An overhaul of how Medicare pays hospitals for joint replacements could pare hundreds of millions of dollars in program spending while getting facilities to pay more attention to the cost and quality of care.

Why it matters: It's an example of how hospitals are the health sector that's being most rocked by the policy changes of President Trump's second term.

Driving the news: Medicare officials last month expanded a pilot program that bundled payments for hip, knee, and ankle replacements — some of the most common surgeries for seniors — to incentivize providers to manage their spending.

• Nearly all hospitals in the country will have to participate.
• The pilot ran from mid-2016 through 2024 in selected regions and generated more than $112 million in savings in its sixth and seventh years.
• The expansion is projected to save $725 million over five years.

How it works: Starting in 2028, Medicare will set spending targets for post-surgical care and other services delivered for 90 days after an operation.

• Hospitals that spend less will get paid the difference. Those that spend more have to pay Medicare back. Quality measures will also affect how much a hospital pays.
• The change "gives more patients the opportunity for a better care experience" by encouraging hospitals to improve care coordination, reduce unnecessary care, and prioritize patient outcomes, said Abe Sutton, director of Medicare's innovation center.

Friction point: Hospitals say mandating participation is counterproductive and especially difficult for smaller facilities and those with narrow margins.

• "At a time when policymakers are rightly focused on bringing down health care costs, increasing reliance on mandatory models represents a step in the wrong direction," Charlene MacDonald, CEO of the Federation of American Hospitals, told Axios.
• The hospital group suggested in comments a willingness to take the effort to court before Medicare finalized the plan, arguing the administration can't impose an indefinite, required payment change.

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A scientific journal this week retracted a study about excess mortality during the COVID pandemic that was featured at a June Senate hearing and interpreted as suggesting that vaccines are dangerous.

Why it matters: mRNA vaccine injuries have become a flashpoint in the roiling debate over the pandemic response, with some Republicans charging that federal health officials and the medical establishment suppressed information about the shots.

Driving the news: BMJ Public Health said it retracted the 2024 paper over misinformation in the discussion regarding the possible causes of excess mortality and because the authors didn't sufficiently describe "the limited nature" of their original work.

• The action comes more than two years after a researcher cited in the work flagged issues with the study, per the database Retraction Watch.
• The retraction cited an investigation by the Princess Maxima Center in the Netherlands, where three of the four authors were based, that found the paper paid "disproportionate attention to the possibility that COVID-19 containment measures and vaccination might have caused excess mortality" and didn't sufficiently discuss alternative theories.

Flashback: The Senate Homeland Security Subcommittee on Investigations hearing on June 3 was titled "Plausible Mechanisms of COVID-19 Injections Causing Cancer and Attacks on Scientific Publications and Research."

• Lead author Saskia Mostert testified that "censorship and suppression tactics" were used against doctors and scientists who questioned the "official COVID narrative," according to MedPage.
• The full Homeland Security Committee subpoenaed Anthony Fauci to appear at a separate July hearing on COVID origins and policies, where he declined to answer questions.

OpenAI's nonprofit arm today is committing $100 million toward a public health effort built around using advanced artificial intelligence to help expand treatment rates for Hepatitis C, HIV, and other conditions.

Why it matters: Hepatitis C is curable in more than 95% of patients, but about two-thirds of Americans living with the liver disease remain untreated and about 40 die each day, officials behind the effort said.

Driving the news: The OpenAI Foundation is partnering with the Common Health Coalition in an attempt to double Hepatitis C cure rates over the next two years in eight states and localities, initially focusing on Alabama, Illinois, Louisiana, and Massachusetts.

• It would deliver oral antivirals that can cure more than 95% of infected people within eight to 12 weeks.
• Public health officials and providers envision using generative AI tools to identify patients who've fallen through the cracks in the health system, synthesize patient records, and handle other administrative work.
• AI-enabled tools can also track progress and help providers identify those areas with greatest need.

Officials said the effort could be scaled up for other needs, including HIV prevention and curable cancers.

💉 Public health advocates are awaiting signs of whether new CDC Director Erica Schwartz will defend the current childhood immunization schedule. (CIDRAP)

🦠 The Ebola outbreak in Congo is on track to surpass the deadliest one in history, which killed over 11,000 people, the head of the World Health Organization said. (AP)

🤖 A new paper sketches an ambitious vision for AI creating a "digital organism" that could simulate how a drug or genetic change moves through biology. (Axios)