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By Alexis Kayser

Healthcare Editor

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This is a preview of the November 5 edition of Access Health—Tap here to get this newsletter delivered straight to your inbox on Thursdays.

Good afternoon. Democrats delivered a historic midterm victory this week, flipping enough seats to take control of both chambers of Congress. The results promise a change in direction for Washington, with Democrats poised to challenge the Trump administration's health care agenda.

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But the winds of change may take some time to reach hospital balance sheets. Health care policy experts and consultants are sharing a straightforward message for hospital and health system executives: Don't make any sudden moves.

The political landscape has shifted considerably, but the financial realities facing hospitals in 2027 have not. President Donald Trump still occupies the White House, and his signature One Big Beautiful Bill Act remains law.

"Because the executive branch is still run by President Trump, on some level, not much has changed immediately for providers," John Barkett, a former White House senior health policy adviser and managing director at Berkeley Research Group (BRG), told me Thursday.

Trump must still sign any new legislation, and his administration retains authority over how federal regulations are interpreted and implemented. Democrats can introduce bills and negotiate with the White House, but they cannot simply undo the president's policies.

David Brueggeman, a BRG managing director who advises health systems on financial strategy, said he's been fielding calls from hospital CEOs and CFOs wondering whether the election changes their plans for next year.

His answer, at least for now, is largely no.

Some provisions affecting Medicaid and Affordable Care Act coverage are scheduled to take effect January 1, before the newly elected Congress convenes. Even if lawmakers eventually reverse or modify certain policies, hospitals could experience financial consequences in the meantime.

Brueggeman emphasized that executives need to distinguish between what could happen in the next two weeks, the next two months and the next two years.

For now, he said, health systems should continue preparing for coverage disruptions, including strengthening processes to identify patients who may qualify for Medicaid.

"From a short-term perspective and from a financial projection perspective, we are not recommending significant modifications to budgets that have been developed for the next year," Brueggeman said.

Scripps Health President and CEO Chris Van Gorder offered a similar assessment Wednesday.

"While the election has changed who controls Congress, it doesn't change the financial challenges hospitals will face in 2027," he said in a statement shared with Newsweek. "Democrats won't have the votes to simply reverse major federal healthcare cuts over a presidential veto."

Van Gorder added that lawmakers could still use their oversight and budget authority to influence how cuts are implemented and protect funding where possible.

That doesn't mean the election is inconsequential; Barkett expects Democrats to spend the next two years challenging the administration's policies and developing proposals that could shape health care legislation beyond 2027. He identified price transparency and PBM reform as potential areas for bipartisan cooperation.

Brueggeman also pointed to a more immediate source of change: state governments.

"A lot of the activity is actually a lot more real from a state perspective [than a federal perspective]," Brueggeman told me, noting that the new slate of Democratic governors could intensify pressure on hospitals to limit price increases.

"States are becoming a part of that negotiating table, trying to set premium increase limits [and manage] affordability in negotiations between payers and providers," Brueggeman continued. "Payers are definitely leaning into that, if there's a specific target percent that's being set, that hospital costs or pricing cannot increase above that level."

He expects this trend to "intensify" moving forward: "There is going to be pressure on hospitals to tamp down outsized [price] increases. The challenge is, that's going to be lower than what [hospitals'] existing cost trend looks like."

So—while the election may warrant a fresh look at long-term strategy—there's consensus that it doesn't demand an immediate rewrite of next year's operating budget. Brueggeman recommended considering "wider cones of possibilities" in multiyear strategic plans, particularly as Democrats develop their agenda ahead of the 2028 presidential election.

Is your organization rethinking long- or short-term plans in the midterms aftermath? Email me at a.kayser@newsweek.com and let me know.

In Other News

Major health care headlines from the week

• Attention U.S. hospitals: Newsweek and Statista released our ranking of America’s Best-in-State Hospitals for 2027.

  • Now in its fourth year, the ranking recognizes 800 hospitals across all 50 states and Washington, D.C., based on hospital quality metrics, recommendations from medical professionals, patient experience and the implementation of patient-reported outcome measures (PROMs).
  • This year's methodology includes some notable changes: For the first time, the ranking incorporates Leapfrog hospital safety and quality data, along with additional accreditations and certifications. It also places greater emphasis on PROMs and limits eligibility to hospitals with an overall CMS star rating of at least three.
  • See where your hospital stands here.

• A new lawsuit is raising questions about patient consent to AI-powered clinical documentation. A Pennsylvania woman has filed a proposed class-action lawsuit against Allegheny Health Network and Highmark, alleging that the organizations failed to adequately disclose their use of Abridge’s ambient scribe. The complaint alleges violations of Pennsylvania's wiretap laws, patient confidentiality and privacy protections, among other claims, according to TribLive.

  • The lawsuit alleges that patients were not properly informed that recordings would be transmitted to a third-party company or potentially used to train commercial AI models. AHN began using Abridge in 2024 and has since expanded it to approximately 400 providers across more than 40 specialties, according to the complaint. The plaintiff is seeking monetary damages and an injunction requiring clearer disclosures and consent before using recording technology. AHN and Highmark declined to comment to both TribLive and Newsweek.
  • Meanwhile, one health system AI chief is warning against treating medical AI as an entirely new phenomenon. Philip Payne, chief health AI officer at BJC HealthCare and WashU Medicine, told attendees at Newsweek's AI Health Summit that the industry risks overlooking decades of research as organizations race to adopt increasingly sophisticated technology. Get the full scoop in my latest article.

• CVS Health is breaking up. The health care giant announced plans to split into two publicly traded companies, separating its roughly 9,000 retail pharmacies from its insurance and pharmacy-benefit management operations.

  • The split, expected in early 2028, will effectively unwind the vertically integrated business model created by CVS's nearly $70 billion acquisition of Aetna in 2018.
  • CVS Health will keep Aetna, Caremark, Oak Street Health's senior-focused clinics, Signify Health's home-based care business and specialty pharmacy operations. The new CVS Pharmacy company will house its retail and mail-order pharmacies, MinuteClinic locations and Health100, an AI-powered consumer health platform.
  • CEO David Joyner said the separation will allow each company to focus on its respective business, maintaining that the decision was not driven by mounting regulatory scrutiny of vertically integrated health care companies.

• The federal government could enlist celebrities and influencers in its fight against counterfeit medicines, my Newsweek colleagues reported this week.

  • The U.S. Patent and Trademark Office is exploring a nationwide public awareness campaign warning Americans about fake pharmaceuticals and medical devices. Government procurement documents outline plans for social media content, videos and outreach to celebrities, influencers and journalists. The initiative remains in the exploratory stage, with no confirmed participants, budget or launch date.
  • The potential campaign comes amid growing concerns about counterfeit drugs entering the U.S. supply chain. In August 2025, federal officials seized 54,843 counterfeit products during a weeklong operation in Cincinnati, including more than 16,000 fake prefilled medication pens. The FDA has also warned about counterfeit Ozempic injections found in the legitimate U.S. drug supply and contaminated eye drops that could cause serious infections or vision loss.
  • The Patent and Trademark Office is accepting industry responses through Nov. 16 to help determine its next steps.

Pulse Check

Executive perspectives on key industry issues

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Flu season is here. And while influenza activity remains relatively low nationwide, it's picking up earlier than usual, according to the Centers for Disease Control and Prevention.

The agency's latest weekly surveillance report shows that more than 6,000 patients were admitted to U.S. hospitals with influenza during the week ending October 24. The CDC estimates that the 2026-27 season has already resulted in at least 1 million illnesses, 16,000 hospitalizations and 900 deaths.

The agency also reports that influenza-related hospitalization rates are unusually high for this point in the season, although it cautions that an early increase doesn't necessarily mean a more severe flu season lies ahead.

On October 28, I spoke with Dr. Bruce Farber, chief public health and epidemiology officer of Northwell Health, about what he's seeing on the ground, how hospitals can prepare for a potential surge in patients and which indicators executives should be watching as flu season progresses.

Read on for a portion of our interview.

Editor's Note: Responses have been lightly edited for length and clarity.

As we enter the 2026-27 flu season, what are you seeing in the early data that hospital and health system leaders should be aware of?

I would say a couple things. One is that influenza has appeared relatively early. Not unheard-of early, but certainly it's appeared relatively early. At the present time, for example, our facility has over 10 people in the hospital with influenza. The number will certainly dramatically climb over the next several months.

It usually peaks sometime between November and February, stays very high for about six weeks, and then slowly peters out sometime in the early or late spring, depending upon the season.

Everybody is painfully aware that we're facing very big headwinds when it comes to getting large percentages of the population vaccinated. They're hearing an enormous amount of misinformation, lies and untruths regarding vaccines, and they paint with a broad brush.

Although influenza is generally not targeted, vaccines as a whole are targeted, and that makes people less compliant because they get mixed messages. The people who normally give very full-throated endorsements, like the CDC, are not, and if anything, are sowing doubt. That bothers me because I think that's a harbinger of a poorly vaccinated population.

We know that the influenza virus vaccine is not particularly good at preventing influenza, with efficacy rates between 35 and 55 or 60 percent, depending upon the people being vaccinated. But we do know that it's pretty good at keeping people out of the hospital and preventing people from dying.

Under the current circumstances, if we have a bad flu season, it's certainly going to affect ER visits, hospital census and delayed discharges. The people who tend to stay in the hospital with influenza usually have significant comorbidities like chronic obstructive pulmonary disease, heart failure, cirrhosis of the liver and the like.

What's new is that there is a new vaccine out. It's the messenger RNA vaccine. It almost didn't get evaluated, but it did finally and, interestingly enough, got approved by the FDA.

It's made with the same technology that was used to make the COVID vaccines, which to some people makes it dangerous, and to other people like myself makes it better. Preliminary data has shown that it is more successful at preventing the flu.

The major advantage of this will be that there'll be less mismatch in the future, because you won't have to decide in February what type of flu vaccine you're going to give in September and October. That's how long it takes to make it, and by the time you make it, if the influenza virus has changed, then you have a bad match.

I think in the future that will become less of a problem because they won't have to make a commitment to a specific strain type of flu vaccine so early.

People's immunity to flu is never long-lasting. You need a new flu shot every year, and it needs to be changed and updated every year.

You mentioned that the new vaccine almost didn't get evaluated but was eventually approved by the FDA. What was the holdup?

When the trial was initially outlined, it was being done for people over the age of 50, and that's what the FDA recently and finally approved.

But people over the age of 65 have the option of using the high-dose regular vaccine, and anyone over 65 should get the high-dose regular vaccine because it's more effective than the regular dose that's given to people under 65.

The hangup was changing the goalposts in the middle of the game, in the sense that the FDA initially said, "Well, you didn't compare the vaccine to the high-dose vaccine."

There was a lot of discussion. When we first outlined the trial, which began years ago, that was the definition. Those things are always ironed out before the trial begins, so that when you finally get to the trial, the FDA can't say, "We don't like the way it was designed."

They went back and forth and ultimately approved the vaccine for people over the age of 50, which is how the trial went.

We don't know if it's specifically better than the high-dose vaccine in those over 65. It was shown to be about 25 percent more efficacious in the entire group, but there was no direct comparison to the high-dose vaccine.

With those changes to vaccinations and waning public trust, how do you recommend that health systems participate in public messaging around the flu shot this year?

I think they have to present the facts, just the way all of the major medical societies and academies are doing, whether it's the pediatric society or the adult society or the public health society.

I think everybody is on board that this is unprecedented, and we need to be ambassadors for factual information.

No one is saying that every vaccine is 100 percent safe. No one is saying that every vaccine is 100 percent effective. But as a general rule, they save hundreds of thousands, and in total, millions of lives they've saved over the years. Many millions.

We need to counter this misinformation and terrible message that they often get. Even when they don't get a bad message, they just get a mixed message, which sows doubt.

Prior to this happening, there was always very strong messaging on TV, online, on radio that these things were endorsed, and that's no longer the case.

You see the measles outbreaks. You see the increase in pertussis in the communities. You see the attempt to prevent hepatitis B vaccination in infants. You see it everywhere you look.

Health care workers face increased exposure to respiratory illnesses. What strategies have you found most effective at Northwell for protecting employees and maintaining adequate staffing during flu season?

We strongly encourage our employees to get vaccinated. If they refuse, they have to watch a video and sign consent saying that they've declined formally. To do that, they first have to undergo an educational process.

We adhere to and are slowly adapting to what I think is a positive of treating most all respiratory viruses the same in the hospital setting.

If you don't get your flu vaccine, by the way, in New York state, you have to mask starting now until the end of flu season. You don't have to mask if you've gotten your flu vaccine.

We encourage people to take precautions when people are sick, and we test an incredible amount.

We have a viral panel that looks for COVID, flu and RSV, and anybody with any inkling of a respiratory illness gets screened in the hospital, which helps us identify people early and hopefully prevent spread to our employees and to other patients.

What are some of the biggest mistakes you've seen hospitals make when preparing for flu season, particularly around anticipating demand or allocating resources?

That's tough because with the flu, you never really know, to be honest.

It looks like it could be bad, but you never really know how good the match is until the season begins. We just don't have enough information yet to know how good the match between the vaccine is.

But we do know that if people are not vaccinated, then it doesn't matter how good the match is. There's going to be a very naive population.

Under those circumstances, I think you have to plan for crowding and very decreased turnaround rates in patients in the hospital, which clogs up and sometimes prevents elective procedures and bookings for other things, analogous to what happened with COVID.

There were many people during the COVID epidemic who died not from COVID, but because of COVID. Meaning, so many other services became paralyzed that things that ordinarily would get done didn't get done.

When assessing how severe a flu season might become, what indicators should hospital leaders monitor beyond the number of confirmed cases?

I think the positivity rate of the tests being done in the community is a good marker.

It's not perfect, but when you see rates like they are now, where 3 to 5 percent of tests being done are positive, you know that it's there, but it's relatively low prevalence in the community.

When you start seeing those rates climb to 20 or 25 percent, which they will in the middle of an epidemic, meaning in the winter when it happens, then you know that there's an enormous reservoir of flu in the community.

Under those circumstances, you can make decisions that you otherwise wouldn't make, like empirically using Tamiflu in people who are sick but not being seen, and sometimes deferring visits that don't need to be seen if the patient's not short of breath or confused.

Those are all ways that you can try to ease traffic into crowded facilities.

C-Suite Shuffles

Where health care leaders are coming and going

• Albany Med Health System has fired its president and CEO, Daniel T. Pickett III, amid sexual assault allegations. The board voted unanimously Wednesday to terminate Pickett, who had been placed on paid administrative leave in October after a former girlfriend accused him of sexual assault in a civil lawsuit. Pickett was appointed to lead the New York health system in December 2025.

  • The board determined that a leadership change was necessary following an independent review. In a systemwide email obtained by the Albany Times Union, the board chair said the review focused on the best interests of employees, the community and the health system's mission. Executive Vice President and General Counsel Matthew Jones will remain acting CEO while Albany Med conducts a nationwide search for a permanent replacement.
  • Pickett denies the allegations and has filed a defamation lawsuit against his accuser. He alleges that the woman's accusations surfaced after he asked her to leave his Manhattan apartment, where he says he had provided housing and financial support. The woman disputes his account of their property arrangements. New York City police investigated the sexual assault allegation but did not file criminal charges, according to local reports.

• MultiCare tapped Ellen Wiegand as senior vice president and chief information officer.

  • She joins the Tacoma, Washington-based system from VCU Health in Virginia, where she most recently served as senior vice president and chief information and digital officer.

• Tampa General Hospital promoted Lijah Lokenauth to executive vice president and CFO.

  • He’s been with the Florida system for more than eight years, according to his LinkedIn profile, serving as senior vice president of finance since May 2024.

This is a preview of the November 5 edition of Access Health—Tap here to get this newsletter delivered straight to your inbox on Thursdays.

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