Trilliant Health’s 2024 Trends Shaping the Health Economy: Macro Edition “KEY TAKEAWAYS
Health status for Americans continues to decline, especially for younger Americans. Mortality remains higher than pre-pandemic, with the largest increase in the 18-44 age group.
Early onset cancers are rising, with higher volumes of patients ages 45 and younger for breast (+6.6%), colon (+10.0%), kidney (+2.1%) and uterine (+16.0%) cancers from Q4 2018 to Q4 2023.
GLP-1s have surpassed insulin to become the second most common medication for type 2 diabetes, rising from the eighth most common drug regimen in 2018.
Actual usage for clinical artificial intelligence (AI) remains low, with only 202K patients across all AI CPT codes between 2018 and 2023.”
About health insurance/insurers
Heard on the Street: Humana Could Plunge Into Cigna’s Arms “When Cigna considered a tie-up with Humana last year, Humana was worth about $60 billion. That made it a sizable target for Cigna, whose market value was then about $80 billion. Cigna eventually walked away after shareholders balked at the deal.
Now, a merger is looking a lot more palatable. Cigna, which is focused on the commercial insurance market and has therefore avoided headwinds in the Medicarebusiness, has seen its stock continue to gain, as Humana has struggled. Cigna is now worth nearly $100 billion, while Humana’s market capitalization has sunk to about $27 billion.
Humana shares were down 13% Wednesday midday, due to recent changes to the government’s quality ratings that could eat into the company's bonus payments. The insurer warned that fewer of its plans would be rated four stars or above, hitting profits in 2026.”
CONGRESSIONAL BUDGET OFFICE Report to the House Ways and Means Committee about the effect of Medicare Part D Changes. Was the result of this action unintended or just caused by stupidity? “After accounting for information about 2025 bids from plans that provide coverage under Part D, CBO expects that the additional plan costs reflected in those bids will result in an increase in federal spending of $10 billion to $20 billion in calendar year 2025, compared with our earlier projections.
CBO also estimates that the temporary subsidies will increase federal spending in calendar year 2025 by an additional $5 billion and that, over the next decade, this will lead to an increase of $2 billion in net spending for interest, relative to prior projections.”
About hospitals and healthcare systems
One or Two Health Systems Controlled the Entire Market for Inpatient Hospital Care in Nearly Half of Metropolitan Areas in 2022 “Key Takeaways
One or two health systems controlled the entire market for inpatient hospital care in nearly half (47%) of metropolitan areas in 2022.
In more than four of five metropolitan areas (82%), one or two health systems controlled more than 75 percent of the market.
Nearly all (97% of) metropolitan areas had highly concentrated markets for inpatient hospital care when applying HHI thresholds from antitrust guidelines to MSAs.”
Hospitals prepare for monthslong supply disruptions after Helene, port strike “The healthcare industry is facing significant supply chain challenges that are starting to disrupt essential services. Between the temporary Baxter North Cove plant closure and the East and Gulf Coast port strikes, hospitals are beginning to feel the impact, raising concerns about the availability of critical intravenous solutions and other essential medical supplies.”
Acute Hospital Care at Home Reports An excellent CMS report on this topic.
About the public’s health
Arm Position and Blood Pressure Readings “Findings This crossover randomized clinical trial of 133 adults showed that supporting the arm on the lap overestimated systolic BP by 3.9 mm Hg and diastolic BP by 4.0 mm Hg. An unsupported arm at the side overestimated systolic BP by 6.5 mm Hg and diastolic BP by 4.4 mm Hg, with consistent results across subgroups.
Meaning Commonly used, nonstandard arm positions during BP measurements substantially overestimate BP, highlighting the need for standardized positioning.”
Comment: The standard position is the arm resting on a desk. Make sure that your BP is tested that way when you next have it checked.
'Good business and good health go hand in hand': Reducing inequities could add $2.8T to GDP by 2040, Deloitte finds “Improving health equity could add $2.8 trillion to the U.S. gross domestic product by 2040, Deloitte found, and, for U.S.-based businesses, corporate profits could increase by $763 billion. Businesses could also see improved workforce participation (people who would no longer be leaving due to premature death and disability) and productivity (rates of absenteeism and presenteeism).”
About healthcare IT
2024-2030 Federal Health IT Strategic Plan An excellent document laying out governmental plans and reasons for their implementation.
Black Book IT Leader Survey Reveals 8 Technologies Draining Value From Health Systems “Over 900 healthcare technology experts identified key data systems that fail to deliver ROI and siphon funds from providers after implementation. In 2024, U.S. respondents reported that compounding inefficiencies, system downtimes, and ineffective health IT integration have driven total industry losses to over $8 billion annually, a sharp increase from $1.7 billion in 2017.”
About health technology
Nobel Prize in physiology or medicine awarded for discovery of microRNA “American scientists Victor Ambros and Gary Ruvkun won the 2024 Nobel Prize in physiology or medicine Monday for the discovery of microRNAs, a class of tiny molecules that have been connected to heart disease, a wide variety of cancers and viral diseases.
Mutations in microRNAs, just like those in genes, can lead to diseases, and fixing or replacing mutant microRNAs may prove crucial to developing treatments.
Ambros and Ruvkun figured out that these small molecules have the power to reduce or block production of proteins, responsible for virtually every human action from breathing to thinking.
Not to be confused with messenger RNA — which acts as a “middleman” in the process of translating genetic material into proteins — microRNAs add a crucial, previously unrecognized layer to the process. MicroRNAs can bind on to the messenger RNA and are able to help cells regulate the kinds and amounts of proteins that are made.”
FDA APPROVES EXACT SCIENCES’ COLOGUARD PLUS™ TEST, SETTING A NEW BENCHMARK IN NON-INVASIVE COLORECTAL CANCER SCREENING “FDA approval was based on findings from the pivotal BLUE-C study, one of the largest prospective, head-to-head studies ever conducted in CRC screening. Among the subset of nearly 19,000 average-risk participants, the Cologuard Plus test demonstrated 95% overall cancer sensitivity and 43% sensitivity for advanced precancerous lesions at 94% specificity with no findings on colonoscopy. Results from BLUE-C also show the Cologuard Plus test significantly outperformed an independent fecal immunochemical test (FIT) for overall CRC sensitivity, treatable-stage CRC (stages I-III) sensitivity, high-grade dysplasia sensitivity, and advanced precancerous lesion sensitivity.”
About healthcare finance
Activist investor Starboard builds $1bn stake in drugmaker Pfizer “Activist investor Starboard Value has built a $1bn position in Pfizer, according to two people familiar with the matter, as the drugmaker behind the top-selling Covid-19 jab struggles to reverse a fall in its share price to below pre-pandemic levels. Starboard is seeking a turnaround of Pfizer, according to the two people. It has taken the stake as investors question the New York-based drugmaker’s path to post-pandemic growth after its Covid-19 vaccine delivered a shortlived bump in revenues that waned faster than expected. Pfizer’s market value stood at $161bn as of Friday, after a 52 per cent drop from its pandemic peak. Its shares have traded flat this year, while the S&P 500 has risen by about 20 per cent.”
