Preventive Health Care: Economic Impact on the U.S.

Government Policies Promoting Preventive Health Care

Government policies promoting preventive health care are crucial for enhancing health outcomes and affordability. UnitedHealth and Cigna emphasize the importance of government-sponsored programs like Medicare and Medicaid, value-based care, and policy solutions aimed at universal coverage and better health outcomes, which collectively support a sustainable health system.

"The individual exchange market in aggregate, we see as an important part of the U. S. Health care system for those individuals who don't have access to an employer sponsored plan or a government sponsored coverage from Medicare, Medicaid, TRICARE, etcetera." --- (CI, conference, 2024/06/11)

"UnitedHealth has stated that its political contributions are designed to advanced policy options excuse me, advanced policy solutions that focus on achieving universal coverage, improving health care affordability, enhancing the health care experience and achieving better health outcomes." --- (UNH, event transcript, 2024/06/03)

"And we expect that's likely to transpire over the course of the next couple of years, meaning it's going to take a couple of years to work its way through, whether it's the Medicaid redeterminations and the net result on health status and acuity and rate matching, whether it's in Medicare, the funding environment with where the rate notices have landed, whether it's the STARS methodology changes, whether it's the risk adjustment model changes, all of that's going to take a few years to sort of sort its way through as it relates to those government markets." --- (CI, conference, 2024/06/11)

"Our differentiated long term strategy is built around 2 core complementary ambitions: helping accelerate the U. S. Health system's transition to value based care by aligning incentives across care providers, health plans and consumers to deliver the highest quality outcomes at the lowest cost, while at the same time bringing to bear the full resources of our enterprise capabilities, our technology, data and clinical expertise to fundamentally empower and transform the way American consumers engage with their health care.These twin ambitions are underpinned by 5 strategic growth priorities." --- (UNH, event transcript, 2024/06/03)

"We believe this increases value for customers and consumers, improves people's experience and health, reduces redundancies and waste, and ultimately leads to a more sustainable health system. For example, the proven health and economic value to consumers and" --- (UNH, earning call, 2024/Q2)

Cost Savings from Preventive Health Care

Preventive health care initiatives, such as value-based care, have led to significant cost savings. For instance, Caremark clients saved $140 million on lower gross costs, and Optum Health's revenues grew by 16% due to increased patient numbers in value-based care.

"Earnings from operations increased due to cost management initiatives, partially offset by costs associated with serving newly added patients under value-based care arrangements and incremental medical costs for accommodations to support care providers as a result of the Change Healthcare cyberattack." --- (UNH, sec filing, 2024/Q1)

"And I think there's been a big shift. I saw an article a few days ago that talked about Caremark clients already saving $140,000,000 on lower gross costs related to that switch." --- (CVS, conference, 2024/05/14)

"Optum Health's revenues grew by 16% to $26.7 billion, as we increased the number of patients served and are on track to approach five million patients in value-based care by year end." --- (UNH, earning call, 2024/Q1)

Impact on Insurance Premiums and Coverage

Insurance premiums are rising significantly due to higher per member Medicare premiums and increased Medicare Advantage membership, as noted by Humana and CVS. Coverage is expanding, particularly for weight loss treatments, but the cost of bundled plans is expected to increase, impacting overall benefits.

"Premiums Revenue Insurance segment premiums revenue increased $2.7 billion, or 10.6%, from $25.6 billion in the 2023 quarter to $28.3 billion in the 2024 quarter primarily due to higher per member Medicare premiums and individual and group Medicare Advantage membership growth." --- (HUM, sec filing, 2024/Q1)

"There is a very substantial change in plan liability there, which will result in much higher premiums, which we think is going to impact both overall benefits within the bids, but also as we think about those seniors that are currently in the market to purchase a bundle, that the cost of that bundle is going to rise pretty dramatically for them, which may even with a less robust set of benefits make Medicare advantage an attractive option in 2025." --- (CVS, earning call, 2024/Q1)

"So that's growing nicely. Stepping back a little bit in terms of just looking at the coverage for GLP-1s for weight loss indications overall in the Express Scripts business, we've now got essentially 50% or so of plan sponsors covering for weight loss indications." --- (CI, earning call, 2024/Q2)

"And the majority of our prior authorizations are simply checking for coverage prior to treatment.We continue to look at ways in which we can reform and reduce the number of prior authorizations required, and we're also piloting across the country a gold card scheme to further improve people's experience." --- (UNH, event transcript, 2024/06/03)

"Premiums Revenue Insurance segment premiums revenue increased $2.6 billion, or 10.4%, from $25.5 billion in the 2023 quarter to $28.1 billion in the 2024 quarter and increased $5.4 billion, or 10.5%, from $51.0 billion in the 2023 period to $56.4 billion in the 2024 period primarily due to higher per member Medicare premiums as well as individual and group Medicare Advantage and state-based contracts membership growth." --- (HUM, sec filing, 2024/Q2)

Corporate Wellness Programs and Economic Benefits

Amazon's significant investments in employee wellness programs, including technologies, resources, and training, aim to reduce risks and enhance workforce productivity. These initiatives, coupled with economic development efforts, underscore the economic benefits of corporate wellness programs.

"We continue to invest heavily in technologies, resources, training and programs that aim to reduce and eliminate risks for our employees, partners and communities." --- (AMZN, AGM, 2024/05/22)

"Our investment will also deliver workforce training programs and a new AWS InCommunities Fund aimed at supporting initiatives in tech education, sustainability, economic development, and more." --- (AMZN, Twitter, 2024/04/25)

Healthcare Providers' Perspectives on Preventive Health Care

Healthcare providers emphasize the importance of preventive health care through improved quality outcomes, efficient processes, and innovative care models. They highlight the role of technology and policy reforms, such as the Affordable Care Act, in enhancing healthcare delivery and expanding access, ultimately aiming to reduce costs and improve population health.

"The people of HCA Healthcare continue to deliver for our patients with improvements in key non-financial metrics, including improved quality outcomes, more efficient process measures in emergency room services, which have accelerated time to discharge and increase satisfaction, and finally, better inpatient capacity management with reduced length of stay and increased acceptance of patients who needed to be transferred to our hospitals." --- (HCA, earning call, 2024/Q1)

"We’ve also been very effective at bringing in some allied health workers and changing – or making changes to our care delivery model that allows us to treat patients with more LPNs, nursing assistants and making those adjustments that had a favorable impact on our salaries, wages and benefits." --- (CYH, earning call, 2024/Q1)

"The government’s ultimate goal is to promote more effective (quality) and efficient healthcare delivery through the use of technology to reduce the total cost of healthcare for all Americans and utilizing the cost savings to expand access to the healthcare system." --- (UHS, sec filing, 2024/Q1)

"The Institute focuses on improving health care delivery and population health through innovative research and education, in partnership with health plans, delivery systems, and public health agencies." --- (HCA, press release, 2024/04/19)

"The most prominent of these efforts, the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010, or collectively, the Affordable Care Act, affects how healthcare services are covered, delivered and reimbursed, and expanded health insurance coverage through a combination of public program expansion and private sector health insurance reforms." --- (CYH, sec filing, 2024/Q2)

Public Awareness and Education on Preventive Health Care

Pharmaceutical companies like Pfizer and Eli Lilly emphasize the importance of direct-to-consumer marketing and educational initiatives to enhance public awareness and adherence to preventive health care. Merck highlights the need to increase vaccination rates despite known benefits, while efforts to address non-communicable disease risk factors and strengthen health systems are also crucial.

"With oral CGRP penetration leaving room for potential significant growth, we will continue to focus on reducing access barriers for health care professionals and patients, as well as on education through direct-to-consumer marketing." --- (PFE, earning call, 2024/Q1)

"And I think there is an educational need here, but we and the competition needs to take the lead on to make sure that patients don't go on and off because we don't know the impact of that in terms of the body composition." --- (LLY, conference, 2024/06/10)

"Despite the proven public health benefit of HPV vaccination, the latest global cancer statistics from the International Agency for Research on Cancer indicate there is more to do to help increase vaccination rates." --- (MRK, earning call, 2024/Q1)

"You've mentioned focusing on physician awareness in a different way and reducing friction for patient access any more color you can provide there." --- (PFE, earning call, 2024/Q2)

"With this additional funding, UNICEF will seek to improve efforts to address NCD risk factors, strengthen health systems, enhance the ability of health workers to care for people and support millions of children and their families challenged by diseases like type 1 diabetes, respiratory illnesses, rheumatic and congenital heart disease, and sickle cell disease in resource-limited areas in India." --- (LLY, press release, 2024/05/29)

Technological Advancements in Preventive Health Care

Technological advancements in preventive health care are being driven by AI, personalized care, and health monitoring apps. Companies like Amazon, Microsoft, and Apple are leveraging AI to enhance healthcare efficiency, develop responsible tools, and provide real-time health metrics, significantly transforming preventive health care.

"As healthcare systems like Mass General Brigham lean into AI to accelerate their work, we see great potential for new foundation models that utilize advanced technologies." --- (AMZN, press release, 2024/07/25)

"We are honored to partner with SacValley MedShare on their continued journey to advance healthcare and are confident our technology, combined with our dedicated, skilled team members, will deliver the improved efficiency and support SacValley MedShare needs to achieve its healthcare transformation goals, said Dan Burton, CEO of Health Catalyst." --- (MSFT, press release, 2024/04/25)

"And that's the Vitals app, a new way to quickly view your most important health metrics, receive alerts when it's time to pay more attention to your body, and gain better context when it comes to your health." --- (AAPL, event transcript, 2024/06/10)

"Serving patients and providers for more than 125 years, GE HealthCare is advancing personalized, connected, and compassionate care, while simplifying the patient's journey across the care pathway." --- (AMZN, press release, 2024/07/25)

"As healthcare leaders, we need to carefully and responsibly develop and evaluate such tools to ensure high-quality care is in no way compromised," said Keith J. Dreyer, D.O., Ph.D., chief data science officer and chief imaging officer at Mass General Brigham and leader of the Mass General Brigham AI business." --- (MSFT, press release, 2024/07/24)

Long-term Economic Benefits of Preventive Health Care

Preventive health care offers long-term economic benefits by reducing overall medical costs, improving retention of Medicare Advantage members, and enhancing workforce productivity. Integrated care models improve health outcomes and affordability, while early identification and management of chronic diseases lead to significant cost savings.

"And to your point, there is significant kind of synergy or interrelated benefits between the Medicaid growth and the Medicare book because of duals and between CenterWell and the Medicare book because of the ability to impact quality and total cost of care." --- (HUM, earning call, 2024/Q2)

"What does that mean? That means lower overall medical costs will improve retention of those Medicare Advantage offers over time, will grow because we have a different and unique assets that we can bring to our Medicare Advantage members." --- (CVS, conference, 2024/05/29)

"And so the employers we serve, which again are predominantly 51 and up, employee size, more often than not use health benefits as a talent attraction and retention tool as well as something to enable productivity, absence management and the ongoing health and well-being of the employees and their" --- (CI, conference, 2024/06/11)

"Because it identifies affordability opportunities incredibly quickly. It also identifies chronic disease that needs to be managed and it gets them connected to primary care quickly." --- (UNH, earning call, 2024/Q1)

"The model is designed to improve health outcomes and affordability for individuals and for the health system as a whole, while offering our members a simple, seamless healthcare experience." --- (HUM, sec filing, 2024/Q2)