Health insurance executives meet this week in Las Vegas at a time when the industry faces significant pressure over costs, access and policy changes.
AHIP Annual Conference begins Tuesday morning, with two days of sessions and discussions focusing on the key challenges facing insurers today, from new technologies to consumer engagement to rising medical costs.
Fierce Healthcare will be on hand this week to provide key insights from the exhibit hall, but before the conference begins, here’s a look at some of the most important topics to keep in mind on the agenda:
Affordability and access
It’s no secret that healthcare costs are rising. Patients can feel it at the pharmacy counter when the price of their prescriptions increases, and providers can feel it in the administrative overload of their workflows.
For health plans and plan sponsors, that means finding the balance between managing the cost of care and ensuring patients can easily access the services they need. It’s a complex calculation, and onerous utilization management programs aimed at containing costs have drawn harsh criticism.
Affordability is a common theme at AHIP this year, with a keynote address on Tuesday morning aiming to delve into a possible path forward. Adam Boehler, CEO and founder of Rubicon Partners and former director of the Center for Medicare and Medicaid Innovation, will join Lazard CEO Peter Orszag at 10:50 a.m. PT.
In Tuesday’s closing session at 5:20 pm PT, hear from Cigna COO Brian Evanko and EMD Serono President Miguel Fernández Alcalde about ways to improve prescription drug affordability.
Affordability also factors into several sessions of the conference’s Influencer Series on Wednesday. At 1:05 pm PT, Beth Keyser, president of the western business region of Anthem Blue Cross and Blue Shield; Katie Martin, president and CEO of the Health Care Cost Institute; and Pascale Thomas, CEO and head of global benefits and well-being at BNY, will join Business Group on Health CEO Ellen Kelsay for a “call to action” on collaboration that can drive affordability.
Additionally, and at the same time, Michelle Gourdine, MD, chief medical officer of CVS Caremark and senior vice president of CVS Health; Laura Herrera Scott, MD, vice president and chief medical officer of CareFirst BlueCross BlueShield; and Ken Silverstein, MD, medical director of Evernorth’s EviCore, will provide an update on the industry’s commitment to review prior authorization.
Member Engagement and Satisfaction
Keeping members happy and engaged in their health poses a challenge even when they don’t feel the pressure of high medical costs. Insurers have a bit of an image problem at best, and amid the cost crisis, lawmakers and policymakers are putting pressure on “Big Insurers” to play a role in it.
AHIP will host a session focused on consumer and member engagement over the two days of the conference, with conversations ranging from the role of technology to increasing transparency.
For example, several CVS leaders will meet Tuesday at 2:45 p.m. Pacific Time to discuss the company’s approach to addressing fragmentation and ways to simplify the patient experience. Panelists include Tony Ambrozie, senior vice president and chief digital, technology and information officer at CVS; Brian Leadingham, Senior Vice President of PBM Operations at CVS Caremark; and Pushpendu Pal, MD, senior vice president and chief digital and technology officer, CVS Caremark.
In another follow-up session at 3:45 pm PT on Tuesday, hear from Greg Barber, director of experience and market research at CareFirst BlueCross BlueShield, and Jigar Shah, senior vice president and chief marketing and strategy officer at Blue Shield of California, about how member engagement can serve as a critical lever to drive efficiency and retention.
Member participation also extends to other areas of the conference. For example, a session on Tuesday at 12:25 pm PT aims to examine whether “the medium or the messenger” poses the greatest challenge to effective participation.
In that session, hear from Sophia Kim, Chief Growth Officer at Heartbeat Health; Marcus Lanznar, president of Signify Health; and Zach Taylor, vice president and chief customer growth and success officer at Signify.
Navigating a complex political environment
In the policy space, there have been significant changes across multiple lines of business for insurers, including the implementation of Medicaid work requirements that is underway in earnest and uncertainty about what’s next for the Affordable Care Act markets.
At 11:40 a.m. PT Tuesday, hear from Alice Hm Chen, MD, executive vice president and chief health officer of Centene Corporation, and Jason Dees, executive vice president and chief medical officer of Molina Healthcare, for the latest on the Medicaid review in the session, “Medicaid Community Engagement: From Eligibility to Continuity of Care.”
The Trump administration recently finalized key guidance on implementing work requirements, which states must have completed in time by Jan. 1.
As for the exchanges, a panel on Tuesday at 3:40 p.m. delves into what’s next and features speakers from multiple state exchanges and policy experts: Jessica Altman, executive director of Covered California; Annie Lee, president and CEO of Colorado Access; and Randy Pate, founder of Randolph Pate Advisors and former deputy administrator and director of the Center for Consumer Information and Insurance Oversight at the Centers for Medicare and Medicaid Services.
Also on the agenda is vaccine policy and access, which has undergone a massive review under the direction of Department of Health and Human Services Secretary Robert F. Kennedy, Jr. In the session “Commitment to Coverage: Strengthening Vaccine Access and Confidence” at 10:55 a.m. Wednesday, hear from multiple experts on how plans can address this critical challenge.
