Health Plans and Employers Are Suffering an Onslaught of Point Solutions. Here’s How Digital Health Companies Can Ease Their Pain.

By Mark Luck Olson - For employers, it’s like having to buy a different cell phone for each contact. And for the consumer, navigating all the different digital platforms, the log-ins, the various apps – it’s a nightmare. I have had a lot of conversations with payers and employer-sponsored health plans about adopting digital health. While many agree that digital health programs can improve the cost and quality of care for their members, they tell me they’re exhausted by the realities of managing dozens of digital health point solutions and their members are being overwhelmed. Read Full Article…

1. Challenges with Point Solutions: Health plans and employers are facing difficulties in managing multiple digital health point solutions. These solutions are narrowly scoped programs that handle individual health conditions. As a result, organizations often have to juggle numerous vendors and technologies, making it a complex and daunting task for both providers and consumers. A person's health is interconnected, and the goal should be to provide holistic care rather than treating symptoms in isolation. The lack of integration among these point solutions adds to the complexity​¹​.

2. Potential Future Solution: The ideal solution for this problem would be the creation of whole-person digital health platforms that act as single destinations for all health care needs. However, this solution is expected to be highly complicated and time-consuming to realize. Meanwhile, consumers need immediate assistance, and the industry cannot afford to wait for this ideal solution​¹​.

3. Best Practices for Digital Health Companies: In the interim, digital health companies are encouraged to adopt certain best practices to address these issues. These include ensuring their health company is more than just a single-point solution and offering a single, uniform brand experience for users. This could involve rebranding the digital health program under the health plan or employer's preferred company logo and color scheme. Additionally, it's crucial that the clinical protocols of digital health vendors align with the organization’s care standards to reduce complexity and enhance management of care​¹​.

Pharmaceutical trade group sues US over Medicare drug price negotiation plans

By Patrick Wingrove - The Pharmaceutical Research and Manufacturers of America (PhRMA), the leading industry lobby group, and two other organizations on Wednesday said they were suing the U.S. government to block enforcement of a program that gives Medicare the power to negotiate drug prices. Read Full Article…

VBA Article Summary

1. The Pharmaceutical Research and Manufacturers of America (PhRMA), along with the National Infusion Center Association and the Global Colon Cancer Association, have filed a lawsuit against the U.S. government. They aim to block a program that empowers Medicare to negotiate drug prices, arguing that the program is unconstitutional​¹​.

2. This legal action is the fourth lawsuit challenging the Inflation Reduction Act (IRA), a law that forms part of President Biden's signature initiatives. The pharmaceutical industry has argued that price negotiations with the government will cut into their profits and discourage the development of innovative treatments. Additionally, they claim that the "unrestrained authority" given to the Department of Health and Human Services (HHS) conflicts with the separation-of-power principle in the U.S. Constitution. They also contend that the program violates the Eighth Amendment, which protects against excessive fines, and the Fifth Amendment, by exempting key decisions from public input​¹​.

3. PhRMA and the other two groups are seeking an injunction against the price caps and a declaration that the IRA's price negotiation is unconstitutional. The price negotiations are set to begin in September after the agency that runs Medicare and Medicaid releases its list of 10 costly drugs selected for the process, with the agreed prices expected to take effect in 2026. In response to the previous lawsuits, the White House has defended the legality of the program, asserting that there is nothing in the U.S. Constitution that prevents Medicare from negotiating lower drug prices​¹​.

4 findings that reveal the financial state of Americans

By Deanna Cuadra - The U.S. economy has been turbulent at best, as consumers watched the Federal Reserve try to control inflation with 10 consecutive interest rate hikes in the last year. Unsurprisingly, Americans aren't too optimistic about their financial future. Read Full Article… 

VBA Article Summary

1. Cost Cutting: Northwestern Mutual's study revealed that 64% of Americans are cutting costs in their everyday lives, with 50% focused on building up their savings and 41% delaying large purchases. This shift in spending behavior is largely due to the rising cost of living and record-high interest rates, making Americans more hesitant to spend on non-essentials​¹​.

2. Saving and Inflation: Despite personal savings going up by nearly 5% this year, Americans are unable to keep up with the 2022 inflation rate of 6.5%. Inflation was the top financial concern for Americans, with 51% ranking it as number one. While salaries grew by 4.2% by the end of 2022, they couldn't keep pace with the inflation rate of 6.4%, highlighting the financial challenges Americans face​¹​.

3. Impact on Younger Generations: Compared to Gen X and Baby Boomers, Millennials and Gen Z are more likely to put their lives on hold due to the U.S. economy. Northwestern Mutual found that a significant percentage of Gen Z and Millennials postponed buying or building a new home and delayed changing jobs or looking for a new one. Despite these challenges, the article suggests optimism for the future, as the economic landscape will evolve​¹​.

House passes ICHRA bill to give (small) employers a 'cash-for-coverage’ option

By Alan Goforth - The Custom Health Option and Individual Care Expenses (CHOICE) Arrangement Act would allow business owners to reimburse employees for individual health insurance plans - and would make that coverage portable. Employers could give workers cash they can use to purchase individual health coverage under legislation passed by the U.S. House on Wednesday. Read Full Article…

VBA Article Summary

1. The U.S. House has passed the ICHRA (Individual Coverage Health Reimbursement Arrangement) bill, also known as the Custom Health Option and Individual Care Expenses (CHOICE) Arrangement Act, that allows small employers to provide a 'cash-for-coverage' option. This legislation aims to enable business owners to reimburse their employees for individual health insurance plans, thereby making coverage portable​¹​.

2. The bill codifies health reimbursement arrangements set up by the Trump administration in 2019, offering an alternative to employer-provided health plans. Under this law, employers could provide workers with cash that they could use to purchase individual health coverage. The funds provided for qualified medical expenses would be tax-advantaged​¹​.

3. According to Rep. Jason Smith, the chair of the House Ways and Means Committee, the bill helps prevent any hindrance from Washington in workers obtaining the health-care coverage that best fits them and their families. Additionally, it allows workers to carry their insurance plan even if they leave their current job. The legislation also gives small businesses the choice to relieve themselves from the administrative burden of managing traditional insurance coverage while offering workers more options for their health care​¹​.

Cell and gene therapy manufacturing: the next generation of startups

By Gwendolyn Wu - Developing a new drug is a long, expensive process that comes with a high risk of failure, often because would-be medicines are unsafe or ineffective. For companies specializing in cell or gene therapies, an equally pressing concern is figuring out how to reliably make their products. Unlike small molecule or antibody drugs, genetic medicines typically involve a variety of specialized parts woven together through a complex process. Read Full Article…

VBA Article Summary

1. The production of cell and gene therapies involves a complex process that includes a variety of specialized parts. This complexity often proves to be a challenging aspect for companies, especially since unlike small molecule or antibody drugs, genetic medicines are difficult to produce at scale. A surge in cell and gene therapy research has also led to a shortage in manufacturing capacity, leaving startups to face long waitlists​¹​.

2. To address these challenges, a growing number of new manufacturers have been established since 2017 with the aim of easing the bottlenecks in cell and gene therapy development. These companies often focus on helping startups and academic labs that are unable to afford their own manufacturing facilities. However, turning to contract manufacturers can also present problems, as transferring technology from a small lab to a larger organization can be a difficult process that requires troubleshooting for any issues that arise​¹​.

3. Rather than directly competing with larger contract development and manufacturing organizations (CDMOs), some manufacturing startups aim to provide a more cost-efficient path for companies to develop in-house production capabilities. These startups work with clients from early stages, teaching them about raw material control strategies and setting realistic timelines for gathering early clinical data. This approach not only helps startups save millions of dollars in the long term, but also attracts academics and nonprofits that have struggled to work with larger CDMOs​¹​.

Grant Thornton survey: Half of employees note mental health as top cause of burnout

By Grant Thornton LLP - Grant Thornton LLP, one of America’s largest audit, tax and advisory firms, has released its third survey in a series exploring the latest trends in employee attitudes, desires and concerns. The firm’s 2023 State of Work in America survey engaged 5,000 full-time employees of U.S. companies, and its findings revealed the mental and emotional toll the national economic environment has taken on workers. Read Full Article… 

VBA Article Summary

1. Mental and emotional stress is the top cause of burnout: According to the Grant Thornton LLP survey, 53% of respondents indicated that mental and emotional stress is the leading reason for burnout in the workplace. Long hours, workload, and people shortages were also identified as significant contributors to burnout.

2. Benefits influence employee retention: The survey highlights that 38% of respondents named benefits as a top reason for staying at their current organization. Base pay and job security were also factors contributing to employee retention. The data suggests that companies can differentiate themselves by offering unique and appealing benefits packages to attract and retain talent.

3. Preference for in-office work with face-to-face collaboration: The survey indicates a shift in employee mindset towards in-office work, with 51% of respondents expressing a preference for working onsite 4-5 days a week. Additionally, 42% of workers stated that face-to-face collaboration would entice them to go to the office. However, employees still value the work/life balance that remote work offers, with 42% noting its benefits. The ideal number of days in the office for employees lags behind leaders' expectations, indicating a need for flexibility in work arrangements.

Overall, the survey highlights the importance of addressing employees' mental and emotional well-being, providing attractive benefits packages, and offering a flexible work environment to create a highly engaged workforce.

As new grads enter the workforce – Top 10 tips on how to stay hired

By Karen Michael - It’s graduation season, and soon, new talent from high school and college will flood the workforce. Schools do a great job of teaching people how to gain the skills to work, but not many teach them how to successfully go to work. I believe so much in the power of teaching people how to be at work that I published the book “Stay Hired: Thriving & Surviving in the 21st Century Workforce.” Read Full Article… 

VBA Article Summary

1. Mindset matters: Lack of skill is usually not the reason why people lose their jobs. Instead, employees often get fired for issues with attendance, attitude, insubordination, bullying/harassment/violence, or lack of ethics. Learning the job might be the easier part, but the way you approach work is what matters the most. Employers value people who are cooperative, flexible, respectful, resilient, self-motivated, and remain positive, engaged, and open-minded​¹​.

2. Be on time for work: If your job starts at 8 a.m., you should be ready to work at that time, not just arriving or waking up. There are rarely good excuses for being late to work, and you should be ready to work at your start time every day. In the rare case that you're late due to circumstances like traffic, an accident, or sickness, you should call your manager immediately​¹​.

3. Virtual work is still work: Remote work provides flexibility, but it's not a vacation time. It's crucial to ask about expectations for virtual days and meet those commitments. Your employer might be okay with you ending your workday early on certain occasions, but don't assume that's always the case. Always ask for permission first​¹​.

Nonprofit hospitals’ charity care shrank as operating incomes, cash reserves grew: study

By Dave Muoio - Years of rising operating profits and cash reserves did not translate to greater charity care across the nation’s nonprofit hospitals, according to a study published this week in Health Affairs. The analysis, conducted by Rice University researchers, reviewed financial data from nearly 2,800 short-term acute care and critical access hospitals submitted to the Centers for Medicare & Medicaid Services between 2012 and 2019. Read Full Article…

VBA Article Summary

1. Nonprofit hospitals reduced average spending on charity care as their financial positions improved: The study revealed that while nonprofit hospitals experienced an increase in operating profits and cash reserves, their average spending on charity care decreased. This trend was observed among 2,219 nonprofit hospitals, indicating a potential misalignment between their financial growth and the provision of community health benefits.

2. Profitable nonprofits failed to justify tax treatment through increased community health benefits: The researchers emphasized that as nonprofit hospitals' operating profits grew, there should have been a corresponding increase in the share of community health benefits provided to justify their favorable tax treatment. However, the study found that despite the financial gains, the increase in profits did not lead to a statistically significant increase in charity care spending by nonprofit hospitals.

3. For-profit hospitals demonstrated comparatively positive performance: In contrast to nonprofit hospitals, for-profit hospitals showed more favorable outcomes. Their mean hospital operating profit and cash reserves increased during the study period, while their average charity care spending also rose, reaching a level similar to that of nonprofit hospitals. The analysis indicated that each dollar increase in for-profit hospitals' profits was associated with a significant increase in charity care spending and cash reserves, highlighting a potential alignment between financial success and community health benefit provision.