Although consumers on Medicaid have historically been harder to engage, we expect to see a wave of innovation prompted by digital- tech and localization-focused new entrants. Etugo Nwokah Managing Director and Partner • Medical- and prescription-cost transparency will tainable growth in premiums (which were about $13,700 be a renewed focus for payers, providers, employers, per employee in 2022). Consumers will increasingly use governments, and consumers. The catalyst is the Center financial services such as “buy now, pay later” to finance for Medicare and Medicaid Services’ Transparency in their medical needs. And this trend may shape how Coverage Rule (CMS-9915-F), which went into effect on industry players enter new markets and engage with July 1, 2022. The dynamics involved—including the MLR existing ones. credit, the financial mechanism that will allow payers to provide incentives to consumers to shop for health • Medicaid is the next frontier for health care care services—are complex. On the prescription side, innovation. Over the past decade, Medicare has been companies such as GoodRx, Mark Cuban Cost Plus Drug the primary focus of innovation, much of it in the health Company, and Amazon are using scale and operational care payer and services space. Medicaid and Medicare efficiency to find pockets of drugs that they can source, face similar cost pressures, especially within the macro administer, and deliver at low cost to consumers. environment, and this has implications at both state and federal levels. Although consumers on Medicaid have • Ongoing advancement in technologies such as AI historically been harder to engage, we expect to see a and ML, blockchain, and workflow automation will wave of innovation prompted by digital-tech and create more opportunities to address the out-of- localization-focused new entrants. Such innovation will pocket spending that US consumers require must touch on social determinants of health but also, more provide health care. Health care costs account for 10% to comprehensively, on individuals across topics such as 20% of a typical US consumer’s wallet—and 20% of total nutrition, mental health, and sleep. US GDP spending—and US employers are seeing unsus-