Health insurance executives convene this week in Las Vegas at a time when the industry is facing significant pressure on cost, access and policy changes.
AHIP’s annual conference kicks off Tuesday morning, with two days of sessions and discussions that center on the major challenges facing insurers today, from new technologies to consumer engagement to rising medical costs.
Fierce Healthcare will be on-site this week to provide key insights from the show floor, but before the conference opens, here’s a look at some of the biggest themes to watch on the agenda:
Affordability and access
It’s not much of a secret that healthcare costs are rising. Patients may feel it at the pharmacy counter when their prescription price increases, and providers may feel it in the administrative bloat in their workflows.
For health plans and plan sponsors, that means finding the balance between managing the cost of care and ensuring that patients can readily access the services they need. It’s a complex calculus, and onerous utilization management programs aimed at cost containment have drawn sharp criticism.
Affordability is a common theme at AHIP this year, with a keynote Tuesday morning aiming to dive into a potential 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 p.m. PT, hear from Cigna Chief Operating Officer Brian Evanko and EMD Serono President Miguel Fernández Alcalde on ways to improve the affordability of prescription drugs.
Affordability also colors multiple sessions in the conference’s Influencer Series on Wednesday. At 1:05 p.m. PT, Beth Keyser, president for the commercial west region at Anthem Blue Cross and Blue Shield; Katie Martin, president and CEO of the Health Care Cost Institute; and Pascale Thomas, managing director and head of global benefits and wellbeing for BNY, will join Business Group on Health CEO Ellen Kelsay for a “call to action” on collaboration that can drive affordability.
In addition and concurrently, Michelle Gourdine, M.D., chief medical officer for CVS Caremark and senior vice president for CVS Health; Laura Herrera Scott, M.D., vice president and chief medical officer at CareFirst BlueCross BlueShield; and Ken Silverstein, M.D., chief medical officer for EviCore by Evernorth, will offer an update on the industry’s pledge to overhaul prior authorization.
Member engagement and satisfaction
Keeping members happy and engaged in their health poses a challenge even when they aren’t feeling the squeeze from elevated medical costs. Insurers have a bit of an image problem at the best of times, and amid the cost crisis, lawmakers and policymakers are pressing “Big Insurance” for their role in it.
AHIP will host a track focused on consumer and member engagement across both days at the conference, with conversations ranging from the role of technology to increasing transparency.
For example, multiple CVS leaders will sit down at 2:45 p.m. PT on Tuesday to discuss the company’s approach to tackling fragmentation and ways to simplify the patient experience. Panelists include Tony Ambrozie, senior vice president and chief digital, technology and information officer for CVS; Brian Leadingham, senior vice president of PBM Operations at CVS Caremark; and Pushpendu Pal, M.D., senior vice president and chief digital and technology officer for CVS Caremark.
In another track session at 3:45 p.m. PT on Tuesday, hear from Greg Barber, director for 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 engagement bleeds into other conference tracks, too. For instance, a session at 12:25 p.m. PT on Tuesday aims to examine whether “the medium or the messenger” poses the greatest challenge to effective engagement.
At that session, hear from Sophia Kim, chief growth officer at Heartbeat Health; Marcus Lanznar, president of Signify Health; and Zach Taylor, vice president and head of client growth and success at Signify.
Navigating a complex policy environment
In the policy space, there have been significant shifts across multiple lines of business for insurers, including the rollout of Medicaid work requirements that is underway in earnest and uncertainty around what’s next for the Affordable Care Act’s marketplaces.
At 11:40 a.m. PT on Tuesday, hear from Alice Hm Chen, M.D., executive vice president and chief health officer at Centene Corporation and Jason Dees, executive vice president and chief medical officer at Molina Healthcare, for the latest on the Medicaid overhaul in the session, “Medicaid Community Engagement: From Eligibility to Continuity of Care.”
The Trump administration recently finalized key guidance on implementing the work requirements, which states must have completed in time for Jan. 1.
As for the exchanges, a panel at 3:40 p.m. Tuesday dives into what’s next and features speakers from multiple state exchanges and policy experts: Jessica Altman, executive director at 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 & Medicaid Services.
Also on the docket is vaccine policy and access, which has seen a massive overhaul under Department of Health and Human Services Secretary Robert F. Kennedy, Jr. In the session “Committing to Coverage: Strengthening Vaccine Access and Confidence” at 10:55 a.m. on Wednesday, hear from multiple experts on how plans can approach this critical challenge.