HVBA Innovation Summit Returns to Tampa August 20 with Cutting-Edge Healthcare Sessions and Upscale Casino-Themed Networking Reception

By HVBA – The Health & Voluntary Benefits Association® (HVBA) will bring benefits professionals, brokers, consultants, healthcare innovators and industry leaders together at the 2026 HVBA Innovation Summit – Tampa on Thursday, August 20, 2026, at Hotel Alba Tampa. Designed to be more than a traditional industry conference, the HVBA Innovation Summit combines timely education with intentional networking opportunities created to help attendees discover new solutions, develop meaningful partnerships and leave with opportunities to grow their businesses. Read Full Article...

HVBA Article Summary

1. Event purpose and format: HVBA is positioning the Tampa Innovation Summit as a hybrid of education and structured networking rather than a conventional conference. The agenda is designed to help benefits professionals and solution providers connect around practical business opportunities and partnerships. The event also emphasizes interaction over exhibit booths as the primary way attendees engage with vendors and peers.

2. Session themes span pharmacy costs, enrollment tech, and benefit design: The program includes talks on a GLP-1 coverage carve-out case study, the intersection of retirement planning and Medicare, and converting unused PTO into financial benefits. It also features a session on using AI to support benefits enrollment for a multi-generational workforce. A fireside discussion will focus on prescription drug costs, PBM strategy, and high-cost pharmacy as areas where employers and brokers may seek alternative approaches.

3. Networking and access details: The summit is followed by a casino-themed reception with food, an open bar, gaming, and giveaways intended to keep attendees circulating and meeting new contacts. The broader schedule also includes an HVBA board meeting and an invitation-only dinner sponsored by Juice Financial. Attendance is limited, and the article notes that qualified brokers may attend the Innovation Summit at no cost.

Universal health would cut U.S. provider revenue 21%, researchers predict

By Allison Bell – Moving the United States to a purely government-run, single-payer health care system could save 114,000 lives per year, reduce spending by more than $1 trillion per year, and reduce physicians' and hospitals' revenue by about 21%, according to the authors of a new universal health system analysis. Abishek Pandey, a Yale public health analyst, and four colleagues predict, in a paper based mostly on government health care spending data from 2024, that eliminating all private health insurers, health plan administrators and health plans could have cut administrative overhead by $286 billion. If health care providers had kept all of the overhead savings, that might cut the net impact of a "Medicare for All" system to $296 billion, or 11% of their income. Read Full Article... ^{_{(Subscription required)}}

HVBA Article Summary

1. Model focuses on recent government spending data and administrative changes: The paper cited in the article is described as being based mostly on government health care spending data from 2024. Its scenario assumes eliminating private health insurers, health plan administrators, and health plans as part of a single-payer approach. That framing means the projections hinge on both payment-rate changes and a major restructuring of how coverage administration is handled.

2. Legislative reference point is specific Medicare for All proposals: The researchers modeled the effects of bills introduced by Rep. Pramila Jayapal in the House and by Sen. Bernie Sanders in the Senate. In the article’s description, those proposals would eliminate cost-sharing and prevent private coverage of items covered by the public program. They would also tie provider payments to traditional Medicare rates, contrasting with employer and commercial plans that the article says typically pay substantially higher multiples of Medicare.

3. Political and stakeholder implications could affect benefits communication: The article notes that Medicare for All debate has fluctuated over time and that Republican support is limited, while some Democratic primary candidates this year have supported expanding government involvement in health care finance. It also highlights concerns from some unions that operate their own health plans and view Medicare for All as potentially worse for members. Against that backdrop, the piece suggests benefits managers and advisors who support a continued private role in financing may need to spend more time explaining their position in the coming year.

The FTC Continues to Let Big Insurers’ PBMS Off the Hook

By Wendell Potter – Remember when the media and policymakers in Washington became outraged over the cost of insulin and lambasted drugmakers for profiteering? Now, thanks to an FTC investigation launched during the Biden administration into the business practices and structure of the nation’s three biggest pharmacy benefit managers, we know the fuller story: Drugmakers were essentially forced to raise their list prices — and hand PBMs substantial kickbacks disguised as rebates —in order to get placed on the PBMs’ formularies. Former FTC Chair Lina Khan’s agency had signaled that fixing this required a major restructuring of the companies themselves. Read Full Article...

HVBA Article Summary

1. FTC settlements emphasize behavioral changes over penalties: The article says the FTC reached settlements with Cigna’s Express Scripts and CVS Caremark that include no monetary penalty and no admission of liability. Instead, the deals focus on commitments like preferring lower-net-cost drugs, delinking compensation from rebates/list prices, and increasing disclosures. The author argues this approach ends the agency’s major PBM enforcement effort without a trial or structural remedy such as a breakup.

2. FTC allegations center on rebate incentives that can raise patient costs: The FTC alleged the three PBMs created incentives for drugmakers to compete by increasing list prices to offer larger rebates for formulary placement. The complaint described PBMs steering patients toward higher-list-price products that yield richer rebates, while leaving patients paying cost sharing based on the inflated list price rather than the net price after rebates. The article uses Humalog’s price history (rising from about $21 per vial in 1999 to more than $274 by 2017) to illustrate the magnitude of list-price escalation described in the case.

3. OptumRx remains unresolved while broader structural reform debates continue: UnitedHealth’s OptumRx is described as the last of the three PBMs without a finalized consent agreement, with terms not yet public and formal FTC approval still pending. The piece notes criticism from the American Economic Liberties Project and points to proposed legislation (including the bipartisan Break Up Big Medicine Act and the Patients Before Monopolies Act) aimed at restricting insurer/PBM/pharmacy ownership combinations. The author contends the settlements may yield some savings (including insulin affordability measures) but leave the underlying market structure and vertical integration issues intact.

Merck, Moderna declare Phase 3 success for personalized mRNA cancer vaccine

By Max Gelman – The next generation of immunotherapy appears to have arrived. Merck and Moderna on Wednesday said their personalized cancer vaccine, known as intismeran autogene, succeeded in its first Phase 3 trial that tested the program in combination with Merck’s Keytruda in certain melanoma patients. The study hit its primary endpoint, reducing the risk of recurrence or death compared to Keytruda alone by a statistically significant margin. Specific data were not disclosed and the trial will continue to measure overall survival, which can take a long time to analyze in melanoma. But the win marks two important firsts in the immunotherapy field. Read Full Article... ^{_{(Subscription required)}}

HVBA Article Summary

1. First Phase 3 Success for an mRNA Cancer Vaccine: Merck and Moderna’s individualized neoantigen therapy became the first personalized cancer vaccine of its kind—and the first mRNA-based cancer treatment—to succeed in a Phase 3 trial. Personalized vaccines are complex because they use a patient’s tumor sample to create a tailored therapy designed to train T cells to recognize and attack cancer. The result provides clinical validation for an approach that has historically been difficult to develop and has produced relatively few approved therapies.

2. Strategic Importance for Merck and Moderna: The success could help Merck expand its oncology portfolio as it prepares for Keytruda’s expected 2028 patent cliff, particularly since Keytruda generated roughly half of the company’s revenue last year. For Moderna, the trial provides an opportunity to broaden its business beyond respiratory vaccines following post-pandemic cost reductions and other clinical and commercial setbacks. Both companies are also pursuing additional oncology programs, while Moderna is exploring off-the-shelf cancer therapies and other RNA-based approaches.

3. Additional Trials and Regulatory Steps Remain: Merck and Moderna have not announced when they may seek FDA approval, and the treatment will still need to demonstrate effectiveness across individual cancer settings. Earlier Phase 2b data involving 157 patients showed a 49% reduction in the risk of melanoma recurrence or death, while overall survival data remained immature. The companies are also studying the vaccine in lung, bladder and kidney cancers, including as a standalone therapy and in combination with Keytruda or chemotherapy.

Cost pressure doesn't drive employer action on health spending - data does

By Mark Rosanes – Healthcare cost pressure alone does not predict which employers take action on it. The stronger predictor is whether an employer can see their own claims data. Where that data is stored turns out to matter as much as whether they formally have access to it at all. Read Full Article...

HVBA Article Summary

1. Claims visibility is strongly associated with strategy adoption: Employers reporting full, claim-level access to medical claims data were more likely to use each of the 26 hospital and high-cost-claim strategies tracked in the survey. On average, employers with full access used 11.9 strategies versus 7.9 among those with limited or no access. The survey indicates both groups showed similar interest in adopting new approaches, suggesting the difference is more about ability to execute than willingness. The report also cautions that these are correlations and do not prove that data access causes action.

2. Premium and cost-increase pressure did not correlate with more action in this dataset: The survey tested whether employers anticipating the steepest projected cost increases were more likely to adopt the strategies it tracked. Employers expecting cost increases of 9% or more were not more likely than others to be using those strategies, according to the findings. The same lack of relationship appeared for employers already paying above-average premiums. This suggests that rising costs alone may not be enough to drive changes in purchasing behavior without other enabling factors.

3. Where claims data is stored is linked to how complete access is reported: About three-quarters of employers store claims data with their health plan or third-party administrator, and within that group the reported rate of complete medical claims access was 59.2%. By contrast, among employers using an independent data warehouse (about one in four), 85.9% reported complete medical claim-level access and 84.1% reported complete pharmacy claim-level access. The survey also found a gap between reported access and auditability: 65.3% said they had complete medical claim-level access, but only 58.6% said they were allowed to audit their complete files. These differences point to practical governance and verification issues that can affect employers’ ability to act on their data.

FTC probes Epic over competition, health data access

By Kristen Smithberg – The Federal Trade Commission is investigating whether Epic Systems has used its dominant position in electronic health records to restrict competition, including in technology markets serving health insurers. The agency has sent investigative demands to health technology companies seeking information about how Epic grants or withholds access to patient data, Reuters reported, citing two sources familiar with the matter. The investigation remains in its early stages and may not result in charges. The FTC declined to comment. Read Full Article... ^{_{(Subscription required)}}

HVBA Article Summary

1. Scope of the FTC’s inquiry: The reporting says the FTC is seeking information from health technology companies about Epic’s practices around granting or withholding access to patient data. The story characterizes the probe as early-stage and emphasizes it may not lead to charges. It also notes the FTC declined to comment, highlighting the limited public detail available so far. The focus includes potential competitive effects in technology markets used by health insurers.

2. Market position and the competitiveness question: The article describes Epic as the largest electronic health record vendor in the U.S. and cites a specific share of the acute-care EHR market. It also reports Epic’s claims about the scale of its footprint across hospitals and patient records. This market scale is presented as context for why regulators and rivals may scrutinize how data access is controlled. The underlying issue is whether dominance in core EHR systems can influence downstream innovation and competition.

3. Lawsuits and allegations cited as backdrop: The piece points to multiple legal disputes alleging Epic used control over health data to favor its own offerings over competitors’ products. It summarizes allegations from Particle Health and CureIS Healthcare, and also references a lawsuit brought by Texas Attorney General Ken Paxton. The story notes Epic has denied anticompetitive conduct and has disputed the allegations in the various cases. It also includes Epic’s interoperability-related statements, including its position that provider customers control access to patient records.

Patients now shop for doctors like consumers, and the bar just got higher

By Todd Shryock – Patients have stopped giving healthcare providers the benefit of the doubt. Three in four now refuse to book with a doctor rated below 4.0 stars. More than half have already canceled or skipped an appointment because of what they read online — up 15 percentage points in just nine months. And for the first time, AI tools like ChatGPT and Google's AI Overviews influence a patient's choice of provider more than a referral from another physician does. Read Full Article...

HVBA Article Summary

1. Online ratings are becoming a hard gate for patient consideration: The survey describes a “threshold effect” where many patients set a minimum star rating before they will even consider booking. It also reports that healthcare has a higher ratings bar than other business categories cited, widening the gap for practices that are merely “average” online. The article frames this as a structural change in patient behavior rather than a temporary spike in review-checking.

2. Many negative reviews are driven by experience and operations rather than clinical results: The report highlights that complaints often center on how patients are treated and communicated with, including staff interactions and whether patients feel heard by clinicians. It also points to common friction points such as delays and billing as recurring issues that shape online feedback. The article positions reviews as both a marketing signal and an operational diagnostic that can reveal problems before they become larger retention or reputation issues.

3. AI is increasingly shaping discovery and trust, and visibility depends on underlying data and sources: The piece says AI tools are now a leading influence on provider choice, and it breaks down where patients say they place trust on search results pages. It also summarizes research suggesting generative AI citations can favor certain source types (such as hospital rosters and larger, content-heavy organizations), which may disadvantage many independent practices. Separately, it notes that inaccuracies in directories and listings can flow into AI outputs, making consistent, up-to-date practice information a practical competitiveness factor.

The GLP-1 workplace revolution has already started

By Todd Shryock – A quiet but significant shift is already underway in workplaces: GLP-1 medications such as Wegovy, Ozempic, and Mounjaro are beginning to reshape not just how people manage weight, but how organizations think about health, productivity, and workplace well-being itself. For employers, this is not simply a medical development. It is a workplace reality that raises urgent questions about equity, culture, stigma, productivity, and the future design of employee health strategies. Read Full Article... ^{_{(Subscription required)}}

HVBA Article Summary

1. GLP-1 Use Raises Workplace Equity and Access Questions: GLP-1 medications are increasingly common, with about 12% of U.S. adults having used one and roughly 6% currently using them. A Lifesum survey of 2,000 employees found that 74% believe employer-provided GLP-1s could widen health inequalities, compared with 21% who believe they could level the playing field. These findings suggest employers considering GLP-1 coverage must weigh potential health benefits alongside affordability, access, stigma, and employee perceptions of fairness.

2. Employees See Medication as Only One Part of Workplace Well-Being: Only 20% of surveyed employees believe GLP-1s improve focus or reduce absenteeism, while 50% view lifestyle and behavioral factors as the primary drivers of workplace well-being. Additionally, 90% believe nutrition remains essential to long-term health outcomes despite the appetite-suppressing effects of GLP-1 medications. The article argues that employers can complement medical benefits by supporting meal and recovery breaks, nutrition education, physical activity, sleep, and other sustainable health behaviors.

3. Workplace Design Could Influence Health Alongside Medical Interventions: The growing use of GLP-1s is intersecting with discussions about shorter or four-day workweeks, which could provide employees with more time for meal preparation, exercise, sleep, and recovery. While a reduced workweek may not be feasible for every organization, employers can apply similar principles by reducing time pressures and creating work environments that make healthy behaviors easier to maintain. The broader takeaway is that workplace well-being strategies may increasingly combine medical interventions with behavioral support and structural changes to how work is organized.

Doctors argue their role in the age of AI

By Caitlin Owens – The American Medical Association is out with a new framework for physicians' role in the age of AI, provided first to Axios, that insists doctors remain central to patient care. Read Full Article...

HVBA Article Summary

1. AMA framework emphasizes physicians’ enduring role: The AMA released a new framework—developed with the Digital Medicine Society—arguing that medical practice should evolve alongside advancing AI. It contends that while specific tasks may change, core physician responsibilities remain steady. The framework highlights aspects such as human connection and clinical judgment as central to care.

2. Debate sharpened by a contrasting view in JAMA: A JAMA opinion piece argues AI is or soon will be better than doctors at delivering health care and suggests that keeping humans involved could worsen outcomes. The authors project that “superior autonomous AI” could be deployed for many cognitive medical workflows by 2030. They also call for urgent planning around issues such as liability, regulation, reimbursement and medical education.

3. Regulatory and practical questions remain unresolved as AI tools spread: Patient-facing AI capabilities are advancing quickly, while oversight and rules for use are still developing. The FDA issued a discussion paper considering whether generative AI-enabled medical devices could be assessed in ways analogous to physician evaluation. The article notes open questions such as who bears responsibility for AI errors and how AI-provided care would be paid for, alongside attention on whether autonomous care could expand without robust regulatory structures.