Health care impacted by cybersecurity, regulation and AI in 2025

By Susan Rupe - Cybersecurity, regulation, and artificial intelligence will be the top trends impacting health plans in 2025, according to a panel of BakerTilly analysts during a recent webinar. Read Full Article… 

HVBA Article Summary

1. Escalating Cybersecurity Threats in Health Care: The frequency of ransomware attacks on health care organizations doubled in 2024, posing significant risks to patient safety, financial stability, and data security. With an average data breach costing $10 million and taking 191 days to detect, experts stress the need for proactive cybersecurity measures, including asset inventory, risk assessment, and strategic cybersecurity investments.

2. Regulatory Shifts and Policy Implications Post-2024 Election: The outcome of the 2024 election is expected to reshape health care regulations, potentially impacting Medicare Advantage support, Affordable Care Act provisions, Medicaid eligibility, and Federal Trade Commission oversight of mergers and acquisitions. Policy changes could also lead to pharmacy benefit manager reforms, affecting the broader health care landscape.

3. AI’s Expanding Role in Health Care Operations: AI adoption in health care is accelerating, with 79% of organizations already leveraging AI to enhance patient care, automate claims processing, and improve compliance monitoring. However, increased reliance on AI raises concerns about data privacy, ethics, and the need for stronger cybersecurity protections. Additionally, health plans are prioritizing member engagement through AI-driven tools and interoperability advancements.

The Trump executive orders that impact healthcare

By Bridget Early - President Donald Trump has rescinded a set of insurance, drug pricing and public health executive orders that laid the groundwork for former President Joe Biden’s major healthcare policy priorities, and started establishing his own agenda. Read Full Article… ^{_{(Subscription required)}} 

HVBA Article Summary

1. Reversal of Key Healthcare Policies: Trump rescinded multiple Biden-era executive orders related to marketplace insurance, drug pricing, and public health measures. This includes removing special enrollment periods for health insurance exchanges, halting efforts to lower drug prices through Medicare models, and revoking pandemic management strategies that expanded testing and health equity initiatives.

2. Changes to Nondiscrimination and Global Health Policies: A new executive order requires federal agencies to define sex based on birth, overriding protections for LGBTQ+ individuals in healthcare. Trump also initiated the U.S. withdrawal from the World Health Organization, potentially disrupting global health funding and disease eradication efforts.

3. Deregulation of Artificial Intelligence in Healthcare: Trump revoked a 2023 executive order that established AI safety and transparency regulations for federal agencies. This move could allow healthcare providers greater flexibility in AI use but raises concerns over improper prior authorization denials and patient care risks.

Trump Signs Order to Remove U.S. from World Health Organization

By Mark Hagland - On Jan. 20, during his first day in office, President Donald Trump signed an executive order announcing his intention to withdraw the United States from the World Health Organization, citing the “organization’s mishandling of the COVID-19 pandemic that arose out of Wuhan, China, and other global health crises, its failure to adopt urgently needed reforms, and its inability to demonstrate independence from the inappropriate political influence of WHO member states.” Read Full Article…

HVBA Article Summary

1. WHO's Response and Role in Global Health: The World Health Organization (WHO) expressed regret over the U.S. decision to withdraw, emphasizing its crucial role in addressing global health challenges, responding to disease outbreaks, and supporting strong health systems worldwide. The organization highlighted the long-standing partnership between the U.S. and WHO in combating major diseases like smallpox and polio.

2. Political and Strategic Implications: The withdrawal decision is rooted in former President Trump’s criticisms of WHO’s handling of COVID-19 and allegations of favoritism toward China. Experts, including Dr. Ashish Jha, warned that the U.S. exit could leave a leadership vacuum that China might fill, potentially increasing its global influence in health policy and governance.

3. Legal and Financial Concerns: The move raises legal and financial issues, as withdrawal requires a one-year process and continued funding during that period. Legal experts, such as Georgetown’s Lawrence Gostin, argue that Trump’s immediate funding halt may be unlawful and could have significant consequences for both global health efforts and the U.S.'s role in international health diplomacy.

Trump Reverses Some Biden Drug Pricing Initiatives, Potentially Impacting Medicare Costs

By Pearl Steinoz - President Donald Trump’s second-term health care agenda is taking shape with a clear focus on undoing several Biden-era policies.1 On Monday, Trump signed an executive order reversing initiatives aimed at reducing prescription drug costs for Medicare and Medicaid recipients, expanding the Affordable Care Act (ACA), and increasing protections for Medicaid enrollees. Read Full Article…

HVBA Article Summary

1. Limited Immediate Impact on Out-of-Pocket Costs: While Trump’s executive actions have overturned several Biden-era health care policies, experts suggest that these changes will not significantly affect most Americans' out-of-pocket health care costs in the short term. Key cost-reducing measures like the $35 insulin cap and Medicare’s drug price negotiations under the Inflation Reduction Act remain intact.

2. Uncertainty Over Drug Pricing Reforms: The revocation of Biden’s executive orders halted several drug pricing pilot programs initiated by CMMI, including efforts to standardize $2 co-pays for chronic condition medications and reduce costs for high-price cell and gene therapies. This raises concerns about whether the administration will continue efforts to lower prescription drug costs.

3. Potential Shift in Health Care Priorities: Trump's decision to roll back policies that previously aligned with his administration’s cost-cutting goals signals a possible shift in focus. While leaving major Biden-era drug pricing reforms untouched, the administration’s stance on Medicare’s drug price negotiation authority remains unclear, suggesting a more cautious approach to health care cost reduction.

New year arrived with long list of benefits challenges, opportunities, survey finds

By Alan Goforth - Employers today have access to an unprecedented array of benefits options. The challenge is to tailor a package that meets the needs not just of their overall workforce but the specific needs of individual employees. Read Full Article… ^{_{(Subscription required)}} 

HVBA Article Summary

1. Personalization and Flexibility in Benefits: The traditional one-size-fits-all approach to employee benefits is shifting towards a more personalized and adaptable model, catering to the diverse needs of a modern workforce. However, many companies still struggle with implementing flexible benefit options, with only 17% having a cohesive global benefits strategy.

2. Challenges in Engagement and Communication: Despite prioritizing employee engagement with benefits, companies face a major disconnect, as nearly three-fourths report low or average appreciation from employees. Disjointed communication, with 37% of companies sharing benefits information only once a year, exacerbates this issue, highlighting the need for a more unified and transparent approach.

3. Cost Pressures and Strategic Shifts: Rising insurance premiums, increasing by as much as 70%, are forcing employers to shift focus from wellbeing perks to essential benefits like medical and life insurance. Additionally, AI is expected to play a growing role in benefits design, alongside regulatory changes and demographic shifts, shaping the future of employee benefits strategies.

GLP-1 Benefits, Risks Detailed in ‘Atlas’ Mapping Outcomes

By Nancy A. Melville - A study of more than two million people with diabetes builds on evidence of broad-ranging benefits and risks of glucagon-like peptide 1 receptor agonists (GLP-1 RAs) in the clinical setting, providing an “atlas” mapping extensive outcomes and some new insights to potentially explore in more rigorous clinical trials. Read Full Article…

HVBA Article Summary

1. Broad Benefits and Risks Identified: The study confirmed previously known benefits of GLP-1 receptor agonists (GLP-1 RAs) while also uncovering new potential advantages, including reduced risks for substance use disorders, suicidal ideation, neurocognitive disorders, cardiac arrest, and certain infections. However, it also highlighted increased risks for gastrointestinal disorders, kidney stones, and acute pancreatitis.

2. Potential Neuropsychiatric and Kidney Impacts: The study found compelling evidence of GLP-1 RAs' effects on the brain, suggesting neuroprotective and anti-inflammatory properties that may reduce risks for dementia, Alzheimer's, and seizures. However, a notable concern is the increased risk of kidney stones, which may be linked to reduced hydration among users.

3. Limitations and Need for Further Research: While the study offers valuable real-world insights, experts caution that its observational nature limits definitive conclusions. The lack of randomization means potential confounders could influence results, and the relatively short follow-up period raises concerns about unknown long-term effects. More rigorous, randomized clinical trials are needed to validate the findings and fully assess the long-term benefits and risks of GLP-1 RAs.

Root-cause solutions will make America healthy

By Ben Conner - When a check engine light turns on, the reason can range from a loose gas cap to an internal engine failure. There is no way of knowing what the underlying issue is unless you pop the hood of the car and take a closer look. Simply turning the light off could make a potentially quick fix a time-consuming — and costly — repair. Read Full Article… ^{_{(Subscription required)}} 

HVBA Article Summary

1. Shifting from Reactive to Preventative Care: The American healthcare system often prioritizes reactionary treatments, such as prescribing medications and costly procedures, rather than addressing the root causes of chronic illnesses. A greater focus on preventative care—through screenings, health education, and lifestyle modifications—could significantly reduce healthcare costs and improve overall well-being.

2. Breaking the "Sick Cycle" of Chronic Disease: Many chronic conditions, including heart disease, diabetes, and high blood pressure, are often managed with medication rather than lifestyle changes. Without addressing underlying factors like diet, exercise, and mental health, patients remain trapped in a cycle of illness rather than achieving long-term wellness or even reversing their conditions.

3. The Role of Consultants and Advisers in Healthcare Transformation: Employers, consultants, and policymakers have the opportunity to drive meaningful change by promoting preventative health programs, mental health support, and better access to proactive care. By shifting away from a system that merely manages sickness, organizations can enhance employee well-being and contribute to a more sustainable and effective healthcare model.