Conference Presentation, Panel
The Next Era of Health | Global Conference 2026
Milken InstituteEsther Krofah, Robert Bradway, Nancy Brown, Alicia Jackson, Myechia Minter-Jordan, Dipen Parekh
- Demographic shifts are projected to result in the 65+ population outnumbering those over 18 within four years, a trend expected to exacerbate long-term care costs exponentially and necessitate a fundamental system redesign to avoid a crisis of affordability and preparedness.
- Innovation translation is anticipated to face a "hollowing-out" effect as U.S. startups move trials to China for lower costs and faster timelines, while the domestic healthcare workforce lacks specialists needed for new innovations like widespread genetic profiling.
- Strategic goals include reducing the time from discovery to bedside from over 15 years to less than five through technology and regulatory reform, with a specific target to bring a 95% LP(a) reducing therapy to market in under eight years if clinical data supports it.
- ARPA-H plans to focus on reversing aging and defeating devastating diseases, including the development of the first FDA-authorized agentic AI clinician to serve counties without cardiologists, alongside major pushes to modernize 60-year-old clinical trial models.
- The U.S. ecosystem risks erosion if IP respect, capital markets, and industry-government relations are compromised, and the system may face bankruptcy if upstream innovation fails to reach downstream points of leverage in an aging society.
- Current financial incentives are expected to remain misaligned for preventive care due to fee-for-service models that lack penalties for unnecessary services or premiums for quality, though better metrics for tangible outcomes like timely cancer treatment are expected to develop.
- Clinical guidelines are projected to be updated every 12 to 14 months rather than instantaneously, with a focus on examining FDA-accessible unpublished evidence to anticipate trends while ensuring accuracy through a "marination" period for new data.
- Future care delivery is expected to shift primarily to the home to support aging in place, with hospitals becoming a last resort, supported by initiatives like the AARP Age Tech Collaborative to facilitate physician visits without caregiver transport.
- AI is predicted to initially disappoint both optimists and pessimists but is projected to become a long-term democratizing force; immediate efforts include scaling agentic AI across verticals and connecting genomics to electronic records to solve rare diseases.
- Significant opportunities for disruption exist in transaction processing, where drug spending is nearly double due to billing and records, while value-based models are currently seen as unguaranteed for keeping congestive heart failure patients out of the hospital for 30 or 60 days.
- AHA Ventures is expected to invest its own capital in underappreciated areas like women's health, and AARP will continue advocating for the 50-plus population, including a family caregiver tax credit, though consistent payment for screening and early diagnosis is not currently expected.
- Despite the need for preventive care incentives, the U.S. healthcare system is not expected to soon reach the level of fully integrated ecosystems seen in the UAE, and AI-driven risk identification tools are unlikely to change outcomes without accompanying system incentives.
- Venture capital and private equity dollars are expected to continue shifting toward China, with some U.S. venture capital firms shutting down domestic arms to invest exclusively in Chinese markets.