Payers List 2024 Priorities, Health Tech Investors Get Selective, ACOs in the Mental Health Hotseat

The end of the year is quickly coming into view, and healthcare news is shifting to the new year! This month, 23 payer executives list their top priorities for 2024, health tech investors advise startups to expect venture capital firms (VCs) to be a bit more selective, and Arizona considers covering Native healing practices under Medicaid. Plus: A study finds mental health decreases after ACO enrollment, and nine “Big Health” companies account for almost 45% of America’s health bill.  

  • Health tech investors are getting selective. While cautiously optimistic about 2024, VCs advise health tech startups to expect smaller and fewer checks. The decline in funding—which correlates roughly with the end of pandemic—is dramatic. In 2021, health tech ventures drew almost $30 billion, Rock Health estimates; that was down to $15.3 billion in 2022 and $8.6 billion in the first three quarters of 2023. Consolidation is likely. 
  • ACO enrollment doesn’t help mental healthcare access. Contrary to expectations, it appears to both impede access to care and decrease patient-reported outcomes for folks with depression and anxiety disorders. A new Health Affairs study found mental healthcare access and treatment was down by 24% after ACO enrollment. “This was primarily due to lower rates of primary care visits addressing depression or anxiety among patients with depression,” the research team said. 
  • Who profits most from America’s health system? Hint: Not Big Pharma. The nine biggest companies accounting for nearly 45% of America’s health care bill—up from 25% in 2013—do not make drugs and have not, until recently, treated patients. They are intermediaries that sit between patients and their treatments: Insurers, chemists, drug distributors, and pharmacy-benefit managers (PBMs). The Economist, which dubs these companies “Big Health,” notes that they account for eight of the top 25 companies by revenue in the S&P 500 index, “compared with four for big tech and none for big pharma.” 
  • Arizona might become the first U.S. state to cover traditional Native healing practices under Medicaid. The Arizona Health Care Cost Containment System (AHCCCS) is seeking federal approval because the organization recognizes the importance of Indigenous traditions, according to tribal liaison Christine Holden. The initiative can in part be viewed as the adoption of a more holistic model, given that medicine men and medicine women don’t separate the physical from the mind or spirit. 
  • 23 payer executives list top priorities for 2024. Common themes include accessibility, affordability, and member experience as well as mental health, AI, and equity. “My top priority for 2024 is to see mental health on equal footing as physical health,” says Jessica Chaudhary of Carelon Behavioral Health. Value-based care arrangements remain a top strategic priority for many, and Alex Li of L.A. Care (Lost Angeles) adds that his top three equity priorities are addressing maternal and child health, improving physician and mental resiliency, and addressing the needs of the unhoused population in L.A. There’s some indication that even long-standing industry banes may be on the verge of transformation: “Prior authorization reform tops my list,” says Robert Groves of Banner | Aetna. 

What healthcare events have most affected your organization this month—and why? Let us know!    

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