Ascension to acquire AmSurg

 St. Louis-based Ascension said June 17 that it has entered an agreement to acquire AmSurg, an ASC operator with more than 250 facilities across 34 states. 

Six things to know: 

1. The move will significantly expand the Catholic nonprofit system’s outpatient footprint upon the deal’s closing, adding centers that specialize in gastroenterology, ophthalmology, orthopedics and other services to Ascension’s network.

2. With this expansion, Ascension is deepening its outpatient footprint in what the system described as a milestone in its journey to transform healthcare delivery and expand access to compassionate, high-quality outpatient care nationwide. 

“We have 58 ASCs. This is going to add another 250, so it’s going to give us a good presence in 34 states,” Ascension President Eduardo Conrado told Becker’s. “And AmSurg has a great management team. They’ve got an operational platform that mirrors their areas of focus, which is quality, clinical engagement, and patient experience — in a segment [the ASC market] that’s growing 9% to 12% over the next five years. So, everybody’s very excited about coming up on this next step.”

3. The transaction comes as more complex procedures continue to move out of hospitals and into lower-cost, outpatient settings; it also takes a page out of Tenet Healthcare’s playbook.

Dallas-based Tenet has focused heavily on scaling its ASC platform — United Surgical Partners International — and Nashville, Tenn.-based AmSurg supports approximately 2,000 physicians and is the second-largest ASC chain in the ASC market, behind USPI.

4. Mr. Conrado said Ascension plans to continue the strategy that AmSurg has had in terms of physician-led joint ventures and governance.

“It also serves as a platform for other nonprofit systems to accelerate that ASC growth,” he said. “AmSurg is one of the large five [ASC operators] in the U.S., and once the Ascension deal closes, we’ll continue with that strategy to be able to serve other systems. So that is a win for us, it’s a win for physicians and a win for the other nonprofits in the U.S.”

5. Ascension is targeting late 2025 or early 2026 for the transaction’s closing, which remains subject to customary closing conditions and regulatory approvals.

“This acquisition is deeply aligned with Ascension’s Mission to provide compassionate, personalized care to all, especially those most in need,” Ascension CEO Joe Impicciche said in a news release. “It reflects our steadfast commitment to expanding access to care in a way that is more affordable, more local, and more centered around the dignity and well-being of those we serve.”

6. The health system has not disclosed nor confirmed the purchase price. 

https://www.beckershospitalreview.com/hospital-transactions-and-valuation/ascension-to-add-250-ascs-with-amsurg-acquisition/

'How Cleveland Clinic is expanding virtual 2nd opinions'

 The Clinic by Cleveland Clinic has been providing virtual second opinions to tens of thousands of patients a year — and is expanding.

The Clinic, a joint venture between Cleveland Clinic and telehealth company Amwell, recently grew its number of physician licensures around the country, allowing it to see more patients, and rolled out concierge cancer care.

“Tens of thousands of people make better medical decisions thanks to our second-opinion program,” Frank McGillin, CEO of The Clinic by Cleveland Clinic, told Becker’s. “We’ve found that two-thirds of the time we’re helping identify an alternative treatment pathway for the individual, and we’ve been able to support and help health plans and employers reduce the cost of unnecessary surgery or unnecessary care.”

The Clinic by Cleveland Clinic recently partnered with credentialing company Baton Health to grow its provider licenses to more than 10,000, spanning the entire country. The Clinic also launched a cancer concierge program to offer virtual consults with oncology subspecialists as well as cancer care navigation.

“We’re able to take advantage of the multidisciplinary approach that Cleveland Clinic takes to cancer. We’re able to access tumor boards to ensure you’re not just being looked at, for example, by a medical oncologist, but your case is being looked at by medical-surgical as well as a radiation oncologist to make sure it’s a very holistic approach to your care pathway,” Mr. McGillin said. “Research recently has shown that cancer is one of the fastest-growing cost burdens for employers. And over half the counties in the U.S. don’t have an oncologist available. So we were looking to really help fill that gap with this new program.”

The Clinic debuted in 2020 to offer virtual second opinions from Cleveland Clinic’s roughly 3,500 specialists to patients anywhere in the U.S. If the provider is licensed in the patient’s state, he or she can provide a video visit and treatment plan; otherwise, he or she can deliver a written report in collaboration with a local physician.

“One of the important goals of Cleveland Clinic is to increase the number of lives touched,” Mr. McGillin said. “And through this program, we’re able to provide access to Cleveland Clinic expertise to people around the globe. We’re helping patients in all 50 states, as well as significant international volumes.”

Patients can access the program either through an employer health plan or the self-pay rate of just under $2,000. The Clinic estimates it saves about $8,700 per patient by getting them on the right treatment plan.

“We’ve been able to really innovate in terms of how we deliver the second opinion to dramatically reduce the time from initiation to delivery,” Mr. McGillin said. “A few days after we get medical records, we’re able to deliver that second opinion. For a patient, that’s a critical time when they really are dealing with a lot of stress and looking to move forward.”

https://www.beckershospitalreview.com/healthcare-information-technology/telehealth/how-cleveland-clinic-is-expanding-virtual-second-opinions/

Senate bill aims to rebuild drug manufacturing infrastructure

 A bipartisan group of U.S. senators has reintroduced a bill designed to address ongoing shortages of generic drugs by expanding domestic stockpiles and manufacturing capacity. 

Here are three notes: 

1. The Rolling Active Pharmaceutical Ingredient and Drug Reserve Act, reintroduced by Sens. Gary Peters, D-Mich., Marsha Blackburn, R-Tenn., Tim Kaine, D-Va., and Ted Budd, R-N.C., would require HHS to award contracts to manufacturers in the U.S. or allies to maintain stockpiles of essential medications and ingredients, according to a June 12 news release from Mr. Peters’ office. 
   

2. A 2023 report cited in the release showed that at least 15 medications remained in shortage for more than a decade, with many generics being low-cost but complex to manufacture. 
   

3. In addition to expanding the federal drug stockpile, the senators also requested the Government Accountability Office investigate unused domestic manufacturing and federal efforts to scale up advanced production. 

https://www.beckershospitalreview.com/supply-chain/senate-bill-aims-to-rebuild-drug-manufacturing-infrastructure-3-notes/

Vistagen Social Anxiety Treatment Phase 3 Trial Results Coming Q4 2025

Vistagen (Nasdaq: VTGN), a late clinical-stage biopharmaceutical company pioneering neuroscience with nose-to-brain neurocircuitry to develop and commercialize a new class of intranasal product candidates called pherines, today provides an update on the timeline for the ongoing clinical trials in its U.S. registration-directed PALISADE Phase 3 Program evaluating fasedienol for acute treatment of social anxiety disorder (SAD). The Company’s PALISADE-3 Phase 3 clinical trial remains on track for expected topline data in the fourth quarter of this year. Topline results for its PALISADE-4 Phase 3 clinical trial are expected in the first half of 2026.

https://www.stocktitan.net/news/VTGN/vistagen-on-track-to-deliver-topline-data-from-fasedienol-palisade-3-6r9vbji5v7h9.html

Media Cheers a Monarch, Mocks a President

 On June 14, two very different parades took place on opposite sides of the Atlantic. In London, thousands gathered Saturday for the Trooping the Colour, also known as the King’s Birthday Parade. Although King Charles III will not turn 77 until Nov. 14, the royal family traveled through central London by carriage, flanked by military bands, horseback soldiers, and a cheering crowd.

Meanwhile, in Washington, D.C., another parade unfolded: President Donald Trump’s 250th Anniversary of the U.S. Grand Military Parade and Celebration. Like the British ceremony, it was staged with grandeur and symbolism. There were troops, flags, and patriotic fanfare — and it happened to coincide with Trump’s 79th birthday and Flag Day.

The juxtaposition couldn’t have been more striking: a king and a populist, each leading the nation in a moment of public ritual. But only one parade was hailed by the media as dignified tradition; the other was condemned as egotistical pageantry. 

A Crown for Them, Contempt for Us

Nowhere was the contrast more glaring than in the American response to Trump’s parade. Hours before the evening event, thousands of “No Kings” protesters clogged the streets of major cities, small towns, and countries beyond our borders, including Canada and Mexico. Funded by dark money NGOs like Indivisible, the American Civil Liberties Union (ACLU), and 50501, the movement showed not just a coordinated resistance to Trump himself, but a broader hostility to the very idea of American exceptionalism. What was advertised as a protest against “authoritarianism” quickly revealed itself to be a rejection of patriotism, military honor, and the founding ideals that built this nation.

Contrast this with the media’s glowing coverage of the British monarchy — a literal blood-based ruling class — and the hypocrisy becomes impossible to ignore. When King Charles dons his crown and rides in a fancy carriage, CBS News headlines photos of Princess Kate and celebrates the royal family’s commemoration of Air India plane crash victims.

When Trump shines his birthday spotlight on America’s defenders, the same outlet headlines how “rare” such displays are in the U.S. while running multiple articles providing readers city-specific “what to know” guides for “No Kings” demonstrations in Michigan, New York City, Northern California, Los Angeles, and Texas. CBS News, which is still facing a lawsuit from President Trump over the network’s edited 60 Minutes interview clip of Kamala Harris, even promoted “No Kings” day merch in a story published Friday.

The media reduced the U.S. celebration to three words: “Trump’s military parade.” That shorthand, adopted by outlets like CNN, NBC News, and the New York Times, wasn’t unbiased reporting. It was a loaded dismissal, meant to frame the event as a self-aggrandizing, militaristic, and vaguely un-American spectacle. Stripped of context, the propaganda press made America’s parade sound like something out of North Korea instead of a patriotic tribute that transcended party lines and marked 250 years of constitutional liberty.

British papers weren’t any better. The BBC’s preemptive reporting attached the “No Kings” protest to its headline about “Trump’s military parade,” featuring an image of a woman running past a large tank in D.C. — an obvious attempt to evoke Tiananmen Square, not the National Mall. Meanwhile, in its coverage of the Trooping the Colour, the same BBC’s story said King Charles III was “cheered by crowds” celebrating the monarch’s official birthday. And while the Guardian ran a piece tracing the U.S. parade “from Mesopotamia to MAGA,” its coverage of the King’s parade was out of sight.

They Don’t Hate Kings — They Just Hate America

Let’s be honest: Democrats and their media allies don’t actually hate kings. They just hate leaders who govern with the consent of the governed, especially if those voters are from the heartland, flyover states, or wear a uniform. Trump’s parade didn’t bother them because it looked regal. It bothered them because it was proud. It refused to apologize for America’s strength, for its history, or for the men and women who still believe this country is worth defending.

Ironically, the people waving “No Kings” signs are the very ones most eager to be ruled by elite, unelected institutions: international bodies, activist judges, and administrative state agencies. They claim to hate tyranny, but they’re perfectly content being governed by “experts” they never voted for, just so long as those “experts” hate the same people they do

In reality, it’s not the monarchy they oppose — it’s independence. Trump’s parade celebrated 250 years of defiance, of choosing self-rule over hereditary power. The Trooping the Colour celebrated a family lineage. One looked to the Constitution; the other to a crown.

Two Parades. One Choice.

So yes, there were two parades on June 14. One celebrated the symbolism of hierarchy. The other celebrated the spirit of a republic — messy, loud, proud, and free. And only one of them sent the media into a meltdown.

Let them praise the King. We’ll keep the Constitution.

Julianna Frieman is a writer based in North Carolina. She got her bachelor’s degree in Political Science from the University of North Carolina at Charlotte. She is pursuing her master’s degree in Communications (Digital Strategy) at the University of Florida. Her work has been published by the Daily Caller, The American Spectator, and The Federalist.

https://spectator.org/two-parades-one-king-cheer-monarch-mock-president/

Don't Stop, Israel. Regime Change Now!

 by Roger Simon

(“From a bridge in Tehran, an Iranian woman asks Israel to eliminate Iran’s supreme leader and his son in addition to attacking the IRIB television and radio network.” — Amir Tsarfati)

While some debate whether regime change in Iran is ongoing, it is already happening.

And of course it is necessary. As one of the now deceased Iran nuclear scientists explained just weeks ago, their scientists and nuclear installations can all be destroyed but the information required to construct weapons remains. Everything can be reconstructed. True that.

But that’s just one reason regime change is mandatory. The other is what these sadistic Shiites do to women. The misogyny of the ayatollahs is beyond comprehension. This is regime that got started by scraping makeup from women’s faces with razor blades. It got worse from there, especially regarding females who were incarcerated, almost always falsely..

Here’s just a tinge from Grok since it’s been my observation that most Americans, even supposedly educated ones, don’t know much about this:

“… there is substantial evidence from multiple sources, including human rights organizations, former prisoners, and international reports, indicating that the Iranian regime has engaged in the systematic rape of female prisoners, particularly virgins, before their executions. This practice, rooted in a distorted interpretation of Islamic law, was especially prevalent during the 1980s, notably during the mass executions of political prisoners in 1988. The justification was based on a belief that virgins would go to heaven if executed, and rape was used to prevent this. These acts were often framed as "forced marriages" or "temporary marriages" (sigheh) to prison guards or officials, ensuring the women were no longer virgins before execution.”

While doing research for the screenplay “Keys to Paradise” that is set in Iran, Sheryl and I learned that the parents of the raped women were informed of this “marriage” of their daughters that very night as a final exercise in what one might term paleo-sadism.

At that time we also met several of the former political prisoners whose faces resembled Picasso’s from the artist’s cubist period, their bones beaten into distortion from repeated beatings. Your heart went out to them even as you had difficulty looking directly at them.

To put it mildly, this made me partial to regime change. Horrifying as it is, I could not but approve when I saw this video Jun16 from Iranian TV that is a harbinger of the change that is coming rapidly. (Watch to end)

These evil people could have met their end years ago were in not for Barack Obama. Here’ another excerpt from Grok about what I consider close top the darkest moment of US, when we betrayed freedom to such an extent many of us were sickened:

“The phrase ‘Obama, are you with us or are you with them?’ was reportedly chanted by Iranian demonstrators during the 2009 Green Movement protests, which erupted after the disputed presidential election on June 12, 2009. These protests, sparked by allegations of electoral fraud in favor of incumbent President Mahmoud Ahmadinejad, saw millions of Iranians, particularly supporters of opposition candidate Mir Hossein Mousavi, take to the streets. The specific chant emerged as a plea directed at U.S. President Barack Obama, reflecting some protesters' desire for international support, particularly from the United States, amid the Iranian government's violent crackdown.”

Obama was obviously “with them,” as he elected to “negotiate” (to no end, needless to say) with Ahmadinejad rather than support the demonstrators in any meaningful way.

Many have speculated on why Obama did that, so I won’t do so except to say that those who pretend to the monikers “liberal” and “progressive” are the furthest thing from those.

https://americanrefugees.substack.com/p/dont-stop-israel-regime-change-now

Let Workers Control Their Health Insurance

 The most significant healthcare reform of Donald Trump’s first term may have been letting businesses give their workers pre-tax funds to buy their own health insurance.  But few firms have opted to embrace this option.  A modest regulatory reform could soon change that.

Tax incentives have made employers the main purchaser of health insurance in America.  But employer-sponsored insurance plans poorly fit individual workers’ needs and typically overpay for medical care.  Although a 2019 reform allowed firms to give their workers pre-tax funds to purchase their own health insurance, this new arrangement is being held back by overregulation.

The purchase of healthcare benefits by employers doesn’t work well.  Just when staff have begun to understand their insurance plans, human resource departments tell them that everything is about to change.  Employers don’t enjoy the experience either.  The cost of covering a family has risen from $9,950 to $25,572 over the past two decades, and Starbucks now spends more on healthcare for its staff than it does on coffee. 

Businesses struggle to get a good deal purchasing health insurance for their employees.  This is because workers resist curbs on access to unnecessary services and higher out-of-pocket costs for visiting costlier providers.  Patients bear the associated inconvenience, but typically believe that the resulting savings accrue to their employers rather than to themselves. 

While individuals care about having their own doctor, local hospital, and a few other key medical providers in their health insurers’ networks of preferred providers, employers must satisfy workers spread across different neighborhoods who use a wide variety of providers.  That makes it very difficult for group health plans to negotiate good rates by threatening to leave costly medical systems out of their networks – encouraging expenses to spiral upwards.

The collective purchase of health insurance by employers also causes benefit packages to be needlessly expansive.  One study estimated that workers would be willing to forego 10% to 40% of the funds their receive from employers, to control of the choice of their health insurance plans.

Nonetheless, employers purchase most private health insurance because it allows them to compensate staff without bearing income or payroll taxes.  To redress this distortion, the first Trump administration from 2019 permitted firms to give staff pre-tax funds to purchase their own insurance from the individual market by establishing Individual Coverage Health Reimbursement Arrangements (ICHRA).  Yet, in 2024, fewer than 1% of workers received health benefits through ICHRA style accounts. 

Until recently, the appeal of ICHRA was inhibited by the woeful state of the individual market’s risk pool.  But this has since been redressed: whereas Gold-tier individual market plans in 2018 cost 19% more than the average employer contribution to similar group insurance, in 2023, Gold-tier individual market premiums averaged 13% less.

As a new Manhattan Institute report notes, this development gives ICHRA benefits potentially widespread appeal – which is now being held back only by a regulatory prohibition on employers giving staff a choice between group health benefits and funds to purchase their own insurance. 

This regulation is designed to stop firms from designing their benefits to selectively dump employees with the costliest medical needs on the individual market.  But this approach prevents businesses from allowing any workers to benefit from a switch, unless they are willing to force all workers off their current plans.  That makes offering ICHRA benefits a big leap for human resource departments, and an unpalatable option for firms.

The Trump administration could maintain this anti-dumping safeguard much less onerously, by reforming ICHRA’s regulations.  It should simply require that ICHRA contributions exceed minimum standards and that associated group plans conform to the same benefit requirements as those which apply to the individual market. 

Doing so would allow firms to give each of their staff the choice to control their own health insurance.  This would allow them to opt for plans which better meet their needs at lower cost – a development which would benefit employers and employees alike.

Chris Pope is a senior fellow at the Manhattan Institute.

https://www.realclearhealth.com/articles/2025/06/16/let_workers_control_their_health_insurance_1116959.html