Closing Out 2022

Evening winter village landscape with snow covered houses

We did not want to leave 2022 without reminding you of some of the important issues from our fall events, including results of the polling and top take aways plus and a few highlights from some of our other work.

The Benefits Breakfast Club (BBC) 

On September 22nd Chris Gory of Orchard Benefits, Barbara Martinez of Canada Life, Michael Macoun of People Corporation joined the webinar to discuss disruptors in the benefits industry. New providers, insurer innovation, and the future of the independent advisor and ongoing development of large group benefits brokerages. The session poll results gave insights into how innovation and technology solutions in the industry were impacting attendees and how well the industry is doing in informing the benefits stakeholders about developments – not great! Chris Gory provided a link to his list of virtual providers. Here are some of the top takeaways from attendee evaluations:

  1. New benetech entrant trends, which will continue to come fast and furious. Quick evolution in this space, and new solutions will continue to evolve.
  2. Mergers and acquisitions are everywhere, with large amounts of capital being raised for some. This will continue to happen on many levels.
  3. Extent of consolidation in broker field and rate at which it is happening and benefits this offers advisors.
  4. Some big leaders in tech space, including insurers and Loblaws who is active in the industry.
  5. Carrier activities and improvement in innovating and partnering in recent years.

On October 13th Tim Clarke of tc Health Consulting, Dr. Aaron Izenberg from Sunnybrook Hospital, and John Adams of Best Medicines Coalition and Canadian PKU and Allied Disorders, joined the webinar to discuss the role of private payers in drugs for rare diseases. The session poll results gave insights into how much attendees already knew about drugs for rare disorders, including how many have no therapy, how much was spent, how many rare disorders are estimated to exist and what therapeutic category of disorders represent the highest percentage of medicines in the pipeline. Here are some of the top takeaways from attendee evaluations:

  1. The challenges of formulating a national drug policy and no 100% solution from private payers – none expected.
  2. Better understanding of prevalence and number of rare diseases and lack of treatment options.
  3. Red tape in getting treatment for rare diseases and delays in approving drugs for patients.
  4. Lack of awareness of the cost of drugs for rare diseases and the problems of underwriting the cost of specialty drugs.
  5. Understanding spinal muscular atrophy.

On February 9th, 2023, we will be hosting a webinar on the Changing Risk Landscape. After brief presentations from four industry leaders exploring the root causes of the challenges in drug benefits affordability and potential solutions, you are invited to join in a lively panel discussion to further explore options to improve the current risk landscape through new risk sharing solutions. You can register here.

The Benefits and Private Healthcare Associate (BPHA) program

On November 1st Tim Clarke presented his updated BPHA module on The Future of Health Delivery and How Canadian Benefit Plans Must Adapt and Evolve. The session poll results gave insights into the audience (almost half were advisors), the biggest change in benefits plans, expectations for change in the next 3 years, employee expectations and what changes clients are most likely to adopt or entrench in their plan. Here are some of the top takeaways from attendee evaluations:

  1. How the healthcare landscape has changed to include digital health solutions.
  2. Applications of digital health – future will be focussed on assessment vs treatment.
  3. Advisors need to know and evaluate options to inform clients and have strategies to deal with challenges.
  4. For maximum success address priority, what needs to be solved, engage members with solutions that best meet needs and measure results.
  5. Relatively slower pace of health innovations compared to technology.

Take advantage of changes in the BPHA program recently announced. Take the full 35 CE credit online program, or enrol for BPHA Basics or BPHA Advanced, which splits the BPHA program into two bite size pieces! You can find out more or register here.

Other Activities

Vision Care with the Canadian Association of Optometrists

Vision care is not something that most of us in benefits spend a lot of time on. My work with the Canadian Association of Optometrists has convinced me we should spend a lot more time on it. Innovation hasn’t passed by optometrists, but sadly group vision care benefits have. Viewed traditionally as a dollar in, dollar out benefit, an insurance element is needed to provide coverage for those services that allow optometrists to better detect eye diseases early so that they can be treated early. Not everyone needs these additional services, but for those who do, the results can save their sight or even their life. Look for more in 2023 on how group vision care benefits need to change to fill the gaps in care.

The Simplify Prior Authorization Initiative

Many of you have already registered for the January 17th, 2023, webinar on Prior Authorization 2023: New Resources and Solutions. If not, you can find out more and register here. Our panelists will include:

  • Ned Pojskic, Vice President, Pharmacy Benefits Management, Green Shield
  • Joan Weir, Vice President Health and Disability from the Canadian Life and Health Insurance Association (CLHIA)
  • Rachael Manion, Executive Director, Canadian Skin Patient Alliance
  • Dr. Alan Low, Clinical Associate Professor, University of British Columbia
  • Ramy El-Kholi, Chief Commercial Officer, OkRx

There has also been a lot of activity behind the scenes in 2022. We have continued to dialogue with prior authorization stakeholders and vendors to facilitate an agreement to adopt an electronic prior authorization process. We have also been developing a new Simplify Prior Authorization website that will launch in January 2023. This new site provides prior authorization resources for all stakeholders and will be the foundation of future projects from the Simplify Prior Authorization initiative.  

Once again, a big thank you to everyone who has contributed to make what we do possible. Be sure to watch for lots more to come in 2023!