In our last blog, we explored the potential impact of a Trump 2.0 administration on healthcare and its implications for HealthScoreAI™. Today, we expand on that analysis, dividing this discussion into three parts: (1) recent developments in the Trump 2.0 administration, (2) the current state of healthcare, and (3) the role of AI in this evolving landscape.
Trump 2.0: A Game-Changing Vision for 2025
Interest in Trump’s approach to healthcare has surged since our November 13 blog. Among the key developments is the confirmation of a proposed Department of Government Efficiencies (DOGE) and the nomination of Robert F. Kennedy Jr. as Secretary of Health and Human Services (HHS).
The Power of HHS
HHS wields significant influence in the US Government and the 50 states, providing care to Medicare, Medicaid, Disabled individuals and Children beneficiaries totaling over 140,000,000, overseeing 13 divisions, 80,000 employees, and $1.6 trillion in funding. Its most prominent agencies include:
- Centers for Medicare & Medicaid Services (CMS): Governs provider operations and technological aspects like the Office of National Coordinator
- Centers for Disease Control (CDC)
- Food and Drug Administration (FDA)
- National Institutes of Health (NIH)
- Indian Health Services (IHS)
While Kennedy’s confirmation is uncertain, it’s clear that President Trump has a mandate to disrupt the status quo. Kennedy’s well-known anti-establishment views suggest a focus on overhauling traditional systems. His “Make America Healthy Again” campaign could leave a lasting legacy, battling inefficiency and bureaucracy at every level.
DOGE: A Healthcare Cost Overhaul
As anticipated, DOGE will likely target inefficiencies within healthcare, from provider operations to regulatory frameworks. The focus we believe will include:
- Cutting Administrative Waste: Current spending on non-care-related costs (e.g., billing, reporting, denials, fraud) exceeds $500 billion annually nationwide.
- Optimizing Technology: Expect scrutiny on companies like Oracle Health and Epic to ensure technology reduces friction, not inflates costs.
- Driving Data Outcomes: Leveraging healthcare data to enhance outcomes-based compensation models, such as Medicare Advantage and Accountable Care Organizations (ACOs).
These measures aim to empower consumers and reward providers for maintaining health, shifting the system from reactive “sick care” to proactive health management. Imagine a future where doctors earn more for improving patient health outcomes than for simply scheduling repeat visits.
Understanding the Numbers
Healthcare is not just a problem yesterday, today and tomorrow; it is a problem under its current trajectory for a decade. We are consuming $5 trillion per year (2024) in National Healthcare Expenditures. That is just under 18% of GDP. However, HHS own Actuaries project that number will increase to $7.7 trillion by 2032 and consume just under 20% of all the GDP of the United States. Just under Trump 2.0 it will increase by a hard $1 trillion over 4 years. The scope is mind-numbing.
Current State of Healthcare
Two recent headlines underscore a critical shift in healthcare:
- November 12, 2024: Modern Healthcare reported that the AMA is lobbying for stricter oversight of nonprofit hospitals. The AMA alleges that many nonprofits fail to meet their community benefit obligations despite enjoying tax exemptions. This represents a bold move by the AMA, highlighting concerns long voiced by for-profit hospitals.
- November 14, 2024: Medical Economics shared survey findings that 75% of Americans view healthcare as “broken” but are optimistic about technology’s potential to improve it. Consumers want tools to empower decision-making while maintaining human connections with providers.
Both stories reflect rising consumer dissatisfaction with the status quo and a demand for greater accountability and innovation.
AI’s Role in a New Era
The 2024 HLTH Conference offered a glimpse into AI’s growing role in healthcare. Venture capital interest in health tech is booming, driven by AI’s potential to tackle inefficiencies and empower consumers.
Challenges for Startups and Tech Companies
The conference reinforced a critical lesson: healthcare startups must solve real problems rather than fixate on flashy technologies. A memorable quote encapsulates this sentiment:
“There are a lot of startups in love with their technology. You need to be in love with the problem you’re trying to solve.”
Under Trump 2.0, tech mandates from CMS are likely to stall, creating a chilling effect for companies dependent on regulatory-driven adoption. Meanwhile, innovators focused on consumer empowerment and provider efficiency may find unprecedented opportunities.
A Consumer Powered Future
For years, we’ve championed the idea of “patient-centered care.” But after deep reflection, we’ve revised our view: consumers must control healthcare, not merely sit at the center of it.
To achieve this, consumers need tools to access, consolidate, and analyze their health data across fragmented silos. Mandated by law since 2010, electronic health records (EHRs) remain underutilized by the very individuals they were meant to serve. This is why our focus is on empowering consumers to control their data and use AI-driven insights to make informed questions to discuss with their provider about their wellness. AI in this use can both benefit the consumer from technological advances and keep the personal touch with a human.
The Trump 2.0 administration signals a potential healthcare transformation, targeting inefficiencies, empowering consumers, and rewarding providers for better outcomes. The stage is set for innovators to lead the charge, leveraging AI and technology to reimagine healthcare.
As we move forward, one thing is clear: healthcare’s future isn’t just about better systems—it’s about putting consumers in control of their health.
https://www.hlth.com/2024event
https://oxiohealth.io/healthcare-ai-the-u-s-healthcare-model-is-broken-and-getting-worse/
-Noel J. Guillama, Chairman
About HealthScoreAI ™
Healthcare is at a tipping point, and HealthScoreAI is positioning to revolutionize the industry by giving consumers control over their health data and unlocking its immense value. U.S. healthcare annual spending has reached $5 trillion with little improvement in outcomes. Despite advances, technology has failed to reduce costs or improve care. Meanwhile, 3,000 exabytes of consumer health data remain trapped in fragmented USA systems, leaving consumers and doctors without a complete picture of care.
HealthScoreAI seeks to provide a unique solution, acting as a data surrogate for consumers and offering an unbiased holistic view of their health. By monetizing de-identified data, HealthScoreAI seeks to share revenue with consumers, potentially creating a new $100 billion market opportunity. With near-universal EHR adoption in the USA, and advances in technology, now is the perfect time to capitalize on the data available, practical use of AI and the empowering of consumers, in particular the 13,000 baby boomers turning 65 every single day and entering the Medicare system for the first time. Our team, with deep healthcare and tech expertise, holds U.S. patents and a proven track record of scaling companies and leading them to IPO.