Success in the healthcare industry requires staying on top of the latest trends, particularly in the dynamic B2B sector. However, this is no small task. The rapid pace of technological advancements and the crop of regulations that are constantly emerging in response make it challenging to stay informed. As a leading healthcare media relations agency, we understand these complexities.
That’s why we’ve compiled the top industry news and updates of late—to empower fellow healthcare marketing and communications professionals with timely insights to help their own organizations.
Once you scan the summaries below, if you’re new to the healthcare industry or feeling overwhelmed digesting the latest and greatest headlines and updates, we have a plethora of information on our blog that can help. Page through some of our recent posts to get firsthand industry know-how from healthcare media relations agency pros on our team.
Advancements, course corrections in technology & digital health
The American Medical Association (AMA) and America’s Health Insurance Plans have teamed up with 14 organizations representing payers, providers and consumer technology companies to heighten standards around and adoption of digital health solutions. The group is armed with $50 million to find the tech that actually benefits patients.
In contrast, the virtual care market has taken a hit with Walmart shutting down its virtual care services and UnitedHealth Group putting an end to Optum Virtual Health. Even the digital progress in the payer space is falling flat; J.D. Power reported that only 21% of insurers’ apps and websites met all the criteria to be considered highly functioning digital solutions.
Healthcare AI innovation prompting regulatory oversight
While a staggering 93% of physicians reported feeling burnt out in a survey conducted by Athenahealth and The Harris Poll, four in five physicians believe artificial intelligence (AI) could be part of the solution. Recent trends in health tech AI demonstrate its potential to transform healthcare delivery, from improving diagnostics and patient care to enhancing operational efficiency and cybersecurity measures, leading to less staff burnout. Other roles of AI could include EHR integration and speeding up the prior authorization process.
Proportionate to the growth of AI is federal lawmakers’ involvement. Senate members are weighing in, pushing for stronger regulations and determining what role Congress should play in finding a balance between “protecting innovation and protecting patients and their privacy,” according to Senate Committee on Finance Chairman Ron Wyden, D-Oregon. The Department of Health and Human Services (HHS) has also joined the conversation on AI and will require AI developers to detail how their products are managed and evaluated starting at the end of 2024.
Reimbursement, access, and plan standardization: The latest Affordable Care Act (ACA) updates
Several major payers have signaled that they see significant growth opportunities via ICHRA (individual coverage health reimbursement arrangements), spurring provider concerns over reimbursement rates. As an alternative to offering a traditional group health plan, ICHRA allows employers to shift the responsibility for purchasing insurance to employees in exchange for employees receiving tax-free premium reimbursement for plans purchased on the ACA Marketplace. Employer adoption of ICHRA is up 29% since 2023, positioning the ACA to become the primary coverage option for small employers and the next battleground for reimbursement.
The latest rule from the Centers for Medicare and Medicaid Services (CMS) seeks to expand health coverage and further improve access. It will allow consumers with household incomes at/below 150% of the federal poverty level to apply for marketplace coverage outside of open enrollment, add adult dental coverage, and seek to unify network standards across state marketplaces and state-based marketplaces on the federal platform.
On the payer side, insurers are asking CMS to pause their limiting of non-standardized ACA plans to ensure insurance companies can tailor coverage to consumers with specific conditions or other needs.
Quicker-turn prior authorization to take effect in 2026
Starting January 1, 2026, federally regulated health insurers will be required to process urgent prior authorization decisions within 72 hours. Standard, non-urgent requests must be processed within seven calendar days. As a result, some payers will see their deadlines cut in half. Payers will also have to note a specific reason for any prior authorization denials, easing the process for doctors on resubmissions and appeals. This change is expected to save physician practices upwards of $15 billion over 10 years.
Aside from this final ruling affecting prior authorization, states are enacting their own reform. More than 30 states have introduced over 90 bills in their legislation so far in 2024.
Patient experience ratings are rising
Patient experience rates are on the upswing after dramatic lows during the pandemic, per The Leapfrog Group. The organization uses HCAHPS data to assess organizations’ performance on five patient experience measures directly impacting patient outcomes, including:
- Nurse communication
- Doctor communication
- Hospital staff responsiveness
- Communication about medicines
- Discharge information
Despite patient experience measures increasing since COVID, providers and payers may not be prepared to meet new CMS health equity regulatory requirements. According to Ernst & Young’s latest report, the three requirements providers are least prepared for include disparity root cause assessments (21%), culturally tailored services (24%), and social needs referral pathways (27%).
The world of healthcare is changing rapidly. Keeping up with the constant shifts and how they impact organizations in can be a challenge, but healthcare media relations agency Activate Health can help. Since 2010, we have partnered with companies in every corner of this industry, supporting a wide mix of marketing and PR services. We know the ins and outs of creating effective campaigns for our clients and have proven expertise in developing successful healthcare media relations campaigns.
If you’re interested in learning what else a healthcare media relations agency partner can do for you, contact us today.