In this episode, Weekly Dose Podcast host Ira Apfel looks back at the big health care stories of 2021 and looks ahead to the trending storylines of 2022.
It's been an incredible year in health care, so we thought this was a good time to look back at where we started, and try to get an idea of where health care is headed for 2022. COVID-19 dominated health care news, of course, but there were many other critical topics, including the expansion of the Affordable Care Act, health equity and disparities, the IPO boom, drug pricing, artificial intelligence, gene therapy, and more.
SPEAKERS
Srinivas Sridhara, Rhonda Randall, Ira Apfel, Kristy Duffey, Matt Vesledahl, Zach Sopcak, Krista Nelson, Erin Satterwhite, Jill Hagenkord, Amy Shaw, Natasha Hennessy
Ira Apfel
Hello, and welcome to UnitedHealth Group’s Weekly Dose Podcast where we'll get you up to speed on the latest trends shaping the future of healthcare. Please subscribe to the weekly dose. Now on Apple podcast and Spotify. This is the final episode of the year; we'll be off until January 6 to recharge our batteries. But the weekly dose will return in 2022. With all new episodes covering delays, trends, shaping the future of healthcare. It's been an incredible first year for the podcast. So we thought this was a good time to look back at where we started, and trying to get an idea of where healthcare is headed for 2022. So we're gonna begin with COVID-19. Of course, I think it's safe to say that the pandemic dominated healthcare news for the second straight year, and the weekly dose was on top of the story. We brought listeners unique stories about the pandemic, including COVID-19 impact on Latin America, and how special needs groups are getting vaccinated. Back in May, when COVID-19 cases were surging in Latin America, Amy Shaw, CEO UnitedHealthcare global discussed COVID-19 has impact on the region.
Amy Shaw
With the with the rise of COVID and the second waves in South America, we're seeing a larger number of people needing to be on ventilators. And that's creating a supply issue not just for our business, but for the country's quite frankly, of certain drugs that are needed to intubate people in order to put them on ventilation. And I'm proud to say that the power of the global reach, you know, through our efforts, we've been able to source various medications in partnership with our colleagues at Optum, in partnership with drug manufacturers and other distributors across the globe to get the much-needed medications into country so that we can continue to treat COVID patients as well as other patients who are seeking care.
Ira Apfel
Later in the year, Natasha Hennessy, Chief pharmacy officer for Genoa health care, explained the challenge of helping people with behavioral health issues get vaccinated.
Natasha Hennessy
Yeah, so Genoa is one of Optum Rx's pharmacy care services lines of business, we have almost 600 locations, we actually opened number 582. Today, in Connecticut, we have those 600 locations are located within 47 states and the District of Columbia. And generally they are co located within a community mental health center. Genoa is the largest behavioral health care pharmacy in the United States. And we really focus on specializing in serving the needs of those with behavioral health, addiction and complex chronic issues.
Ira Apfel
In response to the pandemic, the Biden administration opened a special enrollment period for uninsured Americans with additional subsidies to make that coverage more affordable. And in May, Krista Nelson, Chief growth officer for UnitedHealthcare government programs explained the impact of those changes.
Krista Nelson
Actually, as of yesterday, we just heard from Biden that over a million people have actually enrolled through healthcare.gov, since February 15. Which is, which is amazing. Again, for context, at this same time, last year, there were only about 391,000 people. So this is, you know, almost three acts of that. And really, it's probably broader than that 1 million because that's really just those who are enrolled in healthcare.gov. And there's people who also enroll directly with their state-based exchanges. So yes, a lot of people are signing up. And in context, you know, we at UHC also participate on the exchanges. We expanded our footprint this year into seven new states. And just like the market is seeing, you know, we've seen growth during this special enrollment period, about 20% of our members are actually coming through in these growth markets during this SCP since February 15. And so signaling that our offerings are really continuing to resonate. And we're also seeing that growth in the market.
Ira Apfel
There were many terrible consequences of pandemic, and none more so than the impact it had on health equity. Simply put, the pandemic exposed deep inequalities in health care in America.
Dr. Rhonda Randall
Prior to the pandemic, access to care was improving across the states, the uninsured rate went down substantially went down by 37%. Their period measurement years we're between 2010 and 2014 was the baseline and then we compared it in the years reported between 2015 and 2019. So in that period of time between 2010 and 2019, the uninsured rate in the United States went down 37%. That's something to pay attention to. Another thing that we saw was, although the rate of uninsured among American Indian and Alaska Native populations in Wyoming, it was significantly higher than the uninsured population, the white populations in DC, so you see those differences between race and ethnicity and geography. So all those gains were not experienced equally. Another really good example, infant mortality rates. We made progress with infant mortality rates in the United States. Those also continue to go down. It went down in 22 states between the measurement period year 2003, and 2006, and fast forward to 2015 to 2000 and in 2018. However, despite those national gains, we still see disparities between races, black infants are almost three times more likely to have infant more experienced infant mortality that is death before the first birthday 2.8 times higher than their Asian and Pacific Islander counterparts.
Ira Apfel
That's Dr. Rhonda Randall, Chief Medical Officer of UnitedHealthcare E&I explaining why health disparities are so stark in America right now. Meanwhile, Dr. Janice Huckabee, Chief Medical Officer maternal child health with Optum population health services discussed one particularly troubling health disparity, the mortality rate for expecting black mothers compared to white moms to be
you know, we do know that each year 700 women die of complications related to childbirth, and that African American women are two to three times more likely to have that happen than their white counterparts. And similar discrepancies exist when it comes to near misses or complications, such as hemorrhage requiring transfusion, etc. This issue is not one that we can say, Oh, if you just do X, then you'll get Y there's so many widespread contributors to maternal health outcomes that having partnerships is crucial. No one entity could do it by themselves, not the government, not health systems not provide physicians. And so I think that's one reason that United has, has done that in terms of partnerships. And I'm really proud of the fact that yes, we do have partnerships with organizations like March of Dimes with big national footprints. But we also have partnerships with local organizations and their communities that are having a huge impact like cradle Cincinnati, in Ohio, that's had a very positive impact on women's health and infant health. And so I think that those partnerships, distributing them between large and then small, is a crucial aspect to success.
Ira Apfel
There were other health care stories in 2021. Among them, was the growth in health care IPOs and SPACS, Zacks Sopcak, Vice President of Investor Relations with UnitedHealth Group visited the podcasts to break down the trend.
Zach Sopcak
First would be an unprecedented amount of fiscal stimulus within the financial markets dating back to the last the big Great Recession in 2008 2009. Second would be, you had outsize market returns. So if you look since the lows in 2008 2009, the US market, and this is going on all over the world, by the way, is up over 500%, you know, annualized return of about 18%, which, compared to the 140-year history of the US stocks exchange, the average has been about 9%. So you've really seen excise outsized growth over the last dozen years or so, which has made it more attractive to be a publicly traded company to search for funding.
Ira Apfel
Another big healthcare trend, drug pricing. The Trump administration tried to address it, and the Biden administration is working on it as well. In this clip, Matt Vesledahl, a senior vice president with UnitedHealthcare offers his perspective on lowering out of pocket cost of prescription drugs for consumers.
Matt Vesledahl
I think we have to be innovative; I think we have to; we have to start thinking differently around how to protect our members and really drive costs. And then we have to make sure that you know, the right drug is used for the right person at the right price at the right time. 90% of their drugs. 85% of the drugs that are dispensed are generic drugs, and they're relatively affordable from a cost perspective. We just need to continue the journey to making sure people are getting to those generic drugs where they're available. We need to make sure that we're out covering those drugs first, incentivizing members frankly, to make the right decision when it's when the physicians prescribing for them, allowing them to have enough information to ask the appropriate question around what alternatives exist For me, and how do I get the lowest price possible? And then when they make those good choices, how do we share the value with them. So not only do we lower premiums or lower overall cost, but is there incentive that's that we could put in the hands of the member, when they're making a personal choice to get to a lower cost alternative, that kind of thinking needs to proliferate as far as I'm concerned.
Ira Apfel
Now, let's take a look ahead to 2022 and the future of healthcare. We had many guests visit the weekly dose podcast to discuss cutting edge products and services. Simply put, health care's future is now our most popular episode of The Year featured Srinivas treater, a vice president of enterprise data strategy and data science at Optum. Explaining the latest artificial intelligence developments in healthcare.
Srinivas Sridhara
I like to bucket sort of domains into a few areas where I think people are investing time and energy today. One is on things that are operational tasks, you know, so a little bit you mentioned it around, say reimbursements or accurate diagnoses. But this has expanded over time to sort of think about risk capture or claims processing prior authorizations, fraud detection, all of these things we do routinely, in an operational state in healthcare, and they are costly activities. And so there's real opportunity for AI. And I think increasingly, there's a focus in these areas. The second bucket is saying clinical applications. So you mentioned diagnoses, or even when we think about things like wearables, it's all around trying to understand why you know, somebody is going to get sicker in this moment, or have an increased risk of an illness or utilization, or can we help them by intervening sooner, or provide other support services. And so there's a lot of things in that space as well, that you see, and less than, than that, in some ways, you know, so maybe on actuarial methods, and so forth. So I think, especially in the last year and a half or so, there's been quite an acceleration of interest and understanding of some of the various use cases in AI. And folks are starting to really both invest and start setting some meaningful targets
Ira Apfel
around them. Later in the year, Erin Satterwhite, president and general manager of Optum frontier therapies joined the podcast to explain why treating rare diseases is so difficult. And she detailed, bold new plan to address the challenge.
Erin Satterwhite
Optum Frontier therapies was an innovation that we recognized was necessary in the market as the growth of these complex therapies, treating very complex patients is only going to increase. And we took a step back and said, what do patients need, what the providers need, what two pharmaceutical life science companies need, and what the payers need, as this marketplace starts to grow in an unprecedented way. And what we found was that the complexity of care and the cost of these therapies, were creating challenges in the existing sort of way of doing business and specialty pharmacy, in distribution and in commercial services. So we actually designed the business by listening to the people that we're serving, we did about a year's worth of market research and understanding the needs of what we call the four P's which are those four constituents I mentioned. And what we developed was a model that has Ultra specialized distribution with wholesale licensing, a rare disease pharmacy that has a focus on the high touch white glove service that's required both in the logistic support as well as in the patient care and an ongoing management
Ira Apfel
Genomics got it's turn in the spotlight on the podcast as well. In this clip, Dr. Jill Hagen court of Optum genomics discussed a potential new advancement in the field of genomics.
Jill Hagenkord
Yeah, UnitedHealth Group is really in a unique position to be able to kind of, quote unquote, unstick precision medicine, right, because we can impact really, both of the two big problems that I described, we can, you know, increase our you know, the quality standards for the test that we pay for. And there are certainly you know, some efforts in the industry that have been going on in this direction already. An example of this would be a program called mold X app palmetto, which is a one of the Mac's for Medicare, and they do quality checks of the tests before they'll cover you know, or even consider them for coverage. And so kind of carrying on in that in that same vein, there are certain groups in Optum that are exploring ways that we could maybe help the industry by checking in to make sure that there's more quality in these tests. And then my team is also standing up a program that we're calling it evidence engine when we were talking about it amongst ourselves. And the purpose of this is to actually help the test developers understand the evidence they need, and then help them get that evidence more quickly than ever before. So with the assets that we have at Optum and, and UHG generally, and with the skill sets that we have, we're able to kind of pull this data together from either preexisting datasets, or in you know, potentially partnering with a teams that Optum OptumCare Research Institute, or other places where you can deploy a research program and facilitate the development and proper development of this evidence so that payers and providers can more easily and quickly make an informed decision about coverage and utilization.
Ira Apfel
We would be remiss if we didn't spotlight one of the most important groups in health care, nurses, Kristy Duffy, chief nursing officer with Optum came on the podcast to explain why she is optimistic about the future of nursing, even amid the pandemic.
Kristy Duffey
I definitely feel optimistic. I mean, this is something I've been a nurse for more than 25 years and something that I've never experienced in my lifetime. And just to see the teamwork and all of us coming together and seeing the glass half full versus half empty and supporting each other. I'm really optimistic about this bringing the nursing profession closer together, and that the world really needs us and depends on us and, and so I think it's been a catalyst to, to bring us together more.
Ira Apfel
So that's a look back at 2021 and a look ahead to the New Year. I'm Ira Apfel and on behalf of co-host Evan Sweeney, and our indispensable sound engineer, Mark Ukura, and everybody else on team weekly dose. Thank you so much for listening. And, as always have a great rest of your week.