability and skin-substitute payment reform.
Policy Drivers Behind The Adjustment
- A roughly 2.5% portion of the payment bump derives from President Trump's One Big Beautiful Bill enacted July 4th.
- CMS also launched efficiency and MIPS-value pathway moves and proposed a mandatory ambulatory specialty model for heart failure and low back pain.
Kimberly-Clark's Big Acquisition
- Kimberly-Clark announced plans to buy Kenview, the maker of Tylenol, in a deal exceeding $48 billion.
- The combined company would pair brands like Tylenol and Band-Aid with Kleenex and Huggies and aims for about $32 billion in annual revenue.