Tip # 709 - SOBERING INTEL

Sunday, March 1, 2026 Some of the key drivers of health care inflation were explained in a 45-minute webinar entitled “2026 State of the Industry” earlier this week.

A few highlights.

Drug spending from 2023 to 2024 increased by 11%; 47% of that is for GPL-1 weight loss therapies that cost $11,000 - $16,000 per person per year. And the ROI for that spend? (Ya might want to sit down.) A 91% increase in the cost PMPM (Per Member Per Month); from $930 to $1,774. Most of that (225%) is for the GPL-1 itself, but the medical spend increases (+11%), too. 

Over the past ten years, Behavior/Mental Health treatment costs have increased from barely a “blip on the radar” to a “top five” spend; roughly 6%. (For perspective, neoplasms are ~14%, musculoskeletal ~10%, digestive ~7%.)

Then there’s ‘Coding Shift.’ Huh? 30 minute Office Visits (CPT Code 99214) have surpassed the 20 minute visit (CPT 99213) that was the norm for decades. Better care or, AI mining low hanging fruit? 

This presentation has been archived. I actually watched it a second time today. If you have interest, I’ll try and get permission to share it.

Sobering or not, I’m going home to make a Bloody Mary!