ab Global Research |19 April 2021
Healthcare a Likely Pay-For in Infrastructure, but Meaningful Reform Unlikely
Our DC Healthcare Policy panelists expressed some doubt that major Healthcare reform
would be achieved as part of the Infrastructure Bills proposed by the Administration, as
they think Speaker Pelosi and President Biden are likely to prioritize getting an
Infrastructure package passed vs. getting bogged down into Healthcare policy debates,
and slim Democratic majorities in the Senate/House make agreement on a larger reform
package difficult. That said, they expect some lift to the corporate tax rate (potentially
mid-20s) and other targeted Healthcare items to be used to pay for the Bill. Panelists
think MA rates are likely to come under pressure (though not until the 2023 plan year), a
Public Option plan would be difficult to pass (though more aggressive public options
could be pushed at the state level via CMS Waivers), and delays to 2022 PAMA cuts are
unlikely (given strong industry earnings from COVID testing).
Utilization Trajectory Uncertain; Specialty Pharmacy/Behavioral/Digital in Focus
In our Employee Benefits panel, there was a clear focus with regards to benefit design on
filling gaps in mental health, continued use of telemedicine, as well as diversity and
inclusion, though not necessarily richer benefits. COVID has delayed 2022 planning and
RFP processes, and none of our panelists could yet estimate cost utilization for 2022,
each suggesting going back several years to see overall trend lines. We did sense
sponsors are still focusing on addressing access issues and more aggressively controlling
Specialty Rx spend. Overall, there was openness to newer care delivery models and
digital health point solutions, which was echoed by our Telehealth panel with the
President of the American Telemedicine Association. Telehealth panelists indicated
payers, employers, and providers are increasingly looking to expand virtual care into
more complex, integrated use cases to support value-based care, and that new market
entrants (including tech companies) are helping to accelerate the pace of innovation and
focus on patient/provider experience.
MSD 1Q Dental growth with strong implant demand; clear aligner TAM robust
Overall trend was fairly consistent with 1Q21 revenue/"productivity" up ~5% y/y, and
the preference for single-visit dentistry continued. Implant demand continues to
outpace the market, and our experts believe the clinical impact of treatment delays will
support durable, acute demand into the out years. Mr. Richichi (CEO, Dental Associates
of CT) is skeptical the "Zoom effect" for clear aligner demand, but he believes the
marketing done by ALGN and DTC competitors has increased overall awareness of clear
aligners in time. On the DTC clear aligner side, Nick Greenfield (CEO, Candid Co)
pointed to the superior patient experience driving the higher price point vs peers
($2,400 vs $1,900). Treatment length is currently limited for Candid to ~7 months given
aligner limits and margin requirements, but he believes Candid's growing dataset of
high trim line treatment (no attachments or IPR) will increasingly bear fruit over time vs
peers whose data of similar cases is limited.Equities
Americas
Healthcare
Kevin Caliendo
Analyst
[email protected]
+1-212-713 3630
Adam Noble
Associate Analyst
[email protected]
+1-212-713-9495
Andrea Alfonso
Associate Analyst
[email protected]
+1-212-713 1342
Brett Gasaway
Associate Analyst
[email protected]
+1-212-713 4820
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