Health plans, employers & providers expect to increase spending on digital health solutions

By Alan Goforth - The recent robust spending on digital health solutions is expected to continue in the coming year, according to the 2024 State of Digital Health Purchasing survey from the Peterson Health Technology Institute. Read Full Article… ^{_{(Subscription required)}}

HVBA Article Summary

1. Increasing Digital Health Investment: A majority of employers (97%), health systems (86%), and health plans (84%) plan to maintain or boost digital health spending, driven by consumer demand and potential health benefits.

2. Performance-Based Contracts: Most digital health contracts are short-term (under two years), with 79% involving performance-based arrangements focused on outcomes for health systems and engagement for employers.

3. Key Health Focus Areas: Purchasers prioritize digital health solutions for conditions like diabetes (53%), preventive care (51%), and mental health (50%), with nearly half-covering six or more clinical conditions.

Walgreens plans to close 1,200 pharmacies

By Ngai Yeung - Walgreens is closing 1,200 stores, or 14% of its locations, as it fights to turn around its business. The retail pharmacy chain will be closing the stores over the next three years, the company said in its fourth-quarter earnings Tuesday, which includes 500 in the 2025 fiscal year, which started last month. Read Full Article…

HVBA Article Summary

1. Pharmacy Struggles: Walgreens, with 8,700 US locations, faces challenges from lower drug reimbursements, online competition, and reduced consumer spending, leading to store closures. CVS is also cutting jobs to reduce costs.

2. CEO's Cost-Cutting Plan: CEO Tim Wentworth is focused on reducing costs by exiting primary care and closing over 100 VillageMD sites, aiming to reinvent the unsustainable pharmacy model.

3. Financial Outlook: Despite a $3 billion loss due to opioid settlements and a China investment, Walgreens saw a 6% sales increase, with plans for a "rebasing" year to control costs.

Blue Cross Blue Shield settles US health provider class action for $2.8 billion

By Mike Scarcella - Insurer Blue Cross Blue Shield has agreed to pay $2.8 billion to resolve antitrust class action claims by hospital systems, physicians and other health providers alleging they were underpaid for reimbursements, the plaintiffs said in an Alabama federal court filing on Monday. Read Full Article…

HVBA Article Summary

1. Largest Antitrust Settlement: Blue Cross Blue Shield agreed to the largest healthcare antitrust settlement, despite denying the claims, to avoid extended litigation.

2. Lawsuit Claims: Health providers sued BCBS in 2012 for creating exclusive non-competitive regions, which raised insurance costs and lowered reimbursements.

3. Settlement Details: BCBS will implement a new system to improve claims transparency and efficiency, while spending hundreds of millions on operational changes. Legal fees may reach $700 million.

Health insurers' market preview: When agents, brokers can expect Q3 earnings

By Allison Bell - Health insurers and other benefits players are about to talk about what's really going on there. Benefits players that sell stock to the public are preparing to post earnings for the third quarter. Read Full Article… ^{_{(Subscription required)}}

HVBA Article Summary

1. Medicare Focus: Health insurers may discuss Medicare and Medicaid trends during earnings calls, but commercial health details could be limited.

2. Earnings Dates: Key benefits companies like UnitedHealth and Cigna will report earnings from mid-October to early November, offering insights on Medicare and employee benefits.

3. Stop-Loss Insights: Prudential's new stop-loss business for self-insured plans will be a focus, with Sun Life commenting on rising claim costs.

Community Pharmacies Fill Critical Healthcare Gaps in Rural Areas — Here’s How We Can Empower and Support Them

By Yoona Kim - Rural Americans have long experienced poorer health outcomes compared to their urban counterparts. New evidence shows that the divide is widening, with rural adults aged 25 to 54 significantly more likely to die of chronic diseases and cancer than individuals living in cities. Read Full Article…

HVBA Article Summary

1. Rural PCP Shortages: Many rural areas lack enough primary care physicians, worsening health outcomes. A predicted shortage of up to 100,000 PCPs in the next decade will disproportionately affect these communities.

2. Pharmacies as Frontline Care: Rural patients increasingly rely on pharmacists for healthcare. Some states are expanding pharmacists' roles to fill care gaps in areas with limited physician access.

3. Tech and Reimbursement for Pharmacies: AI can help pharmacists provide better care by preventing medication errors and personalizing treatment. Improved reimbursement is needed to sustain their critical role in rural healthcare.

Expect employers to get more picky about who you see for care

By Tom Murphy - A health care spending surge looms in the new year, and Business Group on Health is helping employers understand it. Read Full Article…

HVBA Article Summary

1. Cost Increase: Employers expect an 8% rise in healthcare costs next year, the highest in a decade, and will adjust coverage to manage expenses.

2. Selective Care: Employers will push for high-quality care through curated networks, reducing provider choices but improving service quality.

3. Mental Health & Weight Management: Mental health is a key focus, and employers will carefully manage weight loss drug use, ensuring it fits appropriate populations and long-term strategies.

Precision Psychiatry is Possible — Especially if We Use Evidence-based Neural Measures to Drive Better Mental Health Treatment and Outcomes

By Greg Hajcak - Depression, a common yet complex mental health issue, affects millions worldwide. Despite its prevalence and long clinical history, treating depression remains fraught with challenges. Read Full Article… 

HVBA Article Summary

1. Precision Psychiatry and Brain-Based Biomarkers: Precision psychiatry uses EEG and ERPs to identify brain-based markers, enabling personalized treatments for mental health conditions like depression based on objective brain function.

2. ERPs and Depression Subtypes: ERPs help detect distinct brain function patterns in depression, offering insights into specific neurotypes and guiding more targeted, effective treatments.

3. ERPs in Clinical Care and Drug Development: Incorporating ERPs into clinical practice and drug development allows for more personalized treatments, reducing trial-and-error approaches and improving outcomes for mental health conditions.