Good morning from Colorado, where I'm at Aspen Ideas: Health, a festival organized by the Aspen Institute. Say hello if you're here as well!
Today's word count: 755 words, <3 minutes.
Illustration: Lazaro Gamio/Axios
Not-for-profit hospital systems increasingly operate more like corporate titans on the stock exchanges than the charities they promote themselves to be, Axios' Bob Herman reports.
The big picture: As hospital systems have gotten larger, they have hosted more investor calls, released more financial data and attended more conferences and roadshows to attract banks and municipal debt buyers — all while health care spending continues to soar.
Where things stand: Almost 60% of community hospitals are private and nonprofit, and therefore don't pay income or property taxes. But hospitals are more on par with pharmaceutical giants and insurance companies than soup kitchens.
The intrigue: Hospitals that want to erect new buildings or buy new technology issue debt in municipal bond markets instead of the public markets.
The bottom line: "Not-for-profit" does not mean "no profit."
President Trump will issue an executive order on Monday requiring more transparency around negotiated health care prices, WSJ reports.
Hospital and provider groups may hate the leading House and Senate proposals for ending surprise medical bills, but the largest providers will likely be least affected, according to a Moody's analysis.
Driving the news: The Federation of American Hospitals, the American Hospital Association and the American Medical Association all oppose tying payments for out-of-network care to the median in-network rate for the service.
What they're saying: This wouldn't be bad for all providers, according to Moody's — just the ones that collect higher-than-average payments.
Overall, resolving surprise medical bills for patients is "mostly credit negative" for the industry, according to Moody's — which implies that the industry benefits from the ability to balance bill patients.
What we're watching: The change could lead to further provider consolidation, Moody's predicts.
A lawsuit filed by CVS against a former employee suggests that major industry players are more worried about Amazon's foray into health care than they initially let on, CNBC reports.
The incumbent companies are worried that Amazon could negotiate directly with insurers, cutting out the need for pharmacy benefit managers.
The other side: "It is important to keep in mind that what's being reported here is another company's speculation about our business strategy for a lawsuit to which neither Amazon nor PillPack is a party," a PillPack spokesperson told CNBC.
As measles spreads, a debate is heating up nationally over whether to mandate vaccines or keep in place laws that allow for more individual choice, my colleague Eileen Drage O'Reilly reports.
Driving the news: Trust in government and in the health care system tends to be linked to people's belief that vaccines are safe, according to Imran Khan, Wellcome Trust's head of public engagement, who discussed their Global Monitor Report on a panel on Wednesday.