Panel 4: What to Expect for Health Policy in the Next Administration?

Claire:
It’s now my pleasure to welcome our fourth and final panel to this stage, What To Expect For Health Policy in the Next Administration. I’m thrilled to introduce our moderator, Tanisha Carino, who’s a Partner at Brunswick Group, and our phenomenal, it says right here, phenomenal Chair of our Alliance Board. Tanisha is a healthcare expert bringing more than 20 years of experience across multiple healthcare leadership positions in government, private and non-profit sectors. She provides strategic counsel at the highest levels in the public and private sectors, employing her rare combination of business strategy, government affairs, and stakeholder management.
Prior to joining Brunswick, Tanisha held executive roles as the first Chief Corporate Affairs Officer at Alexion, Executive Director of FasterCures/Milken Institute. She led public policy at GlaxoSmithKline and was the Head of Life Sciences Strategic Advisory Services at Avalere Health. Dr. Carino is a Fulbright fellow, has served as a visiting fellow for the White House Office of Science and Technology Policy, and earned her PhD in health policy from Johns Hopkins University. Tanisha.
Tanisha Carino:
Thank you. [inaudible 00:01:05] Thanks, Claire. I did not tell her to say that. Really excited that you guys are still here in the last session of the day, which I’m extraordinarily excited to be joined by my colleagues, Demetrios and Dan and fellow board members. As you guys read in the agenda, our goal is the capstone of the conversation today. We’re going to talk about the administration. Yes, we’re going to talk about first 100 days, what the executive branch can and can’t do, but we’re also going to talk about the tone from the top and the types of agendas and focus that this next administration may have. And I’m really excited to be joined by these two today because not only are they steeped in government and what government can and can’t do, but they also have a deep investment as investors and a deep focus in the private sector, and in seeing what’s around the corner for us in healthcare and the role the government can have to really scale and solve some of the most challenging issues that we face in the healthcare system and in society.
So with that, let me do a quick round of introductions. It’s not going to be as long as Claire’s because everybody has the bios in your pamphlets. But Dan to my right is the CEO of Morgan Health of JPMorgan Chase and Co. He was previously the founder and CEO of Avalere Health and my old boss, great boss, best boss ever-
Dan Mendelson:
Colleague, I would say.
Tanisha Carino:
Dan was also an operating partner at Welsh Carson, a private equity firm. And before founding Avalere, Dan served as the Associate Director for Health at the Office of Management and Budget at the Clinton White House. Demetrios, next to Dan, has deep expertise in almost every healthcare sector spanning business law and government. Today, he’s a Partner at Team8 Health Venture Foundry, which Demetrios will tell you a little bit more about what they focus on, but he’s also the Director of Paragon Health Institute’s Medicare Initiative. From 2017 to 2021, Demetrios served as the Chief Executive of the Medicare program at the Centers for Medicare and Medicaid Services. He also served as Principal Associate Deputy Secretary and Deputy GC of HHS and working across the department’s vast portfolio.
So with that, I’m really excited to dive right in. There are many people that are in the audience that are probably very seasoned about what happens during a transition, but we also have people listening in on the discussion that may have never really been in Washington. So transition is an exciting time in Washington where you have one set of people that know that there’s an end date to what they’ve got to be able to accomplish, and you have another group of people full of ambition, all about anticipation, probably the most excited they’re going to be before day one. And so maybe we can start with you, Dan. When you’re sitting in a government agency, knowing that you’re going to be transitioning out, what’s going through your mind? How do you think that our colleagues are preparing themselves?
Dan Mendelson:
Maybe I’ll start with transitioning in as opposed to transitioning out, but look, I’ll say about transitions is it is a time of a lot of change, that the incoming crew does have goals, and to the extent that they’re staying disciplined about what those goals are, they’re coming in with very specific plans. What is going to be reviewed under the Congressional Review Act? What is going to be done in the first 100 through executive orders? What can be possible? I’d say that with the passage of time from the Clinton administration where I served up until today, that the views of executive power have gotten more aggressive, and that I would expect this crew to come in with really very ambitious plans about China, about AI, about changing the way that the government is structured and these are really going to be the basis of the EOs and we can talk a little bit about that outside of healthcare. And then within healthcare, also another series of EOs that I would expect to see.
Look, with respect to the outgoing crew, I would expect nothing but very gracious behavior because that is the tone that is being set at the top and that is the conversations, but yet a lot of them are looking for jobs, as probably everybody in this room knows. And so they’re also out looking and they want to make sure that what they’re doing is getting tied up, knowing full well that a lot of what they’re doing is likely to be reversed. When I left the Clinton administration and the Bush team came in, I had worked for about a year and a half on the first draft of the HIPAA regs. And they were completely rewritten by the new team, and you can’t feel bad about that. It’s just the way the government works and the peaceful transition of power is what we’re going to see.
Tanisha Carino:
That’s great. We are going to jump into the first 100 after this discussion, but Demetrios, what are people on the transition team in the President-elect’s community thinking about right now?
Demetrios Kouzoukas:
Well, I’ll just speak generally about transitions.
Tanisha Carino:
And no personnel. We’re not going to talk about personnel.
Demetrios Kouzoukas:
Well, I think that what you’ve got here is a relatively unique situation because you’re talking about a transition of a president who’s already been in office, and usually that’s a very unusual circumstance. So there’s always with transition, a lot of education and learning and getting up to speed on issues, that’s part of the engagement with the civil service. And so in this case, you’ve got an administration at least at the very top that has already had previous experience and a set of beliefs about how government works and some opportunity to have tested that in the past. So that could be something that’s really unique here.
And then in terms of the transition out, I would say that in any kind of situation like this with any job in any administration, you’ve always got to remember that your days are numbered and you never know exactly how long you’re going to have an opportunity to make an impact. And so-
Dan Mendelson:
Sounds like you’re from the mob or something. Listen to that.
Demetrios Kouzoukas:
Well, I don’t know about that, but it’s definitely a sense of-
Tanisha Carino:
More of a countdown.
Demetrios Kouzoukas:
It’s a really unique opportunity to make an impact, and you know that you’ve only got that window of time and everything takes really long in government. And so if you’re an effective leadership team, you’ve been the ideal transition, utopian, I don’t know if anyone has ever accomplished this would be, “Well, we’re just going on schedule because we’ve always planned for this,” but inevitably, there’s always a rush at the end to do things and very few people to do it with because people start leaving too.
Dan Mendelson:
Right.
Demetrios Kouzoukas:
So these are our challenges, for sure.
Dan Mendelson:
The one other thing that I should add, and you’re going to agree with this, is that the career staff, particularly at OMB, HHS and some of the offices are really outstanding and they make the transition happen. And it’s often the case that the incoming team will not meet with the politicals, but rather, get the briefing from the career staff and really get a sense of it. I think in this respect also, this transition is likely to be different because there is some level of distrust of career staff in general, and in particular, in agencies like the CDC where there’s been some concern about what’s going on there. It might be a little bit more frictional this time around, and we’ll just have to see how that one plays out.
Tanisha Carino:
And we are going to get to that towards the end in terms of the idea of the structural reform of government. I want to dive right into the first 100 days. I think that all of us saw the election returns and were really blown away by what some political pundit said was a mandate for Trump to come in and to stand by his commitment, at least in healthcare, to competition, to choice, to dealing with fraud, waste and abuse in some of the areas that he has really emphasized. When you think, Demetrios, for where he can have a quick impact, whether it’s through executive action or by working with the Congress and their authorities under the Congressional Review Act, where are some really issues where he can move quickly?
Demetrios Kouzoukas:
Well, some of that is to be determined based on what the outgoing… Dovetailing on our last conversation. It’s obviously going to be a focus because the clock is ticking again on the Congressional Review Act and the ability to take up some of those things, that one area of focus inevitably is going to be how do we make an impact or changes to what the previous administration has done, particularly where Congress might need to be involved? And I’ll say this was a recurring theme, time is the medium. It’s almost the currency because everything does take time to do, undo, change and build. And so a deep keen sense of awareness of the various timelines and the realities of what needs to be done in order to get things done is really vital, and you’ve got a team here that’s got experience having done that once already. So it’ll be really interesting to see how that plays out.
The other thing I’d say is that to echo what you said about setting the tone at the top, the first 100 days is an opportunity to really send a message about where the priorities will be, even if there’s not specific actions that happen that impact individual people or consumers within those 100 days, or even necessarily legislation or regulations that are issued. There is the opportunity to issue a broad message about what the focus will be, to let people know that you’re interested in new ideas, to sit down and talk to people about what the issues are. And then there’s always the people who’ve been working on an issue for a number of years. Now they’ve got a new set of people they can go and talk to about that issue. So there’s a lot of the day-to-day business of government that also eats up a big part of that 100 days that isn’t really talked about very much, but there is-
Tanisha Carino:
The action governing part.
Demetrios Kouzoukas:
Yeah, yeah. Well, the part that isn’t necessarily specific to a particular ideology or policy change, but the fact is that somebody needs to make a decision and now you’ve got this new set of people who are coming in and they need to make a decision. I remember when I was serving in government, this must have been about 15 years ago now, and the FDA had an issue with peanut butter and salmonella, and it just happened to straddle the transition. And that was a really delicate situation because the new team had to come in and make decisions, and the old team had to make decisions up until the last day-
Tanisha Carino:
Right.
Demetrios Kouzoukas:
And so on.
Tanisha Carino:
Yeah. Well, I think that’s a great reminder. The government has to function and there needs to be somebody making decisions. Dan, when you think about the opportunity to set messages in the first 100 days in healthcare, what do you think are the types of actions or messages that you believe will come out of the White House the second term?
Dan Mendelson:
Well, I think for starters, some of the broader executive orders, China, for example, will have very significant ramifications on healthcare. We still have major supply chain issues with China. If tariffs come in, ingredient costs go up, that will burden hospitals. So there’s going to be stuff like that that happens. A lot of the specific items on a crash card come from China. And so you’re already starting to see now in anticipation of tariffs, some of the cost of those items going up. And so that’s something where broader message, will have downstream ramifications on healthcare.
AI is I think another nice area where every expectation is that there’s going to be fewer strictures and fewer regulations on AI. And we have at Morgan Health, a portfolio of six assets, six companies that we’ve invested in. Four of them are very deeply into various aspects of AI, and they’re starting to change the way that they’re thinking about the regulatory regime coming down the pike. And so I think that will also be true of some of the AI that’s happening within hospitals as well. So for starters, the bigger EOs will have an effect on healthcare.
And then I think it’s really going to be a question of what the administration prioritizes. So for example, the Medicare price negotiation. It would not surprise me, I have no knowledge, but it would not surprise me to see them come in and say, “This is really important.” It only comes into effect in 2026. I would like to take a look at that and I would like to look at the methodology and I would like to look at the timelines and I want to see how everything has been done and just to slow things down a little bit, and not to send a message that drug pricing isn’t important, but rather, to look at it carefully. I would expect the same thing in Medicare Advantage pricing. And so in a lot of ways, I think that the first 100 days will start to define where the range of uncertainty is with respect to policy for a lot of the operating companies that we track and that are tracked elsewhere by other investors.
Tanisha Carino:
Yeah, you started talking already about AI. There’s not a single conference in Washington that doesn’t include AI, including the Alliance, who’s done a tremendous amount of work.
Dan Mendelson:
Yes. Claire.
Claire:
[inaudible 00:14:48],
Tanisha Carino:
As many of you know, and hopefully attending, around what the opportunities are for AI to solve issues from everything from productivity, workforce shortages, but also the balance around ethics and the integrity, the transparency of the data. In those discussions, we found a real difference and even understanding of what the potential could be. You two sit at the bleeding edge of what companies are thinking about when it comes to AI. This administration has laid out some pretty broad parameters for how to think about AI, but we haven’t really seen true policy development when it comes to this area.
I asked this behind the scenes around this idea of Chevron, the Chevron deference and how much can be done through the administration versus the Congress? Is this an area where you guys are excited about what could happen in the next four years? I don’t know which one of you wants to go first.
Dan Mendelson:
I would say as a general matter, it’s my view that we have very strong regulatory regimes in healthcare. So if you’re billing the Medicare program and you submit a claim, you’re subject to the False Claims Act. And if you submit that claim, there should be no difference as to whether you did or a bot did. You’re going to be on the hook for the validity of that claim, and I think that that’s already been established. And so the primary regulatory focus in most cases has already been established.
Tanisha Carino:
It shouldn’t be any different just because it’s AI.
Dan Mendelson:
Well, look, I think in some cases, there are legitimate questions about disclosure and ethics and whether an AI technology is discriminatory, and these are very, very important questions and they need to be cycled through. And then at the same time, you don’t want to act so quickly that you’re either changing the base regulatory regime that an institution has to live under or moving so fast that you inhibit the kind of innovation that many of us expect to see. Look, one of the things that I worry about every day is the cost of healthcare. It keeps going up. The small businesses, large businesses, everybody’s laboring under that. If AI can come in and actually reduce the cost of goods, it could make a huge difference. And so you want to see some level of experimentation, and I think it’s really in creating that balance that things need to be squared out.
Tanisha Carino:
Demetrios?
Demetrios Kouzoukas:
Yeah, I’d echo Dan’s excitement about the opportunity for AI. Of course, we’re all really excited about it. And where I sit as someone who helps build companies and invest in them, we’re really excited about the kinds of things that AI can do for back office functions. There’s so much inefficiency in the healthcare system, so many manual processes and so much data. This explosion of data that has happened in healthcare, it’s something that people have always been excited about, but it’s almost like the dog who caught the car.
Tanisha Carino:
Right.
Demetrios Kouzoukas:
Now we have all this data in healthcare, but how do we make use of it in some way that really makes a difference for individual patients? And so there are so many opportunities in healthcare for AI and the policy… I actually think that the business imperative of making AI that really works and that people trust, and that people are willing to use, that is going to have a really big self-governing function to it that at the end of the day, if it’s giving you inaccurate results, it’s not going to fulfill its business purpose either.
Tanisha Carino:
Right.
Demetrios Kouzoukas:
And as a result, its people aren’t going to use it and they’re not going to be excited about it and it’s going to inhibit the development of the technology. So I think that that’s something that is an under-appreciated aspect of the AI, trust is a built-in business mandate for AI.
Tanisha Carino:
So you don’t necessarily need regulation if the business community interrogates the tools and says, “Okay, we can trust this.”
Demetrios Kouzoukas:
I think it’s a little early too for people to necessarily understand all of the details of exactly how it’s going to be used and where, and where you’ve seen the government agencies really take action is probably in two or three spaces. One is around doing what you said, which is just making clear, “Well, whatever it is that you can’t do without AI, you also can’t do it when you’re using AI.”
Tanisha Carino:
Right. Same rules apply.
Demetrios Kouzoukas:
And that kind of thing is not without value. Some people may view that as saying, “Well, that’s just a throwaway,” but it’s just a clarification. It’s something that’s useful and important at times to clarify because people do have questions. Another area is where the AI is actually a regulated product itself-
Tanisha Carino:
Right.
Demetrios Kouzoukas:
Like FDA. It’s a unique circumstance, if you will. So then maybe I’d put that in its own bucket. And then the third is around what Dan talked about with regards to disclosure. And I think you’re seeing the states start to experiment with that a little bit. I think Colorado, maybe Utah, a couple of states who have some legislation that either passed or is pending around transparency, and it’s interesting to see how that plays out. And you’ll see different states take different approaches, but a lot of that is also something to be determined because when you’re talking about a back office function, what does it mean to say, “We’re transparent about the use of AI?”
Tanisha Carino:
Right.
Demetrios Kouzoukas:
If the AI was used to prioritize who got a phone call-
Tanisha Carino:
Right.
Demetrios Kouzoukas:
Or who got assigned with that phone call, is that really useful to read a disclosure to a consumer? What is that going to mean? So I think a lot of that’s got to play out.
Dan Mendelson:
I’d add a couple of things to what you said, agreeing with all of it is that first, with respect to the FDA, there is a lot of technology that is coming into the FDA that is based on AI now in one aspect or another, whether it is the way that continuous glucose monitors work or other technologies, and a lot of the data-driven technology is being created using AI. And one thing that I am worried about is having requisite expertise within the FDA to actually look at it well and for the FDA and other regulatory bodies to have salary flexibility to bring in good people. I see this a lot at JPMorgan Chase. There’s a group of about 25,000 people who do AI and the salaries in that area are formidable, and for good reason because there’s a real competition for talent. And then I think over what’s happening right now within government and it’s a problem. So that’s thing one.
The second thing that I’ll mention again, based on Demetrios’ comments is that we still have an issue with respect to who owns data, who owns the data in this country, in the sense that I think that a lot of people and policymakers would think, “Well, the patient owns her own data.” It’s a thing, but yet anybody who’s actually tried to get their medical information has seen that it doesn’t really work that way. And in terms of disclosures and being able to have some say over what happens to your data, you do a lab test, where does that data go? You have no idea. And what is it being used for? You have no idea. And so there’s still a lot of unanswered questions I think, around these issues that then pertain to the training of AI models and the like. And so those are things that I think also need to be sorted to add to your list there.
Demetrios Kouzoukas:
And I think that also plays into this business imperative trust factor. And when you go to the pharmacy and they say, “Well, what about this other medication you’re taking that you never filled there?” And then people will start having questions. They want to understand, “Well what happened and how did that happen?”
Dan Mendelson:
Right.
Demetrios Kouzoukas:
And that’s not really necessarily AI. It’s just [inaudible 00:23:14].
Tanisha Carino:
I think there’s this, in some ways, growing recognition that we are in a period of time with this administration coming in, to your point, Demetrios, they’ve been in before. So they know exactly where all the skeletons are, and a mandate from the American people that the institutions that serve them may not be serving them the way they wanted to be served. So yesterday, we saw the announcement of Elon Musk and Vivek being appointed to this… I didn’t know if it was a DOGE or DOGE, but the real focus of this entity or this group would be to work with OMB, to look at areas of structural reform.
And not to put you guys on the spot for your own list, but we just talked about data. In healthcare, there is so much friction that all of us as consumers of healthcare face all the time where we’re like, “Why does it have to be this hard?” Where do you think stakeholders and the consumers are going to be writing letters to this group to say, “Please look at how government can function better in these areas?” We’ve covered off on data, but where are other places?
Demetrios Kouzoukas:
Well, I think everything will become an issue. It becomes also another opportunity to carry forward an issue. So every-
Tanisha Carino:
There’ll be lots of complaining, but where do you think it will intersect with where there is reinforcement for why this particular administration was elected?
Demetrios Kouzoukas:
I think that one interesting question for that effort is going to be do you look at immediate impact? What is the cost of the overhead operation of government? Or do you look at where is the government process or regulation inhibiting competition or efficiency in some way? Where some kind of modest or major change might unlock a much bigger change down the road? Or do you look at just dollars flowing in and out regardless of what the government apparatus is? There’s a lot to focus on. All three of those could be different possibilities, but that’ll also determine the intersection. I think there’s a lot undetermined yet.
Tanisha Carino:
Yep. Dan, do you have a point of view on this, having been the OMB pad?
Dan Mendelson:
Yeah. I have a few points of view on this. I remember actually, one little anecdote of coming in and the Head of the OMB Health Career Staff, Barry Clinton, and basically said, “We have a file cabinet and it has all the offsets in it.” It’s this huge file cabinet and it’s like, all right, so what’s in there? There are mechanisms for every payment system and there are dials on every payment system, and there are ways that you can reduce Medicaid spending. There are pros and cons for every offset, and when a new administration comes in, the file cabinet comes open, the offsets are on the table, you start thinking about these things.
And I think the real question in my mind for an administration that’s coming in that has a lot of really creative thinkers and people who are out of the box and don’t feel like they should be burdened by the physics of government-
Tanisha Carino:
Right.
Dan Mendelson:
Is, are going to be things that come in that are really innovative that are just different? And I don’t know the answer to that question. And so I think about the Medicare payment systems, which Demetrios knows a lot more about than I do, or do you move into a world where it’s Medicare Advantage for all and you try to get that through the Congress, but then you deal with the physics of the Congress and the idea of a Medicare cut. So look, I think that whenever you think about offsets, one person’s revenue reduction is another person’s offset. Or put differently, it’s like every time you try to cut something, you’re taking money away from somebody else in healthcare. And those interest groups are still there. The pros and cons are still there. All of the physics of the payment systems are really still going to be there.
Now, I want to say just a word about the civil service. One of my frustrations coming into government having worked in the private sector was how rigid the civil service rules are and how it’s so difficult to shake things up, reassign, be more flexible, change the structures of an organization. And I had another memory of who came to be my dear friend, Barry, where he basically said, “Look, this is the structure that we have,” and you don’t want to try to change that because it would take way too long. It’d be way too difficult and there are all these rules in place that would prevent you from doing it.
And I accepted that and moved on and did a bunch of things, including the Children’s Health Insurance Program and all the policy work that I wanted to do. But I left with a feeling of real frustration about how ossified these government structures were and how that really limits the ability of government to do creative and interesting things. And if they can figure out a way around that so that maybe FDA can pay a $400,000 or $500,000 salary to a lead in AI to really be able to do that, and maybe then be more efficient in some other areas. If they can figure out a way around that, I think we should all really welcome it.
Tanisha Carino:
Demetrios, point of view on…
Demetrios Kouzoukas:
I’d say that with respect to each of the areas that I mentioned and the kinds of things that Dan is talking about, that there’s two ways of keeping score. We talk about offsets, either Dan talks about offsets for example. And so the focus largely often within government is around the formal score about what resulted in a reduction or an increase. And the way that those numbers are calculated and kept is based on a long history of precedents and specific assumptions and ways of calculating. Sometimes they don’t always play out.
Dan Mendelson:
Right.
Demetrios Kouzoukas:
The history tells us that they aren’t always accurate.
Tanisha Carino:
Right.
Dan Mendelson:
That’s true.
Demetrios Kouzoukas:
And at some level, the purpose of scorekeeping is to create a level of predictable analysis that both sides can use. That’s at its best when it’s designed to do, but it is not necessarily always the best predictor of what actually happens in the real world. So I think that one possibility we have here is that because this structure is outside of government and it’s traditional strictures is a possibility that it’s looking at things that don’t necessarily correlate perfectly to how government scorekeeping is done.
Tanisha Carino:
Right.
Demetrios Kouzoukas:
And that creates opportunities possibly to make changes in ways that aren’t cabined by that set of rules or precedent.
Dan Mendelson:
That’s really true. Actually, and a great example of that is dynamic scoring and tax. We haven’t talked a lot about tax, but that’s going to be a major focus of the first 100 days, and that could very profoundly affect healthcare in all sorts of ways. Tax deductibility of health healthcare is one example, but really, all different aspects of it. And so in a world where you’re thinking creatively not only about the policy, but also about the fiscal effects of that policy, we should expect to see some different kinds of proposals.
Tanisha Carino:
Well, in a tee up to the Alliance’s agenda for next year, as many of you all know, the Alliance is going to be hosting its signature series, Focus on Aging. It’s an issue that we have been watching closely as everybody knows about the silver tsunami. And no administration’s going to get away from the questions on how they’re going to continue to care and be able to afford caring for our elderly population. What do you think are going to be the most top of mind issues as it relates to the aging that we’ll see? And I wouldn’t restrict ourselves to just Medicare or Medicare Advantage, but what are the types of conversations that need to be had to actually really get ahead of what we see as the demographic shifts?
Demetrios Kouzoukas:
I would say that the question of the role of the caregiver, because you’ve got the sandwich generation. You saw that in both campaigns having proposals around-
Tanisha Carino:
I think we’ve all been in that sandwich generation recently.
Demetrios Kouzoukas:
And definitely in the audience out there in the world too.
Dan Mendelson:
Yes.
Demetrios Kouzoukas:
So that’s a big pressing question for people.
Tanisha Carino:
Do you see the tax policy being part of the solution for caregiving? Where do you think that can go?
Demetrios Kouzoukas:
That’s definitely been floated and it’s another lever, another tool that can be used. Part of this is financial, but part of this is about time. And so I think another aspect of this is about technology because technology can possibly extend someone’s reach, someone’s ability to manage something within the time they have. Obviously money helps, but at some level, there’s just a point at which it takes just time, and my hope is that technology can make that difference. But the way that we pay for technology and healthcare is often basically rooted on systems that were developed to pay for things that before there was any notion about something like what we’ve got going on today, both in Medicare and beyond. And so that’s a disconnect here.
Tanisha Carino:
Yep.
Dan Mendelson:
I like those two. You got to add just the delivery system and the deterioration of the delivery system right now, and difficulty that seniors have in care navigation, particularly outside of MA. In MA, care navigation gets easier. And then all of the issues around care denials and what’s included and what’s not included in MA versus not. So I think the technology issues are so hopeful and it’s a major area of investment for us, as well as for Demetrios. Anything that we can do to accelerate the evolution of technology that is cost-saving or improves quality and reduces costs, that’s going to be the focus of investors, but it takes time to develop these products until they’re really actionable. And I think that there is this period of time right now of five years, whatever it’s going to be, where we really have to get our handle on like what is the experience of that individual, of that senior going through the healthcare system before that technology is ready for prime time and comes to the market? And that’s a more difficult question in a lot of ways.
Tanisha Carino:
Well, I definitely am very interested on the caregiving side, particularly you couple the caregiving burdens with the fact that so many people don’t live in the same geographic location as their family members or siblings are all over, and you hope that there’s some technology fix to all of it. Right? It makes it just easier to patch into the doctor’s offices and be like, “No, that’s not actually what the doctor said, mom.”
Dan Mendelson:
Right.
Tanisha Carino:
Right?
Dan Mendelson:
Right, but in the meantime-
Tanisha Carino:
We’ve all been there, right?
Dan Mendelson:
In the meantime, if it’s going to cost more money, it’s not going to… We’re not in an expansionary environment right now with respect to tax.
Tanisha Carino:
No, and I think when I hear about all these great technology, I think we’ve all also assumed that our insurance benefits’ not going to cover it. So it’s all more cash outlays for the consumer. And so do you see a conversation about affordability that is not just… It was fascinating in the panel. The first panel was the first panel I’ve ever heard that said when people say affordability, they’re not just talking about drug prices. We’ve been talking about high drug prices forever, but people are finding the affordability, whether it’s surprise billing, whether it’s at network payments, insurance feels it’s not covering what it used to, and there are more technologies that are going to be helpful, but it’s all cash-based. So where is that conversation going to go?
Dan Mendelson:
I think it really varies a lot, because it’s not all cash-based. So for example, we’re just about to invest in a company that provides advanced autism care for kids and talk about caregiver issues. It’s huge. And one of the things that’s been very interesting about spending some time over in the employer side, which I’m going to guess like many of you have not been over there, but it is an interesting world. And I want to say that spending a little bit of time there is very instructive, but hearing from parents who have kids with autism is really sobering in terms of the care delivery issues, the difficulty in finding good care, the amount of time that it takes to really care for these kids.
And so we’re investing in this company. They have better outcomes, lower cost. They are willing to take risk on the basis of outcomes, and they’re starting to be covered by insurance. And now what we’re going to help them with is getting covered in more context to really grow this technology to alleviate the caregiver issues, not only in our population at JPMorgan Chase, but also nationally. And so there are ways that we can get at this in some cases, and I think that’s the work.
Demetrios Kouzoukas:
There’s some promising opportunities here that I see around personalization benefits.
Tanisha Carino:
Yes.
Demetrios Kouzoukas:
So in Medicare, you’ve got Medicare Advantage and supplemental benefits. In the employer market, you’ve got point solutions of so many different sorts that are being offered work with a company that is in that space. And what it brings home for me is that different things work for different people. People have different needs. And so a one-size-fits-all approach isn’t going to work. And so now, the positive development here is that there are opportunities to access these more personalized benefits.
And the question will be how do you make that manageable? And it’s on the cost side. What makes them affordable now, working within the existing structure is early identification and narrow targeting of where they can be most beneficial, assuming that the employer or the plan has a flexibility to target those benefits, which is something that in the Medicare program was done some years ago. In terms of the uniformity of benefit rules.
Tanisha Carino:
Right.
Demetrios Kouzoukas:
I don’t want to get too far into the weeds of regulatory analysis here, but on the employer side, it’s an administrative question. Can the TPA or the insurer effectively manage a benefit? That varies by individual, but the fact is that if you can target people early enough and target the people for which the technology is going to make a big difference, then it changes the whole economics around being able to afford it. And AI is going to play a big role in that too.
Tanisha Carino:
Yeah, it’s exciting to hear about the types of things that you guys see every day that could be really transformative to patients and to caregivers and families. And in any transition, change is afoot in every way. And I think that our anticipation for the next four years is that this is a window where we could see even more change to the role of government in healthcare than we may have seen in our lifetimes. And so I’ve really enjoyed the conversation. I think we’re leaving our participants with a very uplifting note for where the future may be going and where the opportunities may be in this window to actually seize upon things that could really change people’s lives.
So with that, I’d like to thank everybody. This is our final panel. I hope I see most of you at the reception.
Dan Mendelson:
Thank you.
Tanisha Carino:
And thank you for joining.