HVBA Benefits Roadshow Nashville Delivers Innovation, Networking, and Purpose-Driven Impact

By Health & Voluntary Benefits Association® (HVBA) – The Health & Voluntary Benefits Association (HVBA) hosted a record-breaking Benefits Roadshow in Nashville on September 3, 2025, bringing together industry leaders, innovators, and business professionals for a day of groundbreaking discussions, dynamic networking, and charitable giving. With standing-room-only attendance, the event marked one of HVBA’s most successful gatherings to date. Read Full Article...

HVBA Article Summary

1. Strategic and Innovative Programming: The day opened with a high-level board meeting and transitioned into the HVBA Innovation Summit, which featured presentations from executives, entrepreneurs, and healthcare leaders. Topics included the future of employee benefits, digital transformation in voluntary benefits, new payment technologies, and innovative broker solutions. Collectively, these sessions provided attendees with a broad view of the shifts shaping the benefits and healthcare landscape.

2. Networking and Collaboration Opportunities: The networking reception extended into the evening and served as a platform for professionals to build meaningful connections. Attendees explored collaborative opportunities while engaging in conversations about pressing issues such as pharmacy economics, cancer care cost containment, and technology-driven efficiency. The atmosphere encouraged idea-sharing and strategic partnerships, reinforcing the event’s focus on collective progress.

3. Philanthropy and Community Focus: In addition to business discussions, the program placed strong emphasis on giving back to the community. A live auction featuring travel and experience packages raised significant funds to support America’s heroes, complementing the day’s focus on innovation and connection. This philanthropic effort, combined with the enthusiastic participation of attendees, underscored HVBA’s commitment to blending industry advancement with social responsibility.

Unable to attend HVBA’s recent Benefits Roadshow in Nashville? Join us on Thursday, November 20th, for HVBA’s big annual bash in Atlantic City. This is the one event you don’t want to be left with FOMO. Click here to secure your ticket.

Trump’s Health Data Plan Could Hand Big Tech The Keys —And Lock Out Startups

By Zaid Al-Fagih – The proposal, which would allow medical providers and private companies to share patient data more freely, has a laudable aim: to break down long-standing silos and speed the transition to AI-driven healthcare. In principle, that’s good news. Sixty companies have already signed on, including Amazon, Apple, and Google. Under the program, a company like Apple could, in theory, tap into health records and wellness data from other participants, such as weight-loss and fitness service Noom. That could give tech giants unprecedented access to people’s daily habits, what they eat, how often they exercise, even how much sleep they get. Read Full Article...

HVBA Article Summary

1. Centralized Health Data Can Unlock AI Benefits — But With Risks: Bringing together fragmented healthcare data across systems has the potential to significantly enhance AI’s ability to automate administrative tasks, improve clinical decision-making, and deliver better patient outcomes. However, if this data consolidation ends up in the hands of Big Tech, it could result in a dangerous concentration of power—a "health data oligopoly"—that limits innovation, reduces transparency, and puts patient privacy at risk.

2. Big Tech Stewardship Threatens Innovation and Equity: Allowing large technology companies to become gatekeepers of health information may lock access behind proprietary systems and terms, squeezing out startups and smaller innovators. Many transformative health tech solutions—such as those developed by BetterHelp, Gabbi, and Spring Health—depend on open access to real patient data through partnerships with hospitals and public institutions. If these partnerships dry up, the entire ecosystem of health innovation could suffer.

3. The Better Alternative: Provider-Led, Privacy-First Data Sharing: The article advocates for a model where healthcare providers remain the primary custodians of patient data, with strict privacy protections and equal access for all innovators. This approach, exemplified by the UK’s Our Future Health project, uses anonymized and tightly safeguarded data to support research and innovation. It ensures that data is used for public benefit, not corporate profit, and maintains trust, fairness, and competition within the health tech sector.

New Telehealth Bill Would Extend Medicare Flexibilities to 2027

By Ashleigh Hollowell – Rep. Earl “Buddy” Carter (R-GA) and Rep. Debbie Dingell (D-MI) are spearheading a bipartisan effort to establish permanency for telehealth access with H.R. 5081, the Telehealth Modernization Act, a bill that was introduced to the House on Sept. 2. The effort comes just 28 days before telehealth extensions for Medicare patients are set to expire on Sept. 30. These COVID-19-era flexibilities have been renewed, yet minimal efforts have been made to create permanence for the new, but widely used, health care modality. Read Full Article...

HVBA Article Summary

1. Telehealth Accessibility Expansion: The proposed legislation seeks to extend telehealth flexibilities until September 2027, aiming to reduce barriers to care for individuals who may struggle with in-person visits—such as seniors, people with disabilities, and those living in rural areas. By broadening the list of eligible telehealth providers to include nurse practitioners, therapists, and other non-physician clinicians, the bill emphasizes making virtual care more widely available across diverse healthcare roles.

2. Mental Health Service Adjustments: The bill proposes postponing the requirement for Medicare patients to attend at least one in-person mental health appointment before continuing telehealth treatment until October 2027. This extension aligns with research, including a 2021 NIH study, showing that outcomes from virtual therapy are comparable to those from in-person sessions in terms of symptom reduction and quality-of-life improvements for patients.

3. Potential Consequences Without Extension: Without the passage of this legislation, previous pre-pandemic rules would resume, including mandatory in-person visits for Medicare beneficiaries and limitations on telehealth provider eligibility. This could lead to disruptions in care continuity, reduced access for vulnerable populations, and increased strain on healthcare systems—especially since nearly 45% of behavioral health providers reportedly do not accept Medicare or Medicaid.

Insurers will need AI to fix prior authorization

By Elizabeth Crawley – Few topics have more power to stoke controversy in health care circles than prior authorization and artificial intelligence (AI). Put the two together, and you get an instant recipe for sensationalism – cue the images of robots denying claims. However, if health care payers are going to make good on their recent commitment to accelerate decision timelines, increase transparency and expand access to affordable, quality care, they are going to need to infuse their utilization management operations with powerful AI tools. Read Full Article... ^{_{(Subscription required)}}

HVBA Article Summary

1. Widespread Support for Prior Authorization Reform: In a major industry push, the nation's leading health plans have pledged to modernize the fragmented prior authorization system, with goals including standardized data submission, reduced authorization requirements, and improved transparency. This effort has gained praise from the U.S. Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS), while providers have offered cautiously optimistic support.

2. Systemic Burdens Highlight the Need for Change: The scale of the problem is significant: approximately 30% of all procedures require prior authorization, and 91% of providers report that this process causes delays in patient care. The complexity is further compounded by inconsistent technology, changing guidelines, and siloed data, creating a substantial data processing challenge that cannot be resolved by superficial technology upgrades alone.

3. Strategic Use of AI and Data is Critical for Sustainable Improvement: Modernization must go beyond isolated tools and focus on end-to-end workflow transformation. This includes assessing baseline inefficiencies (such as high denial and appeal rates), addressing interoperability and data silos, and developing a comprehensive utilization management strategy. Real value will come from integrating automation, voice-based AI, and real-time data exchange into a single, cohesive system, with ongoing monitoring and refinement to ensure measurable improvements in both revenue and patient outcomes.

FTC asks public to weigh in on 'case-by-case' regulation of employers' noncompetes

By Dave Muoio – As a blanket ban languishes in the courts, the Federal Trade Commission (FTC) has put out a new call for the public to guide its “case-by-case” enforcement of harmful employer noncompete agreements. The FTC said the information it gathers may inform "possible future enforcement actions." The 60-day request for information (RFI) circulated Thursday paints a stark line between the rule issued last year under the Biden administration, which aimed to prevent any new noncompetes and phase out most already on the books. That rule was blocked in the courts, and after initially appealing the commission voted Friday to pull out. Read Full Article...

HVBA Article Summary

1. FTC Shifts Strategy on Noncompete Regulation: The FTC withdrew its previously blocked rule on noncompete agreements after court challenges and internal dissent. Conservative commissioners, now holding a majority, opposed the original rule for being overly broad and instead proposed a narrower approach focused on case-by-case enforcement and advocacy, particularly targeting harmful practices in labor markets.

2. Healthcare Sector a Key Focus of Inquiry: The FTC emphasized potential harms from noncompete agreements in the healthcare sector, including reduced patient access to care and limited job mobility for medical professionals—especially in rural areas. The agency is seeking public input through a Request for Information (RFI), with questions aimed at understanding the impact of noncompetes on healthcare availability, cost, and workforce dynamics.

3. Internal Disagreement Over Enforcement Scope: While the agency launched an enforcement action against a company using allegedly harmful noncompetes, internal divisions remain. Commissioner Slaughter, the lone Democrat, dissented not over the specific case but over what she viewed as an inadequate focus on broader structural reforms, signaling continued tension within the FTC over how aggressively to tackle noncompete issues.

Large employers are driving a shift in health benefits to control costs

By Alan Goforth – At a time of significant rate hikes and financial pressures, large employers, which account for more than $800 billion in health care expenditures, are driving the future of the health benefits market. “Large employers -- those with more than 10,000 employees -- are often innovators when it comes to benefit offerings, shaping the trends that are later adopted by small and medium-size employers,” according to a new report from McKinsey & Co.  Read Full Article... ^{_{(Subscription required)}}

HVBA Article Summary

1. Cost pressures dominate benefits decisions: Large employers continue to rank health care costs as their most pressing issue, shaping nearly two-thirds of their benefits purchasing choices. While most anticipate per-employee health care expenses will rise between 5–10% annually over the next three years, they are only budgeting for about 4% increases. This gap highlights ongoing tension between financial planning and the reality of rising medical costs.

2. Growing openness to alternative benefit models: To manage expenses and improve employee satisfaction, employers—especially jumbo firms with 25,000+ workers—are showing strong interest in innovative benefit approaches. These include value-based insurance designs, flexible copay structures, reference-based pricing, virtual-first care, and narrow networks. Such models can reduce costs by up to 30%, lower surprise billing rates, and enhance the overall member experience compared with traditional designs.

3. Demand for measurable value and innovation: Employers are increasingly scrutinizing health programs to ensure they deliver proven returns. Novel therapies like GLP-1 medications and cell therapies pose new cost challenges, making it essential that programs demonstrate a clear ROI, often at least 2-to-1 or 3-to-1. As a result, companies are prioritizing health partners who can innovate year-round, understand business objectives in detail, and adopt pricing strategies that align costs with outcomes.

Wegovy gains new approval: 3 GLP-1 updates

By Paige Twenter – Novo Nordisk’s popular weight loss drug, Wegovy, is the first and only GLP-1 medication approved to treat metabolic associated steatohepatitis, a serious condition marked by liver scarring. The FDA granted the approval Aug. 15. Injectable GLP-1 drugs primarily treat obesity and Type 2 diabetes, and some have additional indications including cardiovascular disease, kidney disease and obstructive sleep apnea. Read Full Article...

HVBA Article Summary

1. Oral GLP-1 Race for FDA Approval: Novo Nordisk and Eli Lilly are competing for the first FDA-approved oral GLP-1 for weight loss. Novo’s oral Wegovy (semaglutide) led to 15.1% weight loss over 68 weeks, while Lilly’s orforglipron showed 10.5%–12.4% weight loss over 72 weeks. Both aim to offer a more convenient alternative to injections.

2. Medical Expansion and Legal Challenges: Novo is studying GLP-1s for Alzheimer’s and dementia, with Phase 3 results due later this year. Meanwhile, Eli Lilly is being sued by Texas for allegedly offering kickbacks to boost prescriptions of drugs like Mounjaro and Zepbound—claims the company denies.

3. New Research and Consumer Access: Studies show GLP-1s may help normalize testosterone, reduce risks of certain cancers, and lower heart failure hospitalizations, though there’s a modest risk of retinopathy. On the access front, Lilly is launching online sales in China, while Novo is halving Ozempic’s price for self-paying U.S. patients via GoodRx.