Why One Expert Thinks the Medicare Drug Price Negotiation Program Is Here to Stay

By Katie Adams - After much anticipation and a bevy of (ongoing) lawsuits, the U.S. government is finally beginning to negotiate drug prices with pharmaceutical companies — the White House announced last week that all 10 drugmakers whose drugs were selected for the first cycle of the Medicare drug price negotiation program have “decided to participate.” Read Full Article…

VBA Article Summary

1. Major Win for Drug Affordability Movement: According to Merith Basey, executive director of advocacy group Patients For Affordable Drugs, the newly-announced Medicare drug price negotiation program is a landmark victory for the drug affordability movement in the United States. This initiative allows the government to negotiate drug prices with pharmaceutical companies, aligning the US with other high-income nations that have been practicing this for years. Basey is optimistic that the momentum gained from this significant development will further advance her organization's endeavors in promoting drug affordability and accessibility for all.

2. Widespread Public Support Amidst Pharmaceutical Industry Resistance: The White House's drug price negotiation initiative faces vehement opposition from pharmaceutical companies, which argue that the program will erode their profits and stifle innovation in the industry. Despite this, there is overwhelming public support for the initiative, with favorability towards pharmaceutical corporations plummeting to an all-time low of 18%. Basey contends that this widespread approval makes the program resilient to changes in the presidency or legal challenges from Big Pharma, as it reflects the public's demand for fairer drug pricing mechanisms and transparency in the sector.

3. NIH Funding and the Push for More Competition: Basey emphasizes the substantial role of the National Institutes of Health (NIH) as a major funder of global health research, contributing public money to the development of numerous drugs. She counters pharmaceutical companies' arguments regarding the high costs of drug development by highlighting the taxpayer's significant financial input through the NIH. In light of this, Basey advocates for policies that promote competition within the pharmaceutical industry, supporting bipartisan bills aimed at curbing practices like pay-for-delay and patent thickets, which impede the entry of generic drugs into the market. These policies, coupled with recent victories like the initiation of Medicare drug price negotiations and price reductions by major insulin manufacturers, signal positive progress for the drug affordability movement.

Helping clients whose families are in the world’s crisis regions

By Lloyd Lofton - In an interconnected world where geopolitical tensions and natural disasters can disrupt lives unexpectedly, insurance agents and financial advisors play a vital role in providing comprehensive support to clients with family ties to regions experiencing upheavals. Read Full Article…

VBA Article Summary

1. Developing Customized Coverage: With risks ranging from conflicts to natural disasters, insurance professionals must offer tailored policies that consider the specific challenges of various global regions. This involves working closely with underwriters to develop comprehensive coverage for evacuation, medical emergencies, and property damage inherent to these high-risk areas. Offering a policy that is carefully customized for the individual or entity not only provides better protection but also establishes a more trustworthy relationship between the client and the insurance provider.

2. Engaging in Active Communication and Regular Policy Updates: Insurance agents should engage in active and proactive communication with their clients. This involves regularly reviewing and updating policies to align with the dynamic geopolitical landscape, informing clients of any policy limitations or exclusions, and suggesting necessary amendments. Sharing insights about geopolitical risks, travel advisories, and assistance programs available is crucial. This approach not only builds trust but also reassures clients that their well-being is a top priority.

3. Providing Holistic Support Through Global Networks and Education: Collaborate with international crisis management services and assistance organizations to offer invaluable support during emergencies. These partnerships enhance the insurance professionals’ ability to provide timely assistance and support, from evacuation procedures to legal help. Additionally, empowering clients through emergency preparedness education and offering resources, including mental health services, ensures that support is holistic. This comprehensive approach, addressing both practical and emotional needs, positions insurance agents as invaluable guides through the complexities and uncertainties of global risks.

Denied insurance claims are problem for nearly 20% of insured adults, survey finds

By Alan Goforth - About 6 in 10 adults experience denied claims, network inadequacy or preauthorization delays when using their health insurance, a new KFF survey found. The survey delved deeper into a few of the challenges surrounding denied claims. Read Full Article…

VBA Article Summary

1. Prevalence and Variation in Denied Claims: 18% of insured adults faced denied claims in the past year, with variations among different groups. Individuals with employer-sponsored (21%) or Marketplace insurance (20%) experienced higher denial rates compared to those with Medicare (10%) or Medicaid (12%). High-frequency users of healthcare services, those with over 10 provider visits annually, had a 27% denial rate, while those with fewer visits experienced fewer denials. Furthermore, 20% of insured adults utilizing emergency or mental health services encountered denied claims. Notably, LGBT individuals were almost twice as likely to face denied claims compared to non-LGBT individuals (30% vs. 17%).

2. Consumer Understanding and Denied Claims: A significant number of consumers with denied claims reported challenges in understanding their health insurance coverage. Approximately 65% struggled to comprehend their coverage specifics, 57% were uncertain about out-of-pocket costs, and 52% found their benefits explanations confusing. This lack of clarity might either be a contributing factor to the prevalence of denied claims or a consequence of the denial experience. It remains uncertain whether these comprehension issues are a cause or effect of the denied claims phenomena.

3. Resolution Efforts and Satisfaction Levels: Many consumers with denied claims actively sought to address their insurance issues: approximately 42% (8 out of 19) took some action like contacting their insurance company or seeking advice from acquaintances or medical professionals. Additionally, 15% filed formal appeals. Among all insured adults who reported facing insurance-related problems, only 50% expressed satisfaction with the resolution of their most significant issue, highlighting a substantial proportion of insured adults left dissatisfied with the outcomes of their denial resolution processes.

U.S. employers covering weight-loss drugs could nearly double in 2024 - survey

By Reuters - The number of U.S. employers who cover obesity medications, including Wegovy from Novo Nordisk (NOVOb.CO) that belongs to a class of GLP-1 drugs, could nearly double next year, according to a survey. The survey of 502 employers by Accolade (ACCD.O), a company that provides healthcare programs for employers, and research firm Savanta said 43% of the employers it polled could cover GLP-1 drugs in 2024 compared to 25% that cover them now. Read Full Article…

VBA Article Summary

1. GLP-1s Increasing in Popularity: With a significant surge in the sales of Novo Nordisk’s Wegovy and Ozempic, as well as Eli Lilly’s Mounjaro, it’s evident that GLP-1s (glucagon-like peptide 1 agonists) are gaining popularity for their effectiveness in treating type 2 diabetes and aiding weight loss. Both Wegovy and Ozempic contain the active ingredient semaglutide, while Mounjaro is another prominent GLP-1 diabetes medication expected to receive approval for weight-loss treatment in the U.S.

2. Employer Healthcare Costs Rising: Due to the growing demand and prescription rates of weight-loss medications, particularly GLP-1s, employers who cover these drugs are witnessing a spike in healthcare costs. Aon, a benefits consultant, predicts that the increasing employee utilization of weight-loss drugs will drive a 1% increase in employer healthcare costs next year, contributing to an overall expected rise of 8.5%.

3. Adopting a Physician-Led Approach: For the 43% of companies planning to offer coverage for GLP-1 medications next year, a physician-led approach is strongly recommended. This approach ensures that GLP-1s are prescribed appropriately and incorporated effectively into patients’ holistic health management plans. Such guidance and oversight from medical professionals are crucial to optimize the benefits of GLP-1s while managing the associated costs. Accolade Associate Chief Medical Officer James Wantuck advises that this approach will enable a balanced and informed implementation of GLP-1 medication coverage in healthcare plans.

How Employers Can Support Employee Mental Health

By Amanda McCollum - In today's workplace, the significance of addressing employee mental health has become increasingly crucial. The well-being of employees directly impacts their productivity, engagement, and overall satisfaction. Employers play a pivotal role in creating a supportive environment that fosters mental well-being and offers necessary resources. Read Full Article…

VBA Article Summary

1. Fostering Open Communication and Destigmatization: Adams Keegan has experienced an unprecedented surge in client calls related to mental health, emphasizing the pressing need for supportive workplace environments. Employers are urged to facilitate open communication, actively working to destigmatize mental health discussions among employees. While the younger workforce is generally more forthcoming about their mental health challenges, there is a notable generational gap that necessitates intentional, inclusive dialogue. Initiating and sustaining conversations about mental well-being will empower employees to seek help without fearing judgment or repercussions, thus creating a psychologically safe and supportive work atmosphere.

2. Enhancing Access to Mental Health Benefits: Employers are recommended to offer comprehensive mental health benefits as part of their commitment to employee welfare. By including mental health services in health insurance coverage, employers ensure that employees have unhindered access to essential care without the strain of financial burdens. Employee Assistance Programs (EAPs) are invaluable, providing confidential counseling and referrals for both work and personal challenges faced by employees and their households. Promoting awareness of these benefits and consistent reminders through various communication channels will not only destigmatize mental health but will also encourage employees to utilize these underused yet crucial resources.

3. Implementing Training, Education, and Support Plans: A proactive approach to mental health in the workplace requires thorough planning and training. Employers should invest in educating managers to identify signs of mental distress early, respond appropriately, and offer the necessary support. Tailored plans should be in place to address the unique mental health needs of each employee, considering various factors and legal implications, including compliance with the Family and Medical Leave Act (FMLA) and the Americans with Disabilities Act (ADA). Continuous support, time-off for counseling, and promoting a healthy work-life balance are essential components of a comprehensive employee mental health support plan. Employers should also engage in regular assessments and improvements of their mental health initiatives, taking into account employee feedback and evolving best practices to create an inclusive, supportive work environment that prioritizes mental well-being.

The 10 Biggest Trends Revolutionizing Healthcare In 2024

By Bernard Marr - A longer-living population, the emergence of transformative technologies with applications across the healthcare spectrum, and continued global economic uncertainty. These are the key societal drivers that will impact healthcare in 2024. Read Full Article…

VBA Article Summary

1. Integrative Approach in Healthcare Delivery:

   Generative AI’s Expansive Impact - As healthcare undergoes significant transformation in 2024, Generative AI emerges as a pivotal element, revolutionizing diverse facets from data utilization to patient care. Its role is irreplaceable in synthesizing data for training medical algorithms while ensuring patient privacy. Its ability to facilitate personalized healthcare recommendations, craft virtual assistants, and support patients’ journey demonstrates its limitless applications, presenting a promising landscape for healthcare’s future.

   Shift Towards Preventative Care - A proactive approach to healthcare is gaining prominence, with preventative care taking center stage. Addressing an aging global population's needs without overwhelming healthcare systems, preventative care strategies integrate technology, AI, and wellness practices to provide long-term patient benefits and minimize costs associated with preventable conditions.

   Harmonizing Mental and Physical Healthcare - The pandemic has accentuated the necessity for a harmonized approach to mental and physical health. In 2024, healthcare providers are increasingly acknowledging the intrinsic interconnectedness of physical and mental well-being, initiating a comprehensive strategy that integrates mental health considerations into the treatment and recovery processes for physical ailments.

2. Technological Innovations Enhancing Patient Care:

   Personalized Medicine through AI - Personalized medicine becomes increasingly sophisticated and accessible through advancements in AI and data technology. AI’s capability to analyze DNA empowers healthcare providers to diagnose, treat, and devise medicines that are meticulously tailored for individuals at a molecular level, championing a personalized healthcare approach.

   Telemedicine 2.0 and IoT - The advent of Telemedicine 2.0 and IoT-powered virtual hospitals offers a holistic and innovative approach to remote patient care. Beyond facilitating remote consultations, this trend exemplifies how healthcare delivery is evolving, with virtual wards monitoring patients in their homes and IoT devices playing a crucial role.

   Virtual and Augmented Reality Applications - VR and AR technologies are not only proving crucial for patient pain management and rehabilitation but are also invaluable tools for healthcare professionals. From providing surgeons with vital real-time digital information to assisting in wound care management and treatment option evaluations, these technologies are significantly impacting patient care and professional medical practices.

3. Future-Oriented Solutions and Elderly Care:

   Digital Twins and Simulations - The utilization of digital twins, or virtual models of real-world systems, provides unprecedented insights and simulations for treatment effects, medication changes, and lifestyle adjustments on the human body. These digital replicas are invaluable in understanding and improving healthcare delivery, service provision, and treatment planning at various levels.

   3D Printing Innovations - 3D printing is radically transforming healthcare delivery and resource availability. It enables on-demand production of essential medical equipment, devices, and potentially, biological organs for transplantation, addressing shortages and reducing procedure costs, thereby providing innovative solutions to pressing healthcare challenges.

   Focused Elderly Care Solutions - With the aging population exerting pressure on global healthcare systems, innovative solutions for elderly care are imperative. These include developing treatments for age-specific diseases and creating support systems that allow the elderly to maintain independence and receive care in their homes, thereby alleviating the burden on hospitals and care facilities.

Essential health care workers deserve better financial benefits

By Nico Simko - The Great Resignation has officially come to an end as interest hikes, slower wage growth, inflation, and layoffs have prompted more Americans to stay put at their jobs. But while many industries driven by office workers are no longer scrambling to fill roles, there is still a significant shortage of front-line workers nationwide. Read Full Article…

VBA Article Summary

1. Addressing Financial Strains: The ongoing healthcare worker shortage in the U.S. is alarming, and the financial stress experienced by these frontline workers exacerbates the issue. With 38% of them facing monetary woes before payday, and looming student loan payments resuming, there is an urgent need for more supportive financial structures for healthcare professionals. Many are living paycheck to paycheck, with some resorting to plasma donations to make ends meet. Offering solutions like on-demand pay can alleviate their financial anxiety, making the positions more attractive to potential employees and retaining existing ones.

2. Enhanced Financial Benefits for Retention and Recruitment: On-demand pay is emerging as a vital part of financial wellness benefits offered by companies to support their workers. This benefit is not just a tool to provide immediate relief to employees but also serves as an effective strategy for attracting and retaining quality staff in the competitive healthcare job market. According to reports, 81% of employers believe that providing financial wellness tools, like on-demand pay, attracts higher-quality employees, while poor benefits are cited as the reason 43% of employees leave their jobs. By addressing the financial wellbeing of employees, businesses can ensure a committed and content workforce, subsequently reducing turnover-related costs.

3. Selecting the Right On-Demand Pay Provider: Employers looking to implement on-demand pay benefits must choose providers carefully. The ideal provider should offer services free of predatory fees or “tips” requests, ensuring employees truly benefit from the service. Furthermore, it’s crucial to consider the destination of the transferred funds. The optimal solution combines FDIC-insured, low-fee bank accounts with on-demand pay, safeguarding employees’ earnings while providing immediate access. This approach, compliant with U.S. lending laws, supports the financial needs of healthcare workers, contributing to the overall wellbeing of not only the employees but also the patients and the broader community.

Why Opioid Overdose Antidotes Should Be Within Reach

By Riley Griffin  - Down in the bottom of my purse, alongside my headphones, notebook and keys, is a package of Narcan, a medication that rapidly reverses the effects of opioid overdose. I sought out the antidote last fall after witnessing an overdose on a quiet street in Washington, DC, and waiting anxiously for first responders to arrive. Read Full Article…

VBA Article Summary

1. Increasing Accessibility of Narcan: Narcan, a life-saving naloxone nasal spray, is now available over-the-counter in major drugstore chains in the United States, providing easier access to households across the country. This accessibility is crucial amid the escalating opioid crisis, as the Centers for Disease Control and Prevention (CDC) reported approximately 83,000 opioid-related overdose deaths in 2022, marking an all-time high.

2. Who Should Have Narcan: According to Caleb Alexander, a professor at the Johns Hopkins Bloomberg School of Public Health, Narcan should be available in households where there is chronic opioid use, non-medical use of opioids, or in communities significantly impacted by the opioid epidemic. Although not necessary for every household, having Narcan on hand is advised in areas with high rates of opioid use and overdose, acting as a preventive measure much like a fire extinguisher in a home.

3. Safe and Easy to Administer: Narcan is deemed safe to use, with its primary side effect being the precipitation of withdrawal symptoms in individuals who receive it. It is designed for ease of administration by friends, family members, or bystanders to effectively counter opioid overdoses. Although it can induce withdrawal symptoms, such as agitation, the importance of saving lives during overdoses far outweighs the potential discomfort caused by withdrawal. Furthermore, with its packaging designed for user understanding, and local pharmacists and first responders available for guidance, administering Narcan can be quickly learned and applied during emergency situations.