瑞信美股医疗保健行业2019年健康保险研讨会总结专家讨论的行业热门主题201952827页

DISCLOSUREAPPENDIXATTHEBACKOFTHISREPORTCONTAINSIMPORTANTDISCLOSURES,ANALYSTCERTIFICATIONS,LEGALENTITYDISCLOSUREANDTHESTATUSOFNON-USANALYSTS.USDisclosure:CreditSuissedoesandseekstodobusinesswithcompaniescoveredinitsresearchreports.Asaresult,investorsshouldbeawarethattheFirmmayhaveaconflictofinterestthatcouldaffecttheobjectivityofthisreport.Investorsshouldconsiderthisreportasonlyasinglefactorinmakingtheirinvestmentdecision.28May2019Americas/UnitedStatesEquityResearchManage[e-mail]@[e-mail],[e-mail]2019HealthInsuranceSymposiumRecap–10ExpertsDiscusstheSector’sHotTopicsOnWednesday,May22,10industryexperts,executives,andconsultantspresentedatour2019HealthInsuranceSymposiuminNewYork.Thesymposiumcoveredavarietyoftopicsandwaswell-attendedbyinvestors.■KeyTakeawaysFromMedicaidMarketSession:With75-76%ofMedicaidpopulationwithinManagedMedicaid,ourMedicaidpresenterseescompanyspecificManagedMedicaidenrollmentgrowthcomingincreasinglyfrommarketshareshifts,asopposedtonewMedicaidexpansionorothertypesofenrollment.EvenwiththetoptenManagedMedicaidplansaccountingfor61%ofMedicaidlives,thesubsectoristheleastconcentratedpayormarketwithroughly70%forindividualmarketconsolidated,upper60%forMA,and63%forcommercial.GivendiminishinggreenfieldopportunitiesandwithMedicaidenrollmentreachinganaturalceiling,ourpresenterexpectsindustryconsolidationtocontinue.■KeyTakeawaysfromPharmacy/PBMLandscapeSession:WithrespecttothePartDRebateRule,whilemostthinkit’slikelytobeimplemented,plansarenot100%surethattheadministrationismovingforwardforJanuary12020.IfthereissomedoubtastowhetherHHSwillmoveaheadwiththeirrebate,ourconsultantbelieveshealthplanswillbeunlikelytobidforalandgrab,giventhattheywillnotbeabletocountonprotectionfromtheproposeddemonstrationproject’snarrowriskcorridors.■KeyTakeawaysfromDCPolicyUpdateSession:OurDCexpertnotonlyseesnoRepublicansupportbutalsodoesn’tbelieveamajorityofDemocratswouldsupportMedicare-for-All.Regardingsecondaryhealthcarepolicyissues(e.g.,medicaldevicetax,healthinsurerfee,scheduledDSHpaymentcuts,homehealthcarePDGMlegislation),ourDCexpertdoesnotseeseparatelegislationbeingprioritized.ThesetypesofissueswouldtypicallybeattachedtoanotherbillthatismovingthroughtheCongress.Ourexpertseesthreeopportunitiesforsecondaryhealthcarepolicyissuestohitcharide:ADrugPricingBill,Surprisebillinglegislation,andFiscalappropriationslegislation.SenateFinanceCommitteeChairmanChuckGrassleyandRankingMemberRonWydenhaveformedasymbioticrelationship,accordingtoourWashingtonconsultant.TheyleadthemostimportantSenatecommitteewithjurisdictionoverhealthforhealthcare.BothSenatorshaveagreedonaproposaltocapprescriptiondrugcopays,whichcouldprovideanopportunitytomoveforwardonreformingsomeareasofdrugcosts.28May2019ManagedCare2■KeyTakeawaysfromTelehealth/TelemedicineSession:OurpresenteraddressedsevenmythswithrespecttoTelemedicine,notingthattheATAisveryfocusedonaddressingthosemythsinthemarketplace:1)TelemedicineisOnlyforRuralAreas;2)TelemedicineisMoreExpensive;3)TelemedicineisNotHighQuality;4)TelemedicineisImpersonal;5)ProvidersPrescribeMoreDrugswithTelemedicine;6)TelemedicineisaThreattoProviders;and7)TelemedicineisOnlySynchronousCommunication.■KeyTakeawaysfromCommercialMarketSession&PanelDiscussionwithHealthBenefitManagers:Roughly69%ofemployersareveryconfidentthattheywillcontinuetoprovidehealthcarebenefitstotheiremployeesoverthenext10years.Thisfigurewashighestsince2008andcompareswithalowof23%in2012.Theincreasedconfidenceislargelyafunctionoftheeconomyandpublicexchangesnotdeliveringthedesiredresults.Separately,severalexpertsbelievethatemployeesconsuminghighcostspecialtydrugsmaxoutoftheirdeductiblelimitquicklyandare,therefore,alreadysubsidizedbytherelativelyhealthyemployees.Therefore,ourconsultantsaysmanyemployersbelieveitisnotfairtoforcefurthercross-subsidizationfromalargerbodyofhealthyemployeesbyprovidingPOSrebates.■KeyTakeawaysfromMedicareMarketUpdateSession:OurMedicarepresentersnotedthatMAplansarelikelytorespondtoHIFre-initiationonaregionallevel.Thereisalikelihoodofmembershipattritioninsomemarkets,ifbenefitsareadjusted.Benefitsthatgetthemostfocusfromseniorsincludingpremium(zero-dollarpremiumplanshighlyvalued),PCPco-pays,somespecialistco-pays,etc.28May2019ManagedCare3DetailedRecapofthe2019CreditSuisseHealthInsuranceSymposiumLastweek,10industryexperts,executives,andconsultantspresentedatour2019HealthInsuranceSymposiuminNewYork.Thesymposiumcoveredavarietyoftopics,aslistedbelow,andwaswell-attendedbyinvestors.MedicaidMarketUpdateoAriGottlieb,A2StrategyConsultingPharmacy/PBMLandscapeUpdateoJimMaritan,FormerVPCorporateDevelopment,Strategy&InternationalatCVSHealthDCPolicyUpdateoEthanSiegal,Founder,TheWashingtonExchangeTelehealth/TelemedicineMarketUpdateoAnnMondJohnson,CEO,AmericanTelemedicineAssociationPanelDiscussionwithHealthBenefitManagersoThomasFerraro,Hea