Before You Say “Aye” to AI…

By CCHP - In April 2024, the Federation of State Medical Boards (FSMB) released the document, “Navigating the Responsible and Ethical Incorporation of Artificial Intelligence into Clinical Practice.” Read Full Article…

HVBA Article Summary

1. Guidance on Responsible Integration: The FSMB document provides essential guidance to physicians and state medical boards for the ethical incorporation of AI into medical practices. It emphasizes the importance of navigating AI integration responsibly, ensuring that physicians remain accountable for patient care despite AI recommendations. This includes maintaining transparency, regularly reviewing AI efficacy, and documenting decision-making processes.

2. Ethical Considerations and Patient Protection: Both the FSMB document and the Bipartisan Senate AI Working Group highlight the need for transparency and accountability in AI utilization within healthcare. They advocate for policies that safeguard patient information, promote equitable access to AI benefits, and encourage ongoing education for healthcare professionals. Moreover, the recommendations underscore the significance of privacy, data security, and ensuring AI systems contribute meaningfully to improved health outcomes.

3. Collaborative Policy Development: As AI continues to evolve, there's a recognition of the challenges in regulating its rapid advancements. Both documents stress the importance of collaborative efforts among regulatory agencies, policymakers, healthcare providers, and technology experts. They call for continual monitoring and refinement of AI policies to address emerging concerns and maximize its potential while upholding patient safety and ethical standards.

Hospital to Union: Pay Up or You’re Stuck With Us in Your Health Plan

By Anna Wilde Mathews - Peter Goldberger, who leads a major union benefits fund, was on the verge of completing a new health-insurance deal with Aetna to cover its 210,000 members. Read Full Article…

HVBA Article Summary

1. Union Fund's Shocking Discovery: When the 32BJ Health Fund sought to exclude NewYork-Presbyterian from its insurance coverage due to high prices, they were stunned to learn that Aetna, their insurer of choice, would have to pay the hospital system a staggering $25 million to accommodate their request. This unexpected demand, reportedly for past medical services, left the union fund reeling, especially considering they hadn't been previously informed about these disputed charges.

2. Opaque Contractual Dynamics: The incident sheds light on the opaque and often one-sided nature of contracts between insurers and high-profile hospital systems like NewYork-Presbyterian. These agreements, typically kept secret from employers and unions, can lock clients into unfavorable terms, including mandatory inclusion of expensive hospitals in their networks. Such conditions severely limit clients' ability to control healthcare costs and often result in significantly higher expenses compared to government rates for similar medical services.

3. Power Dynamics and Financial Implications: NewYork-Presbyterian's formidable reputation and negotiating leverage enabled it to secure provisions in contracts that restrict insurers' capacity to exclude the system from their networks. For 32BJ, locked in a protracted battle to contain healthcare spending, the $25 million demand posed a substantial financial hurdle. Despite initial hopes of cost savings through a new deal with Aetna, the prospect of including NewYork-Presbyterian in the plan outweighed any potential benefits, prompting the union fund to stick with Anthem and leaving the disputed $25 million bill unresolved.

US FDA approves two biosimilars for blockbuster eye drug Eylea

By Reuters - The U.S. Food and Drug Administration (FDA) on Monday approved two close copies of Regeneron Pharmaceuticals' (REGN.O), Eylea, its first-ever clearance to biosimilar versions of the blockbuster eye treatment. Read Full Article…

HVBA Article Summary

1. Approval of Biosimilars: Regulatory agency approves Biocon Biologics' Yesafili and Samsung Bioepis and Biogen's Opuviz, signaling a significant step in the acceptance of biosimilar drugs in the market.

2. Interchangeability without Prescription: The agency's decision allows for the interchangeability of these biosimilars without the need for a doctor's prescription, potentially streamlining access to these treatments for patients.

3. Market Dynamics and Competition: The approval comes amid ongoing legal disputes, such as Regeneron's lawsuits against companies like Amgen and Biocon, reflecting the competitive landscape surrounding biosimilar drugs and the efforts of companies to protect their market share amidst looming biosimilar threats.

62% of Americans favor ACA despite Trump criticism

By Molly Gamble - The majority of Americans are in favor of the Affordable Care Act despite disagreement over the healthcare reform law by the presidential contenders in the 2024 Biden-Trump rematch. Read Full Article…

HVBA Article Summary

1. Shift in Public Opinion: Recent data from a KFF survey indicates a notable shift in public opinion towards the Affordable Care Act (ACA), with 62% of Americans holding a favorable view as of April, up from 59% in February. This increase suggests a growing acceptance and support for the ACA, despite its contentious history.

2. Political Dynamics and Policy Shifts: The 2024 presidential election has brought the ACA back into focus, with former President Donald Trump advocating for improvements to the law rather than its termination. This stance diverges from previous Republican efforts to repeal or replace the ACA, signaling a potential shift in GOP healthcare policy.

3. Legal Challenges and Stability: Despite being the subject of numerous legal challenges, including seven Supreme Court cases in a decade, the ACA has achieved historic enrollment numbers, with over 20 million individuals enrolling in 2024. The Supreme Court's rejection of a legal challenge in 2021, coupled with diminished attention to the law in the 2022 elections, highlights a certain level of stability and resilience in the ACA's implementation and public perception.

Benefits Think: It's time to put your child care benefits first

By Nicholas Park - As the increasing cost of child care in the U.S. keeps parents out of the workforce, child care benefits have emerged as a critical component of total awards within an employee benefits suite. Read Full Article…

HVBA Article Summary

1. Substantial Return on Investment: Robust child care benefits yield significant returns for employers, with potential ROI reaching up to 425%. These benefits translate into heightened retention rates, increased productivity, and decreased absenteeism. Essentially, by investing in child care benefits, employers can expect these benefits to pay for themselves over time.

2. Strategic Shift in Workplace Dynamics: The uptick in U.S. employers enhancing family support and leave offerings isn't just a response to societal shifts; it's a strategic maneuver to fortify their competitive edge. By prioritizing family-friendly policies, organizations aim to bolster employee retention and satisfaction, recognizing the pivotal role such benefits play in attracting and retaining top talent.

3. Modernizing Child Care Benefits: To effectively modernize child care benefits, organizations should follow a strategic approach. This involves:

   • Surveying Employees: Understanding specific needs and concerns through comprehensive surveys enables tailored solutions.

   • Benchmarking Research: Comparing benefits with industry standards identifies areas for improvement and innovative solutions.

   • Implementing Technology: Utilizing modern benefits administration technology streamlines processes, enhances accessibility, and facilitates informed decision-making.

   • Exploring Creative Solutions: Implementing cost-sharing contribution arrangements, such as stipends, FSAs, partnerships with child care providers, employee co-op programs, and flexible work arrangements, can alleviate financial burdens while demonstrating commitment to employees' well-being.

By aligning child care benefits with the evolving expectations of the workforce, organizations not only foster a supportive and inclusive environment but also attract and retain top talent, ultimately enhancing overall team productivity and well-being.

North Carolina ends coverage of new weight loss drugs for 750,000 state employees

By Alan Goforth - Demand for new-generation weight-loss drugs is sky high – and so is the monthly cost. North Carolina's health insurance plan for state employees recently decided to stop covering GLP-1 drugs because of concerns that costs could reach more than $1 billion over the next six years. Read Full Article…

HVBA Article Summary

1. Access Hurdles for Public Employees: In North Carolina, 750,000 public employees enrolled in the state health plan are now required to pay out of pocket for weight-loss drugs like Wegovy due to recent policy changes. This shift reflects a nationwide trend as large employers seek to contain the escalating costs of such medications.

2. Negotiation Challenges with Drug Manufacturers and PBMs: Initially aiming to save costs by restricting prescriptions to patients who attempted lifestyle management programs first, North Carolina faced resistance from drug manufacturers and its pharmacy benefit manager (PBM), CVS Caremark. Manufacturers demanded full list price payments unless the state allowed unfettered access, potentially receiving rebates amounting to a 40% discount. Such contractual terms leave little room for negotiation, forcing states like North Carolina into difficult decisions.

3. Conflict Over Patient Access vs. Cost Control: The standoff underscores a broader conflict between employers' cost-saving measures and patients' access to medically necessary treatments. While employers and PBMs prioritize cost containment, drug manufacturers argue against barriers to access, asserting patients' rights to proven medical treatments without stringent prerequisites. This clash highlights the complexities of balancing healthcare affordability with ensuring comprehensive coverage for chronic conditions like obesity, echoing challenges faced by employers nationwide.

Why this fintech isn't rushing retirees out the door

By Frank Gargano - Collaboration was a core tenet of DCI's foundation more than 60 years ago, when four banks in Hutchinson, Kansas, came together to build a core processor for institutions of all asset sizes. Read Full Article…

HVBA Article Summary

1. Introduction of Part-Time Retiree Program: In response to the evolving needs of its workforce, DCI implemented a part-time retiree program in 2022, initiated by Janet Seiler and Sandra Schmitt. This program enables employees nearing retirement age to transition gradually into retirement while still contributing to the company.

2. Program Implementation and Success: Eligibility for the part-time retiree program is determined based on mutual benefit for both the employee and DCI. Discussions ensue to establish the feasibility of the arrangement and identify any business needs it can address. Succession planning is integral, involving workload adjustments, successor training, and setting benchmark dates for complete retirement. With four successful cases so far, including Janet Seiler's extended tenure, the program has proven effective in retaining valuable talent.

3. Addressing Industry Challenges and Shifting Workforce Dynamics: The financial services industry faces challenges in employee retention and succession planning, exacerbated by the retirement wave of C-suite executives. Programs like DCI's part-time retiree initiative help mitigate these challenges by preserving institutional knowledge and facilitating smoother transitions. Moreover, as demographics shift and more older Americans remain in the workforce, initiatives supporting diverse skill sets and individualized retirement paths become increasingly crucial.

Obesity and high blood sugar play ever growing role in ill-health, study shows

By Jennifer Rigby - Obesity, high blood sugar and high blood pressure among other metabolic issues now lead to almost 50% more years of healthy life lost to either disease or premature death than in 2000, a major international study showed on Thursday. Read Full Article…

HVBA Article Summary

1. Significant Reduction in Years Lost to Undernutrition-Related Factors: Over the studied period, the Global Burden of Diseases study reported a remarkable decline of 71.5% in the number of years lost due to undernutrition-related issues among mothers and children, such as stunting or wasting. This indicates substantial progress in addressing nutritional deficiencies globally.

2. Shifting Global Health Challenges: The study highlights a notable shift in global health challenges as populations age and lifestyles evolve. While air pollution remains a prevalent risk factor, there is a rising concern regarding high body-mass index (BMI) and high blood sugar, particularly among 15- to 49-year-olds worldwide. These factors significantly contribute to the development of diabetes, reflecting changing health dynamics across different age groups and regions.

3. Projections for Future Health Trends: Researchers anticipate a rise in life expectancy by 4.5 years by 2050, with the most significant gains expected in countries with lower current life expectancies, indicating a convergence of life expectancies globally. However, this increase in longevity is tempered by the forecasted rise in years spent in poor health, emphasizing the importance of addressing emerging health challenges such as obesity, addiction, and climate change for healthier aging populations worldwide.

Lower Protein Intake In Midlife May Increase Mortality Risk

By Heidi Splete - Lower intake of dietary protein in midlife was a significant independent predictor of all-cause mortality in later life, based on data from a cohort study of more than 8000 men. Read Full Article…

HVBA Article Summary

1. Inconsistent Findings on Dietary Protein and Mortality: Despite the Recommended Dietary Allowance (RDA) for protein intake being set at 0.8 g/kg body weight, prior studies have produced mixed results regarding the relationship between dietary protein and all-cause mortality, as highlighted by Dr. Pedro Joaquin Ayau Aguilar of the University of Hawaii.

2. Research Methodology and Findings: Aguilar and colleagues conducted a comprehensive review of data from the Kuakini Honolulu Heart Program, involving 7486 Japanese-American male participants. They categorized protein intake into quintiles, both from animal and plant sources, and observed a significant association between lower protein intake and higher mortality rates, irrespective of protein source.

3. Implications and Future Directions: While this study underscores the impact of nutrition on health outcomes, particularly in relation to protein intake, further research is warranted to delineate optimal protein amounts and sources for health optimization. Despite the study's limitations, such as its focus on a homogeneous population and the inability to establish causality, it provides valuable insights into the complex interplay between diet and mortality, informing future clinical recommendations.

Ozempic, Wegovy to be tested as alcohol-related liver disease therapies

By Paige Twenter - Novo Nordisk is investigating the potential of Ozempic, Wegovy's active ingredient and two other drug candidates as treatments for alcohol-related liver disease. Read Full Article…

HVBA Article Summary

1. Exploring Novel Therapies: The phase 2 trial will investigate the effects of semaglutide, cagrilintide, and an investigational therapy targeting fibroblast growth factor 21 on liver damage and alcohol use. These medications offer promise as potential treatments for alcohol-related liver disease, a condition characterized by liver damage due to excessive alcohol consumption.

2. Potential Benefits of GLP-1 Agonists: Semaglutide and cagrilintide, both GLP-1 agonists, hold potential beyond their known effects on hunger suppression. By promoting a feeling of fullness, these drugs may also help reduce cravings for alcohol and other substances, suggesting a new avenue for addiction treatment.

3. Broader Scope of Research: Beyond liver disease and alcohol use, the study reflects a broader interest in exploring the therapeutic potential of GLP-1 agonists. Research teams are investigating their impact on conditions ranging from drug addiction to sleep apnea and metabolic dysfunction-associated steatohepatitis. Novo Nordisk's ambitious study, spanning multiple countries, aims to shed light on the multifaceted benefits of these medications, with results expected by September 2025.