At this month’s HLTH 2024 conference, more than 12,000 healthcare industry leaders gathered in Las Vegas to discuss and debate the bold course for the future of healthcare. To anyone present, one inevitable element of this future would have been unmistakable: artificial intelligence (AI). As Abhinav Shashank, CEO of Innovaccer, RECORDED“Of the 250 startups present, 200 had ‘AI’ built into their marketing.”

In all fairness, AI continues to generate a lot of excitement and investment, with AI startups catching up a third of all venture funding in Q3 2024 and a quarter of investments in digital health. Let alone the biggest The digital health IPO of the year was Tempus AI (“AI” suffix added to core Tempus name in 2023).

AI expression is not new, but the risk is a large amount of noise. As Shashank points out, in real care settings, providers face real-world problems and don’t have time to try exciting but unproven technologies.

While it may not have generated the same pomp and circumstance as AI, HLTH featured several announcements, sessions and discussions about new and innovative models of care. In many cases, these new approaches are uprooting decades-old healthcare oligopolies, payment structures, and disparities in care.

Here are three of the most disruptive and impactful new (and reinvested) models of care that received attention at HLTH this year:

1. Blue Shield of California is reinventing the pharmacy benefit model.

California Blue Shield announced a new partnership with Salesforce aimed at transforming the often slow pre-authorization process. Through this collaboration, Blue Shield plans to automate authorization approvals for healthcare services by leveraging Salesforce’s Health Cloud to provide doctors and patients with near-instant answers.

As Paul Markovich, president and CEO of Blue Shield of California, said on stage at HLTH, “If (prior authorization) isn’t the most painful process in healthcare, it’s pretty close.”

This system is expected to greatly improve efficiency and reduce delays that often prevent patients from receiving timely care. “What used to take hours and days will now take seconds,” Mr. Markovich said.

This initiative builds on Blue Shield’s overhaul of its pharmacy benefit program, which involved bypassing traditional pharmacy benefit managers (PBMs) to reinvent a patient-centered benefit model. Recent changes to the pharmacy model are designed to directly negotiate lower drug prices for members, cutting out the PBM middleman and allowing Blue Shield to develop a cost-effective, member-focused pharmaceutical service. Early successes have already been achieved through o the new business which will allow Blue Shield to purchase a Humira biosimilar at a transparent net price of $525 per monthly dose, which is 25% of Humira’s net price, and make it available to plan members at a $0 co-pay.

While PBMs have dominated the pharmacy benefits market with undisputed authority—the three largest PBMs managing over 80% of prescription drugs dispensed in the US – tectonic shifts in the marketplace have begun to expose cracks in the legacy PBM model. Changing public sentiment and regulatory controlpersistent economic instability and the inaccessibility and growth of consumer use of mobile health apps have set the stage for new models of care (and supporting technologies) to reshape the pharmacy benefit landscape.

2. The changing role and priorities of employer-sponsored health care

A major topic of discussion at HLTH was employer-sponsored health insurance, with topics ranging from women’s and mental health, AI-designed benefits, GLP-1 coverage, and consumerization. Main pass line? Our nearly century-old employer-sponsored insurance model needs and is in the process of being modernized.

The US employer-sponsored health insurance model began in the 1940s, largely shaped by World War II policies and labor market changes. Today, over 60% of the population under the age of 65 has employer-sponsored insurance.

With the changing realities of our modern economy, our legacy model of employer-sponsored insurance is no longer meeting the needs of a growing percentage of the national workforce.

On stage at HLTH, Mark Bertolini, CEO of Oscar Health, said: “We have an economy that has moved away from this model. All individuals have different types of care needs. We have a gig economy where people can’t even get employer-sponsored health insurance. And you have labor force mobility where you don’t stay with an employer long enough to actually get the benefits of employer-sponsored benefits. Now we have to do (the benefits) more to the individual versus the group.”

This is why a fairly new consumer-based benefits model is gaining momentum: Reimbursement arrangements for health care with individual coverage (ICHRAs). This type of employee-sponsored health benefits, introduced in 2020, puts more control in the hands of the consumer, allowing them the flexibility to choose which plan is best for their health needs and the portability to keep their coverage if they change job For small and medium-sized employers, ICHRA is a new way to provide affordable health benefits to their employees.

3. New funding and innovation to support the entire life cycle of women’s health

First Lady Dr. Jill Biden delivered the closing remarks at HLTH, announcing $110 million in Advanced Research Projects Agency for Health (ARPA-H) funding designed to support innovative research in women’s health.

“The United States loses $1.8 billion in work time each year due to menopausal symptoms that turn women’s lives upside down,” said Dr. Biden. “Women’s health is understudied and research is underfunded.”

This initiative emphasizes a holistic approach that covers the entire life cycle of women, rather than limiting women’s health to reproductive care—a shift that is critical to addressing diseases that disproportionately affect women. By prioritizing and funding research and technology for women’s health, the healthcare industry is beginning to address longstanding disparities and improve outcomes for women across the country.

In parallel, Maven Clinic’s recent $125 million Series F FUNDING round marks a milestone for private investment in women’s health, giving the company a $1.7 billion valuation, unicorn. Will Porteous, Chief Growth Officer at Maven Clinic, spoke about the company’s unique approach to supporting women across the entire reproductive lifespan, from fertility and family building to menopause and midlife health.

Also recognizing that women’s health needs a fundamental redesign, actress and Oscar founder Halle Berry. She spoke at HLTH about her company Respin, which provides women with a community that supports connection and well-being during menopause and beyond.

What was evident at HLTH, is that awareness, discourse and capital dedicated to promoting women’s health is growing. And new approaches and models of care are centered on de-stigmatized and comprehensive health care throughout a woman’s life.

While AI advances and technologies may have taken center stage at HLTH, it was those developing new and innovative ways to deliver care that stole the show. For many, health care has continued to become increasingly unaffordable and unaffordable, but new models of care must repair and deliver the very foundation of our health care system, supporting a bold new future for Americans’ health.