This year has been full of challenges and changes for many people with Affordable Care Act health coverage, with enrollment dropping and premiums heading in the opposite direction. Foodborne illness outbreaks and healthcare cyberattacks also captured significant attention from SmartBrief readers in July, and AI continues to make headlines as it changes the way clinicians deliver care. Explore these topics below and find out how they are continuing to evolve.
Health coverage costs on the rise
What happened: A KFF analysis projected that the price of ACA marketplace coverage is likely to rise by a median of 14% in 2027, costing many Americans thousands of dollars more — further burdening patients’ already strapped budgets — after the expiration of enhanced premium subsidies. It would be the second year in a row that the increase has reached double digits. Some experts say rising healthcare service and drug costs are to blame, Axios reported.
At the same time, marketplace plan enrollment declined by 2.6 million people over a year, the Associated Press reported. States such as Ohio and Oklahoma saw their enrollment drop by close to one-third, and others, including Minnesota, Missouri, Indiana and the Carolinas, had high disenrollment rates as well. “This is the first time we’ve seen state-level data that show how much ACA marketplace enrollment truly fell,” said KFF’s Cynthia Cox. “It’s in line with our expectations, but it does show a very steep drop in the number of people with ACA coverage.”
What’s next: Recent news stories have covered the fallout in different states. In California, residents are seeing one of the steepest declines in coverage in a generation, NPR reported. A Politico story outlined growing voter discontent with the situation in Ohio. An NBC analysis examined how Florida and New Mexico residents are affected, and a KOMO-TV report showed that premiums had doubled for 200,000 Washington state residents.
Foodborne illness factors
What happened: Forbes reported in July on an FDA announcement that the US was experiencing a dozen ongoing foodborne illness outbreaks: Four involving Cyclospora, three involving Salmonella, and others centered on E. coli, Listeria monocytogenes and Clostridium botulinum. By July, sources had been identified for only four of the outbreaks.
What’s next: Federal funding and staff cuts have hampered health agencies’ ability to manage and keep the public informed about these outbreaks. Recalls have been issued for some products, such as Taylor Farms shredded lettuce and eggs from Midwest Poultry Services. Visit this FDA website to learn more about foodborne illness investigations, and read a report from the Center for Infectious Disease Research and Policy that offers updated information on recalls.
Shifting cyberattack trends
What happened: Becker’s Hospital Review reported that recent cyberattacks have trended more toward small data extortion and third-party vendor breaches, and away from large health system ransomware hits. There was a record number of major breaches last year – 772 – but the number of affected individuals actually declined 52%. Some experts feel that increasing crackdowns on ransomware groups and victims’ refusals to pay are behind the trends. “We have become somewhat desensitized to the large numbers and the true impact of these crimes,” wrote the American Hospital Association’s John Riggi and Scott Gee last fall.
What’s next: AHA President and CEO Rick Pollack released a guide this month on defending healthcare organizations against cybersecurity breaches. “Cyberattacks are not merely technology incidents,” he said. “They are threats to patient care and patient safety.”
AI strategy in primary care
What happened: A Commonwealth Fund and Public Policy Lab analysis, reported by TechTarget, outlined the best ways for primary care practices to develop effective AI strategies. The report recommended keeping transparency, accountability and equity in mind when implementing AI tools. It also is important to consider patient input, as they may have conflicting feelings of excitement and concern about the technology. “While the goal may be to improve the care experience, without their input, patients may be distrustful or hesitant to use these tools, and the tools may create inequities,” report authors noted.
What’s next: A Medical Economics analysis examines the CMS’ Interoperability and Prior Authorization Final Rule, which is designed to streamline prior authorization by mandating health plan use of standardized electronic systems. Dr. Brian Covino of Cohere Health discussed the importance of physician involvement in AI tool development and how AI can expedite approvals for low-cost, high-volume medical procedures.
“For primary care physicians specifically, I understand they’re seeing high volumes of complex patients with lots of problems and don’t have as much time as they need to care for them. Any way we can make the process easier for them matters,” Covino said.