“Despite what you may think, I have nothing against y’all.” This is not what President Trump said to NATO allies in a speech at Davos this week. This is a quote from Hidden Figures, a movie about three female African-American mathematicians who worked at NASA in the 1960s to make John Glenn’s historic flight to the moon successful. The story shows that smart people who do math have to cooperate with each other to make big missions possible, which is the theme of the health policy topic discussed below in the One Thoughtful Paragraph.
Other smart people in health care are featured in the news this week:
- Glen Tullman, CEO of Transcarent, pointed to declining health care coverage and rising employer health care costs as drivers of the shift toward digital-first care, in an interview with More here.
- Eric Topol, founder/director of the Scripps Research Translational Institute, co-authored an article in the Journal of General Internal Medicine, to explain that without restraints, the proliferation of wellness testing, including direct-to-consumer lab panels and wearables with continuous monitoring, generates excessive, low-value diagnostic information. Instead, he and his co-authors propose a three-tier precision health framework that uses AI-enabled population health assessments to target high-value testing where it matters most.
- Caroline Pearson, Executive Director of the Peterson Health Technology Institute (PHTI), explained how the newly-released Playbook on Performance-Based Contracting will help employers and health plans figure out how to link digital health payments to clinical outcomes and performance.
“Every time we get a chance to get ahead, they move the finish line. Every time.” This line from the powerful film Hidden Figures is about how Black women struggled to show they were intellectually qualified to compete in the 1960s NASA workforce. But I have personally heard this sentiment from actuaries at Medicare Advantage (MA) plans who have been frustrated for years to demonstrate that they are doing what the 2010 Affordable Care Act tasked them with: bringing the managed care tools from the commercial market into the Medicare program to help reduce costs. Just yesterday, I heard John Brooks (Deputy Administrator and the Chief Policy and Regulatory Officer for CMS) say “utilization management, network management… those systemic tools work to bring value to Medicare” and it is why MA benchmark bids (the cost to provide care) average around 80-88% of fee-for-service costs. And yet – MedPAC is issuing a report that implies that all MA plans are gaming the system (see a counterargument here). In February 2022, I wrote about how Health Affairs was publishing the Medicare math expert war about this issue, and Health Affairs is doing so again (see also here) this week. The difference in 2026 is that the team running CMS agrees that the way to make sure MA plans are doing the right thing is by analyzing the right data – and they ran their numbers by MedPAC before publishing their assessment. Ah, cooperation between the smart people that do math is what we need to make Medicare work. This is the theme of Hidden Figures, where one important line of dialogue is: “Any upward movement is movement for us all.”
