Lower costs, greater transparency and accountability, an improved patient experience and technology as a foundation are top priorities for the U.S. Centers for Medicare & Medicaid Services (CMS), said Dan Brillman, Director of Medicaid, and John Brooks, Director of Medicare.
The two officials laid out the agency’s policy agenda during a Morgan Stanley Institute keynote panel at the conference, “The Future of Healthcare Policy: Insights from CMS Administrators.”
“Our framework is stability for the industry and lower prices for patients,” Brooks said.
The CMS directors signaled support for value-based initiatives across the industry and said they want healthcare plans to compete on measurable health outcomes rather than coding intensity—the aggressive use of documentation-driven coding that can artificially inflate risk scores and federal spending without a corresponding change in patient health or care.
“We want managed care to succeed and to restore confidence through accuracy,” Brillman said. “The goal is for the plans to be more predictable, more connected, easier to navigate and with higher accountability for results.”
GLP-1s’ Growth Opportunity
Executives at the conference said diabetes and obesity treatments continue to bring new patients into the market, while the introduction of oral GLP-1s has added to growth rather than cannibalizing existing therapies.
Biopharma leaders also noted that, despite the rapid pace of adoption, current utilization of GLP-1s remains low relative to its potential. One critical development could be the expansion of access through Medicare in the U.S.
Medicare launched a temporary program in July that provides eligible Part D beneficiaries access to specific weight-loss medications for a flat cost of $50 per month. The program had 6,000 participants in its first 60 days.
“We are figuring out how to integrate more patients in the long term,” Brooks said.
AI Could Reduce Drug Development Costs and Timelines
From drug development to customer service, analysts and healthcare industry leaders expect artificial intelligence to transform business models by accelerating timelines, reducing costs and improving efficiency.
“AI will change the face of drug development like no other sector,” Laaman said. “We'll see better drugs to market in a quicker time frame and more access to therapies for patients.”
Speakers at the conference highlighted another notable use case: providers are deploying AI-powered agents for post-discharge follow-up. The agents can check whether patients have scheduled follow-up appointments, need prescription refills or are experiencing ongoing symptoms. Even when patients recognize that they are speaking with AI rather than a person, many continue the conversation, helping providers gather information, support recovery and potentially reduce readmissions.
Executives also highlighted less obvious applications of the technology. For example, physicians are increasingly turning to large language models (LLMs) for information, prompting companies to reconsider how their scientific data can be surfaced and discovered. Some executives also pointed to opportunities for AI to enhance specialized expertise across commercial teams.
Utilization Gains Strength
Healthcare utilization rates—or the actual use of medical resources, such as doctor visits, hospital stays, emergency room trips and prescription drugs—remain robust, according to speakers at the conference.
From traffic to testing volumes and demand for generics, companies see no signs of slowdown in demand.
One of the drivers of that trend is the fact that consumers are increasingly making independent decisions about services and products they think are the best for their health.
“Patients are really taking the wheel when it comes to their own healthcare, whether it's direct-to-consumer testing or direct-to-consumer pharmacy offerings or other ways that generate proactive patient engagement,” said Erin Wright, Morgan Stanley Research’s Healthcare Services Analyst.
