Daily Industry Report - May 9

Your summary of the Voluntary and Healthcare Industry’s most relevant and breaking news; brought to you by the Health & Voluntary Benefits Association®

Jake Velie, CPT
Vice Chairman, President & COO
Health & Voluntary Benefits Association® (HVBA)
Editor-In-Chief
Daily Industry Report (DIR)

Robert S. Shestack, CCSS, CVBS, CFF
Chairman & CEO
Health & Voluntary Benefits Association® (HVBA)
Publisher
Daily Industry Report (DIR)

As Steward Ship Was Sinking, CEO Bought $40M Yacht

By Rachael Robertson - A peculiar private equity deal screwed over an already struggling hospital system while reaping profits for executives, according to the Wall Street Journal. Read Full Article…

VBA Article Summary

  1. Financial Manipulation and Profit Maximization: In 2020, Steward Health Care System faced financial distress requiring a $400 million bailout. Cerberus Capital Management, its owner, orchestrated a complex financial arrangement with Steward's landlord, Medical Properties Trust (MPT), diverting investment away from Steward itself. Cerberus then sold its majority stake in Steward for significant profit, leaving Steward to file for Chapter 11 bankruptcy while Cerberus amassed an $800 million windfall.

  2. Patient Safety Crisis in North Carolina Psychiatric Hospital: Reports from North Carolina Health News unveil alarming conditions at Brynn Marr Hospital, including over-medication, inadequate staff training, and rampant falsification of patient records. Former employees highlighted a chaotic and violent environment, endangering both patients and staff. Incidents of bullying, sexual harassment, and violence against patients went untreated, while staff described feeling ill-equipped to manage the escalating violence.

  3. Security Failures and Patient Harm in Florida Psychiatric Facilities: Investigations by the Miami Herald exposed systemic security failures in Florida state psychiatric hospitals, culminating in violent incidents and patient harm. In one egregious case, a patient at South Florida State Hospital suffered a brutal attack resulting in blindness, indicative of broader safety lapses. Management negligence, delayed response to emergencies, and mishandling of crime scenes underscored a pattern of negligence, posing grave risks to patient well-being.

Secure your spot today. On us!

Gen AI virtual agents may help put the human element back in insurance

By Ashley Hattle-Cleminshaw - Insurers and policyholders disagree on AI in underwriting and claims, but insureds welcome its use in consumer-facing areas, such as marketing and customer service. Insurers often use generative AI and conversational AI to give policyholders access to support 24/7 so the software can address all incoming queries. Read Full Article…

VBA Article Summary

  1. Enhanced Customer Experience: Utilizing generative AI in insurance allows claims adjusters to focus more on understanding the personal situations of policyholders, fostering empathy during their journey with the company. This shift from data crunching to empathetic engagement potentially creates long-term customer loyalty.

  2. AI-Enabled Document Analysis: Generative AI assists policyholders in understanding their coverage by summarizing complex policy documents and identifying key differences between them swiftly. However, precautions are taken to prevent "hallucinations," ensuring accurate information is provided based solely on the available documents.

  3. Human Touch in Critical Scenarios: While AI can simulate empathy to some extent, human agents remain indispensable, particularly in sensitive scenarios like claims processing. Despite advancements in AI, the need for genuine human empathy and personalized assistance persists, ensuring a high level of customer service and satisfaction.

VBA Poll Question of the Week - Please share your insights

In your opinion, which factor weighs most heavily when choosing an insurance payment structure?

Login or Subscribe to participate in polls.

Our last poll results are in!

27.78%

of Daily Industry Report readers who responded to our last polling question with “Retainer/PEPM” when asked “When it comes to receiving compensation on insurance programs, which payment structure do you prefer?"

24.88% of respondents said “Heaped,” 24.20% Hybrid,” while 23.13% prefer “Levelized.”

Have a poll question you’d like to suggest? Let us know!

Wellness takes center stage among employer concerns

By Scott Grushoff - Today's employees are becoming more discerning when it comes to vetting the benefits programs of potential employers — and given the tight labor markets of recent years, businesses are responding. That's a key finding of a national survey of employee benefits brokers that TransUnion conducted in late 2023, which gauged the latest trends in the market. Read Full Article…

VBA Article Summary

  1. Expanding Wellness Paradigms: Employers are increasingly seeking holistic wellness programs that address multiple facets of employee health beyond traditional medical benefits. The top non-traditional benefits requested by employers now include support for mental, financial, physical, and digital health, reflecting a shift towards comprehensive employee well-being.

  2. Emphasis on Employee Value: While price per employee was previously the primary consideration for employers, there has been a notable shift towards prioritizing value to employees. This suggests a reevaluation of benefit paradigms, where employers are recognizing the importance of offering benefits that cater to the well-being and satisfaction of their workforce.

  3. Rising Demand for Mental Health Support: Mental health has emerged as the most requested progressive benefit, with 91% of respondents listing it among the top-five benefits requested. This demand aligns with societal shifts towards ending the stigma around mental healthcare, highlighting the increased need for resources in this area. Additionally, pragmatic economic arguments support greater support for mental health due to its impact on productivity and the global economy.

Employee Retirement Confidence Hasn’t Recovered Much Since Big Drop

By Kathryn Mayer - Employee and retiree confidence about retirement has edged up slightly since a historic drop last year, but overall confidence is still near historic low numbers. Read Full Article…

VBA Article Summary

  1. Incremental Improvement in Retirement Confidence: The latest figures from the Employee Benefit Research Institute (EBRI) and Greenwald Research indicate a slight uptick in confidence levels regarding retirement finances. In 2024, 68 percent of workers and 74 percent of retirees feel confident about having enough money to live comfortably throughout retirement, compared to 64 percent and 73 percent respectively in 2023.

  2. Factors Contributing to Improved Confidence: The increase in confidence is attributed to several factors, including a boost in income confidence fueled by wage growth outpacing inflation. However, concerns about inflation persist, with 31 percent of workers and 40 percent of retirees citing it as a primary reason for their lack of confidence in retirement savings. Additionally, 39 percent of workers and 27 percent of retirees express unease due to insufficient savings.

  3. Persistent Challenges and Call to Action: Despite the marginal improvement, retirement confidence remains low, signaling ongoing apprehensions about retirement readiness. Factors such as inflation, mounting debt, and competing financial priorities continue to erode confidence. This underscores the need for concerted efforts, particularly from employers, to enhance retirement options and address the evolving needs and concerns of workers and retirees.

Alliance seeks public release of insurance data

By Doug Bailey - An alliance of consumer, climate risk and housing organizations, academics, and researchers, have petitioned insurance regulators and the U.S. Treasury Department for public release of insurance data on the impact of climate change on policies, premiums, and business plans. Read Full Article…

VBA Article Summary

  1. Lack of Transparency Hinders Policy Solutions: The insurance industry's resistance to public data disclosure, citing proprietary and privacy concerns, obstructs efforts to address the nation's insurance and housing affordability crises. Consumer groups and researchers argue that access to this data is crucial for informed policymaking, akin to the transparency required in banking under the Home Mortgage Disclosure Act.

  2. Challenges in Data Collection and Participation: Despite initiatives like the NAIC's property and casualty market intelligence data call, challenges persist, with some states, notably Louisiana, opting out, and others, including Florida, considering the move. This reluctance is labeled as "federal overreach" by some industry stakeholders, complicating efforts to gather comprehensive data on insurance markets.

  3. Urgent Need for Data Sharing and Analysis: Amidst worsening weather events and rising insurance costs, consumer groups and researchers emphasize the urgency of not just collecting but sharing detailed insurance data. They argue that access to granular data, preferably at the census tract level, would enable meaningful analysis, shedding light on localized protection gaps and insurer exposures critical for crafting effective policy responses to the unfolding crises.

FDA sets date for advisory meeting on Lilly’s closely watched Alzheimer’s drug

By Jacob Bell - After delaying an approval decision for Lilly’s donanemab, the agency now intends to hold an advisory committee meeting on June 10. After decades of work, Lilly may soon have a marketed product that changes the trajectory of Alzheimer’s. Read Full Article…

VBA Article Summary

  1. Advisory Committee Convening: The FDA has set June 10 as the date for an advisory committee meeting to evaluate donanemab, an Alzheimer's disease medicine developed by Eli Lilly. This meeting will gather experts in neuroscience and drug development to assess the evidence presented by both the FDA staff and Lilly regarding the medicine's safety and effectiveness.

  2. Trial Results and Regulatory Concerns: Donanemab's large clinical trial, involving over 1,700 participants with early-stage Alzheimer's, demonstrated a 35% slower decline in cognition and daily functioning compared to the placebo group. However, despite positive outcomes, regulatory concerns persist. The FDA's decision to convene an advisory meeting indicates a need for further understanding of the trial design, especially regarding the unique approach of enrolling participants with specific levels of tau protein.

  3. Path Forward and Public Input: Despite delays in the approval process, Lilly is preparing to present donanemab's efficacy and safety data to the FDA advisory committee on June 10. The agency is soliciting public comments until June 7, with submissions accepted until May 24, providing stakeholders an opportunity to contribute to the evaluation process. This signifies a critical step in determining the future of donanemab as a potential treatment for Alzheimer's disease.

WHO Overturns Dogma on Airborne Disease Spread. The CDC Might Not Act on It.

By Amy Maxmen - The World Health Organization (WHO) has issued a report that transforms how the world understands respiratory infections like COVID-19, influenza, and measles. Read Full Article…

VBA Article Summary

  1. Recognition of Airborne Transmission: The WHO's exhaustive review involving experts from diverse fields acknowledged the reality of airborne transmission of viruses and bacteria, particularly in indoor settings. This represents a significant departure from previous beliefs that primarily emphasized droplet transmission, leading to a fundamental shift in understanding how respiratory infections spread.

  2. Implications for Public Health Policy: Despite the WHO report's groundbreaking findings, it falls short of offering concrete recommendations for governments, healthcare facilities, and the public. This creates uncertainty about how health organizations like the CDC will incorporate this new understanding into their guidance for infection control. The reluctance to swiftly adopt measures such as prioritizing N95 masks and improving indoor ventilation underscores the challenges of translating scientific evidence into actionable policies.

  3. Challenges and Resistance to Change: Resistance to embracing the airborne transmission paradigm shift persists among some healthcare professionals and policymakers, reflecting entrenched beliefs and concerns about feasibility and compliance. The ongoing debate within the CDC advisory committee highlights the complexities involved in updating guidelines to effectively mitigate the risk of airborne infections, balancing factors such as cost, practicality, and differing contexts of transmission scenarios.

FTC Seeks More Information on the $16.5B Novo-Catalent Deal, Leading to Another Delay

By Katie Adams - Novo Holdings’ planned acquisition of Catalent is facing another delay. Just weeks after Novo Holdings decided to resubmit its application to the Federal Trade Commission, the agency is seeking more information about the deal. Read Full Article…

VBA Article Summary

  1. Extended Timeline: Originally projected to conclude by year-end, the acquisition of Catalent by Novo Nordisk's investment arm faces uncertainty due to repeated delays in the FTC's review process. Recent requests for additional documents have triggered further extensions, casting doubt on the solidity of the anticipated timeline.

  2. Strategic Acquisition: Novo Holdings, representing Danish pharma giant Novo Nordisk, announced plans to acquire Catalent for $16.5 billion, aiming to bolster production capacity for GLP-1 agonist drugs like Ozempic and Wegovy. The acquisition includes three manufacturing sites specialized in sterile injectable drug filling, strategically located in Belgium, Italy, and Indiana.

  3. Competitive Landscape and Scrutiny: Eli Lilly, a key competitor in the GLP-1 space, questions the acquisition's impact on competition, citing concerns about contracts and continuity of supply. The FTC's scrutiny reflects broader concerns in the biopharma sector, with Novo Nordisk and Catalent assuring that all prior customer obligations will be honored amid ongoing delays in the deal's closure.

Tapping the right benefits to support today's modern family

By Chris Gory - We all know that parental leave, health insurance, prescription drug and dental coverage, vision care and even daycare subsidiaries are table stakes. At first glance, these broadly focused areas seem to cover the physical needs of employees and their families. Read Full Article…

VBA Article Summary

  1. Evolution of Family Benefit Plans: As healthcare technology advances, the inadequacy of traditional benefit plans for modern families becomes apparent. There's a growing need for tweaks in benefit design to accommodate diverse family structures and alternative pathways to starting a family beyond the nuclear norm.

  2. Importance for Organizations: With 42% of global employees considering fertility benefits crucial when choosing a job, organizations must adapt their benefit plans to attract and retain talent. Family benefits, including fertility treatments, adoption support, and perinatal care, are integral to diversity, equity, and inclusion initiatives.

  3. Comprehensive Approach to Support: To address the diverse needs of modern families, comprehensive family benefit plans are essential. This includes coverage for fertility treatments, adoption, surrogacy support, and perinatal care, as well as access to resources such as educational materials, coaching, telehealth services, and specialized pediatric support. Employers must also prioritize education and accessibility to ensure employees fully understand and can easily access their benefits.

How Aflac built a customer-centric business culture

By Rosalyn Page - Placing customers at the center of everything they do is paramount for the insurance company, whether it’s simple transactional interactions or more complex claim assistance. Read Full Article…

VBA Article Summary

  1. Prioritizing Employee Education: Customer-obsessed companies prioritize educating employees about their role in driving a customer-first approach. According to a 2023 Forrester survey, 100% of such companies prioritize teaching employees their part in enhancing customer experiences. This underscores the importance of cultivating a unified customer obsession throughout the organization.

  2. Universal Expectations in Customer Service: With customer service expectations becoming universal across industries, companies like Aflac are challenged to meet these evolving standards. As stated by Keith Farley, SVP of individual benefits at Aflac, businesses are no longer compared solely within their industry; rather, they are benchmarked against the service standards set by companies like Amazon and Uber. This necessitates a shift towards customer-centric cultures and practices.

  3. Driving Growth through Customer Centricity: Embracing customer centricity is not only about meeting customer expectations but also about driving growth and profitability. Forrester's 2023 report highlights that customer-obsessed companies exhibit better customer retention rates and faster revenue and profit growth. Aflac's approach involves aligning teams around key customer experience metrics and incentivizing them to deliver exceptional customer service, thereby intertwining customer satisfaction with business success.