John McIntyre’s Post

2024 was a challenging year for healthcare, with patent cliffs and declining reimbursement rates taking a toll. Looking ahead to 2025, policy uncertainty and innovation are setting the stage for a transformative year. Explore the trends shaping the future of healthcare in this blog post from AlphaSense.

Are We Ignoring the True Potential of Prevention in Healthcare? Healthcare now accounts for nearly 20% of the U.S. economy, amounting to $4 trillion annually—more than $11,000 per person. Compare that to the $3 trillion total value of U.S. exports, and it’s clear just how significant this sector has become. Dr. Peter Attia, one of my favorite voices in the healthcare space, recently had a podcast highlighting our challenges. His work always makes me think deeply about what’s possible in healthcare. While innovation has undoubtedly propelled us forward, why aren’t we talking more about prevention? Chronic illnesses like obesity, diabetes, and cardiovascular disease drive the bulk of healthcare costs, yet prevention remains an underutilized strategy. Prevention isn’t just cost-saving—it’s life-saving. Imagine redirecting a fraction of our $4 trillion expenditure toward proactive measures that keep people healthier longer. One day, I hope to meet Dr. Attia and discuss how we can prioritize prevention nationally. What are your thoughts—can prevention shift the tide of healthcare spending? #PreventionFirst #HealthcareCosts #PeterAttia #HealthcareInnovation

In this episode (#327) of The Drive, I speak with Saum Sutaria, M.D., the Chairman and CEO of Tenet Healthcare and a former leader in McKinsey & Company’s Healthcare and Private Equity Practices, where he spent almost two decades shaping the field. Saum unpacks the complexities of the U.S. healthcare system, providing a detailed overview of its structure, financial flows, and historical evolution. We delve into topics such as private insurance, Medicare, Medicaid, employer-sponsored coverage, drug pricing, PBMs and the administrative burdens impacting the system. Saum’s insights help connect healthcare spending to broader economic issues while exploring potential reforms and the role of technology in improving efficiency. Saum highlights how choice and innovation distinguish the U.S. healthcare system, explores the reasons behind exorbitant drug prices, and examines the potential solutions, challenges, and trade-offs involved in lowering costs while striving to improve access, quality, and affordability. Here’s a glimpse of what we discuss: - Overview of how the US healthcare system currently works and how we got here - How misaligned incentives have driven up drug prices in the US - Health outcomes: why life expectancy is lower in the US despite excelling at extending lifespan beyond 70 - Feasibility of a universal Medicare program, and what a real path to sustainable healthcare looks like - More https://bit.ly/3VepYCj

Engage with leaders from #healthsystems, #heathplans, #lifesciences #pharma #advocacy and #government who are innovating strategic initiatives to advance #valuebasecare at the #thincValue: Value Based Care Summit, October 28-29, in Washington, DC. Produced by The Healthcare Innovation Company (thINc) Speakers include: Lee Handke, PharmD, MBA, Chief Executive Officer, Nebraska Health Network Conrad Vial, MD, Senior Vice President and President, Sutter Health Network Richard Gurley, Founder and Chief Executive Officer, Ryse Health Eric Gallagher, Chief Executive Officer, Ochsner Health Network, Ochsner Health Elaine Ziegler, President, Palliative Division, Gentiva Sandy Balwan, M.D. MD, Senior Vice President and Executive Director, Clinical Integration Network IPA, Northwell Health, Mollie Gelburd, JD, Senior Director, Delivery System & Payment Transformation, America's Health Insurance Plans (AHIP) Carol Vargo, Vice President, Physician Practice Sustainability, The American Medical Association (AMA) Aisha T Pittman, MHP, Senior Vice President of Government Affairs, National Association of ACOs (NAACOS) Ann C. Greiner, MCP, President and Chief Executive Officer, Primary Care Collaborative  Jeff Micklos, Executive Director, Healthcare Transformation Task Force Michael Udwin, MD, FACOG, Medical Director, Provider Collaboration and Network Transformation, CareFirst BlueCross BlueShield Alexander Ding, MD, MBA, Associate Vice President, Physician Strategy & Medical Affairs, Humana Catherine Anderson, Senior Vice President, Health Equity Strategy, UnitedHealth Group Stephen Ondra, Vice President, Center for Transforming Health, MITRE; Director, CMS Alliance to Modernize Healthcare (Health FFRDC) Conor Sheehey Sheehey, Senior Health Policy Advisor, Senate Finance Committee, United States Senate  George Lourentzatos, Chief of Strategy and Operations, Union Health Center Lisa Wetherbee, Chief Executive Officer, Trinsic, A Clinically Integrated Network Mark Carley, Vice President-Managed Care & Ambulatory Services, Multistate Division, AdventHealth Zachary Rabovsky, Director, Practice Transformation and Population Health Strategy, CareFirst BlueCross BlueShield Ryan Tyner, MD, FACS, Chief Medical Officer, Ryse Health Lisa Stockdale, Director of Value Based Care, Silver Cross Health Jen Norton, Senior Vice President, Head of U.S. Patient and Market Access, Takeda Joseph (Joe) Smith, MD, PhD, MD, PhD, Chief Scientific Officer, Becton Dickinson Jennifer Bright, President, International Consortium for Health Outcomes Measurement (ICHOM) Jason Spangler, MD, MPH, FACPM, Chief Executive Officer, Center for Innovation & Value Research Natalie Davis, Chief Executive Officer and Co-Founder, United States of Care #healthcare #healthoutcomes #personalizedcare #wholepersoncare #percisioncare #preventativecare https://lnkd.in/eCAp8BpR

💡 What is Regulatory Capture, and How Does It Impact Healthcare? Anthony DiGiorgio, DO, MHA recently shared an excellent post (on X) on the role of regulatory capture in EHR systems (like Epic), and it’s definitely worth the read. For those who don’t know, regulatory capture is when corporate interests utilize governmental regulations and regulatory bodies to impact the marketplace in their favor. The result? Less competition, less transparency, and higher costs across the board. Regulatory capture is extremely common in healthcare and plays a major role in the challenges we face today. One notable example is the influence of corporate interests in shaping provisions within the Affordable Care Act (ACA)—a textbook case of regulatory capture. Here are more specific examples of how it manifests: • Pharmaceutical companies influencing the FDA: Think of the Vioxx scandal, where concerns over safety were overshadowed by corporate pressure, leading to thousands of adverse health outcomes. • Insurance companies overcharging Medicare Advantage: Through heavy lobbying, private insurers have secured higher government reimbursements for Medicare Advantage plans, driving up costs with little improvement in care. • EHR vendors (like Epic) creating closed, complex systems: These systems frustrate doctors, increase administrative burden, and limit interoperability, driving up costs and reducing efficiency in patient care. The impact on healthcare is immense: • Reduced quality of care • Increased inefficiencies in health systems • Higher costs passed down to both patients and physicians. Estimated cost: Regulatory capture contributes to $100+ billion/year in excess spending, inflated prices, and unnecessary administrative burdens. This leads to fewer choices for patients, higher out-of-pocket costs, and overwhelming regulatory hurdles for healthcare providers. It’s crucial that we recognize the role regulatory capture plays in limiting the healthcare marketplace and work toward reforming the system to prioritize patient outcomes and provider efficiency over corporate profits. #Healthcare #RegulatoryCapture #EHR #Pharma #Medicare #HealthReform #AffordableCare #HealthIT #Interoperability #HealthcareEconomics

The Future of Payer Technology is Here! 📊 Our blog highlights the trends shaping healthcare payers in 2024. Find out how to stay on top of the game. #HealthcareInnovation #PayerTechTrends #Viaante

Good morning Healthcare, This article is positive news for the Healthcare Industry. Not necessarily for staffing but for Hospitals. There could be a trickle down effect that benefits staffing however. A quote: "Despite a slowdown in 2024, healthcare M&A activity remained nearly 70% higher than pre-pandemic levels. There were 1,373 healthcare deals in 2024." https://lnkd.in/gYvQqbfw

After reading the article it got me thinking - A Glass-Steagall-like act for healthcare could transform the industry, driving down costs and enhancing care quality by dismantling monopolistic structures, fostering competition, and prioritizing patient interests over corporate profits. 💥 Reduced Conflicts of Interest: Legal separation of insurers from providers and pharmacies to lower costs and increase transparency. 💥 Enhanced Competition: Increased market competition could improve services and innovation as companies compete on care quality and cost. 💥 Improved Patient Care and Choice: More provider options and independence could enhance care quality and patient satisfaction. 💥 Increased Regulatory Oversight: More stringent oversight to ensure compliance with separation mandates, possibly leading to the creation of new regulatory bodies. 💥 Potential Short-Term Disruption: Initial disruptions as companies restructure to comply with new regulations, possibly affecting service continuity. 💥 Economic Impact on Providers: Mixed effects on healthcare providers, with some benefiting from less competition and others potentially struggling without large system support. What do you think? do we need it?

Check out the latest findings from our study: The Provider Perspective: Insights on Policy, Practice, and Patient Care. Healthcare providers are bracing for a perfect storm—shifting reimbursement policies, financial uncertainty, and rising operational costs. What does this mean for pharma? The need to adapt, support, and prove value has never been greater. 🔹 Part 2: https://hubs.ly/Q034KzjN0 🔹 Missed Part 1? https://hubs.ly/Q034KyQY0 Stay tuned for Part 3 next week, where we explore healthcare access challenges for vulnerable populations. For a summary of the series, check out the press release: https://hubs.ly/Q034KBG-0 We’d love to hear your thoughts—what are the biggest challenges you see providers facing this year? Join the conversation below! #HealthcarePolicy #Pharma #HCPInsights #ShapiroRaj