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Business Journals
3 days ago
- Health
- Business Journals
2025 Connect in Nashville: Setting the agenda for health care's future
Eroding trust, soaring costs, accelerating AI and an exhausted workforce are testing the limits of even the most resilient organizations. This fall, the most influential voices in health care will unite to define what comes next. At the Health Evolution Summit XV, leaders laid the groundwork for what's ahead. Dr. Mehmet Oz, administrator of the Centers for Medicare and Medicaid Services (CMS), sparked a critical conversation about leadership in health care amidst a shifting societal landscape. He emphasized that the new administration is eager to work with industry leaders to ask difficult questions — not to assign blame for current challenges, but to reexamine the fundamental issues driving health problems. Oz called for a renewed focus on tackling root causes while offering a fresh perspective on the responsibilities of leadership in shaping the future of health care. As the health care landscape continues to shift, the Health Evolution community is stepping up to set the agenda. With the next administration taking shape and the need for clarity and collaboration more urgent than ever, 2025 Connect will bring together the leaders driving real progress — defining priorities, informing policy and shaping a system built to serve. expand WILDE COMPANY PHOTO Experience 2025 Connect in Nashville Join Health Evolution from Sept. 7-10 at the JW Marriott in Nashville for 2025 Connect. This event offers a unique opportunity to immerse yourself in the collaborative energy of our unmatched community of executive leaders and engage in authentic, off-the-record discussions that drive industry transformation. At 2025 Connect, you'll be at the heart of cross-sector conversations with industry leaders, innovators and stakeholders. Our agenda fosters genuine interactions and collaborative problem-solving, providing an in-depth look at the challenges and opportunities shaping the future of health care. What to expect at 2025 Connect Over four days, you'll engage in dynamic discussions on the critical issues reshaping health care. You'll engage with thought leaders on deploying AI to address health care's toughest challenges, advancing equitable innovation, scaling effective care models, navigating policy change and more. Our conversations will go beyond the headlines to explore the underlying factors driving change. You'll gain insights on overcoming industry challenges, driving innovation and discovering transformative strategies. This is your opportunity to delve deep into the factors that will define the future of health care. expand WILDE COMPANY PHOTO At 2025 Connect, you'll have the opportunity to hear from and collaborate with health care's leading experts and decision-makers. Here's a glimpse of the topics our leaders will be tackling on the main stage: Crisis in confidence: Reckoning with consumer pain points, public sentiments, and loss of trust Reckoning with consumer pain points, public sentiments, and loss of trust Reengineering the consumer experience: Confronting the friction that fuels frustration Confronting the friction that fuels frustration Navigating the new policy landscape: Deciphering the latest developments and charting the course ahead Deciphering the latest developments and charting the course ahead Leading despite uncertainty: Finding untapped opportunities and inspiring bold action Finding untapped opportunities and inspiring bold action Putting AI to work: Deploying technology against our hardest challenges Deploying technology against our hardest challenges Delivering better care: Scaling effective models for treating chronic disease and an aging population Scaling effective models for treating chronic disease and an aging population Unlocking the full promise of personalization: Empowering longitudinal health and wellness Empowering longitudinal health and wellness Community milestone: Celebrating the 10th confab for advancing women in leadership Unlock your role among the brightest minds in health care Health Evolution Connect is your opportunity to be at the forefront of health care innovation. Engage in collaborative discussions, explore groundbreaking solutions and gain insights that will drive the future of the industry. Be part of a community that is not just observing change but actively driving it. Connect with top experts, uncover cutting-edge strategies, and redefine the future of health care. This event provides a dynamic environment where you can influence the industry agenda and explore pioneering solutions to today's most pressing challenges. Secure your spot today.
Technical.ly
4 days ago
- Business
- Technical.ly
To make government more efficient, we must first make it more effective
In 2013, when a scrappy group of Silicon Valley technologists was brought in to help fix they were taking part in a paradigm shift. The service's public failure helped expose the government's need for modern development methods supported by vendors who use them. Eventually, the successful effort to stabilize and rebuild empowered innovators within government to advance much-needed changes. Nava, a public benefit corporation aiming to make government services simple and effective, emerged from the effort to rebuild Our founders, who were among those Silicon Valley technologists, officially formed Nava in 2015 after working with the Centers for Medicare and Medicaid Services (CMS) for nearly two years. They recognized that a modern, human-centered approach to technology could help public institutions operate more effectively and efficiently, which in turn could restore people's trust in government. We're celebrating 10 years as a company this year, and we're still helping governments at all levels build simple and effective services. This experience demonstrated that often, the government has the technology and capabilities to provide excellent services, but complex procedures hinder modernization. Government efficiency is ultimately a byproduct of effective systems, structures and processes. So, to get efficient, we first have to get effective. This means prioritizing outcomes over procedures, holding vendors accountable, and reforming government funding. Prioritizing outcomes over procedures Whether it's getting money in the hands of unemployed workers or ensuring veterans can file claims for disability benefits, outcomes are unequivocally the foundation of restoring public trust. Yet more often than not, government procedures prevent civil servants from delivering effective services. When starting up a new project, it's not uncommon for government agencies to mandate complex, years-long requirements-gathering exercises with immovable deadlines. This can make it impossible to rapidly adapt to new challenges or opportunities. Jen Pahlka, founder of Code for America and the United States' former deputy CTO, writes about this in her book, 'Recoding America.' 'Requirements are the foundation of software development processes in government, and the source of many of its failures.' The results of such procedures are Kafkaesque services that check all the boxes except the most important — working well for the public. To operate more efficiently, we must prioritize outcomes over procedures. This means forming tighter feedback loops between policymakers and those implementing the policy, as well as simplifying bureaucratic requirements. It means allowing implementors to be flexible and accountable in achieving the 'what' without upfront prescriptions from higher-ups on the 'how.' It means acknowledging the layered complexities of government modernization rather than designing processes that ignore them. Unnecessary complexity is the biggest driver of government costs in the long term. Meeting the public's needs from the start, mainly by crafting outcome-driven policy and practicing rapid human-centered implementation, is the most effective way of keeping costs low and sustainable. Holding vendors accountable through true competition Frequently, this accountability comes down to how agencies procure services from vendors. If they solicit services solely based on whether the provider has done similar work in the past, then winning bids will always come from the same vendors. Knowing they virtually can't lose, these vendors have little incentive to bring innovation and new perspectives to delivery. Time and time again, we've seen the harm of vendors who dominate contracts or markets by locking government into their products or services. Reforming government procurement can help set a level competitive playing field. Crisp procurements that ask vendors to demonstrate their capabilities are much more effective than complex procurements that require several-hundred-page bids. Not only does this ensure that the winner can actually perform the work, it also gives opportunities to others who have the delivery chops but maybe lack the same on-paper experience as a massive firm. If a vendor is under-performing, the government must be empowered to fire them. Government contracts have option years — essentially, elective contract extensions — for this very reason. Reforming government funding We cannot seriously discuss reform and efficiency without talking about the money. As of now, Congress allocates funds to federal agencies per fiscal year. Funds don't roll over year-to-year, encouraging agencies to construct budgets around these individual timeframes — not value or multi-year outcomes. The annual funding cycle also inhibits effective modernization. Frequently, government frontloads project spending and then rapidly shrinks the budget as the project enters maintenance. The problem is that the system will eventually need to be modernized, demanding even more resources than it took to build in the first place. By contrast, most modern software projects ramp up slowly as teams conduct discovery research, engage with users, and prototype and test solutions. Working this way promotes continuous improvement and greater adaptability to people's changing needs while avoiding costly modernization spikes. It also ensures that the software evolves daily and maintains stability. Annual funding cycles favor the former way of working. To enable the latter way, Congress must increase funding slowly and incrementally. Changing how our government allocates funds is a massive structural undertaking, but it's also essential if we are serious about using software to operate more efficiently. Looking inward In 2024, over three-quarters of Americans said they did not trust government to do what's right. Despite modest improvements over the past few years, the vast majority still do not feel supported by our institutions. As civic technologists, we must continuously evaluate our successes and, more importantly, our failures, and leverage those insights to work more effectively. The stakes have never been higher.
Newsweek
5 days ago
- Health
- Newsweek
US Health Plans Roll Out Major Reforms
Based on facts, either observed and verified firsthand by the reporter, or reported and verified from knowledgeable sources. Newsweek AI is in beta. Translations may contain inaccuracies—please refer to the original content. U.S. health insurers will implement new steps to streamline prior authorization requirements for medications and medical services. Health and Human Services Secretary Robert F. Kennedy Jr. and Dr. Mehmet Oz, director for the Centers for Medicare and Medicaid Services, announced the health insurance changes during a Monday afternoon press conference. According to the industry trade group, America's Health Insurance Plans (AHIP) insurers aim to establish standardized data and electronic submission protocols for prior authorization by January 1, 2027. This is a breaking news story. Updates to follow.
The Hill
5 days ago
- Health
- The Hill
Watch live: RFK Jr., Oz news conference
Health and Human Services Secretary Robert F. Kennedy Jr. and Centers for Medicare and Medicaid Services Administrator Mehmet Oz are scheduled to hold a news conference on Monday afternoon. Aides say Kennedy and Oz will discuss 'a breakthrough in health insurance that will improve access to care for millions of Americans.' Watch the event, scheduled to begin at 2:45 p.m. EDT, in the player above.
Axios
20-06-2025
- Health
- Axios
Trump admin shortens ACA enrollment window
The Trump administration on Friday narrowed the period to sign up for Affordable Care Act coverage and imposed other restrictions aimed at rolling back Biden-era flexibilities for the program. Why it matters: The Centers for Medicare and Medicaid Services expects the new policies to lower marketplace premiums by about 5% on average, and save taxpayers $12 billion next year. But between 725,000 and 1.8 million people are expected to lose coverage, per CMS's projections. The big picture: Congress is considering codifying many of the same provisions in the massive GOP budget bill that's now in the Senate. That would make them much harder for a future administration to undo. State of play: CMS is shortening the period for enrolling in marketplace insurance by two weeks, starting for plan year 2027. Federal exchanges will then be open for sign-ups from Nov. 1 through Dec. 31 of each year. It's also repealing the monthly opportunity started under the Biden administration for lower-income people to get marketplace coverage. The new rule limits plans' ability to cover gender-affirming care beginning next year. It also excludes Deferred Action for Childhood Arrivals (DACA) recipients from obtaining ACA coverage. CMS said the policies will ensure federal subsidies to offset the cost of ACA coverage only support statutory goals of the law. Yes, but: In response to public comments, CMS is making several of its changes temporary. For plan year 2026 only, CMS will begin charging a $5 monthly premium for consumers who are automatically reenrolled in an ACA plan from one year to the next and would otherwise have fully subsidized coverage. Other changes concerning income verification for enrollees will also end after 2026. Between the lines: Insurance losses from the new policy will be felt hardest in states where "erroneous and improper enrollment is most noticeable," including Alabama, Florida, Georgia, Mississippi, North Carolina, South Carolina, Tennessee, Texas and Utah, CMS said.
