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SmartBrief readers last month keyed on stories about care access and cost, the promise of AI, and tying insurance execs’ pay to member satisfaction.
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In February, SmartBrief readers turned their attention to stories showing how intricately health care and finances intersect – and are interdependent. There was news of the fiscal strain that states are feeling over the coverage of costly weight loss drugs, Americans’ concerns about pricing and access to health services, and how insurance executives’ pay can be tied to customer satisfaction. Readers also were interested in poll results showing how artificial intelligence can generate return on investment for health systems.
What happened: High demand for weight loss drugs such as Wegovy and Ozempic is placing financial stress on some states that cover the medications for their employees. States such as West Virginia, Colorado and North Carolina have either considered dropping coverage or have already done so due to high costs and budget tightening. Employee groups have pointed out that ending the coverage likely will cost states in other ways, including a less healthy and productive workforce and greater outlays to treat obesity-related disease.
What’s next: It was reported earlier this year that Ozempic and Wegovy will be included in the next round of Medicare drug price negotiations, with the new pricing taking effect in two years. In the meantime, manufacturers Novo Nordisk and Eli Lilly & Co. have announced more immediate price reductions for Wegovy and Zepbound, respectively, and the FDA formally stated that the semaglutide shortage has ended.
What happened: A Gallup survey found that health care access and affordability were the most pressing public health issues for about a quarter of respondents. Eighteen percent said safe food and water supplies were their main concern, and 11% said reducing chronic disease was their biggest priority. The survey also shed light on how public health priorities align with people’s political leanings.
What’s next: A fifth consecutive Medicare pay cut for physicians was announced recently, reducing their payment by 6.3% and raising further questions about declining access to care. Rep. Gregory Murphy, R-N.C, commented in a Forbes analysis that American physicians are “struggling like never before” due to these cuts, potentially causing millions to lose access to affordable services, with older adults among the most deeply affected.
What happened: Health insurance giant Cigna announced that its executives’ compensation will be tied to customer satisfaction, part of an effort to improve health care access, affordability and engagement. High-level officers’ bonus awards will depend on the company’s net promoter score, a metric for customer satisfaction and loyalty. The company also outlined plans to hire more care navigation experts, streamline prior authorization and claim processes, and improve its digital portal for clinicians.
What’s next: Cigna said it will release a report early next year to evaluate progress on these initiatives, and it is creating an Office of Excellence and Transformation to oversee them. An Insurance Business report from late 2023 shows which US health insurance executives are the highest-paid.
What happened: A Deloitte poll of health care executives found that 4 of 10 have seen “significant to moderate” return on investment from the use of generative AI technology, while 37% said they felt it was too early to report on ROI, and 12% said they had noted little ROI so far. Systems are using the platforms to automate tasks such as data entry, clinical documentation and medical imaging analysis.
What’s next: Fortune Business Insights research predicts that the worldwide health care AI industry will balloon from about $28 billion to more than $490 billion in the next seven years. Data from the National Bureau of Economic Research suggest that wider adoption of AI could reduce the nation’s health care spending by hundreds of billions of dollars a year.
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#artificial intelligence#health care access#health care costs
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By Julia M. Johnson
Julia M. Johnson is a SmartBrief health team writer and a journalist with 20 years of experience covering health topics. She also has a background in health care communications and media relations.
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