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PODCAST

The Healthcare Policy Podcast ® Produced by David Introcaso

David Introcaso, Ph.D.

Podcast interviews with health policy experts on timely subjects. The Healthcare Policy Podcast website features audio interviews with healthcare policy experts on timely topics. An online public forum routinely presenting expert healthcare policy analysis and comment is lacking. While other healthcare policy website programming exists, these typically present vested interest viewpoints or do not combine informed policy analysis with political insight or acumen. Since healthcare policy issues

government & organizations national

All Episodes

26:07

HCCI's President, Mr. Niall Brennan, Discusses...

The Healthcare Policy Podcast ® Produced by David... ·

2018/07/18

Listen NowWhile coverage under the Affordable Care Act (ACA), Medicare and Medicaid enjoy, deservedly, a great deal of discussion and debate, employer-sponsored insurance (ESI) insures approximately 55% of the non-Medicare eligible population, or approximately 152 million Americans. (Medicaid insures 19.5% of the population and Medicare 16%). Larger employers, or those with over 500 employees, are moreover (82%) self insured, 26% of smaller employers are as well. What we know about ESI and what

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26:51

"Integrating Behavioral Health Into the Medical Home:...

The Healthcare Policy Podcast ® Produced by David... ·

2018/06/28

Listen NowAs listeners may be aware well over 50 million Americans suffer from a mental or behavioral health disorder. Less than half of these individuals actually receive treatment. This reality is substantially worse for minorities. For example, African Americans and Hispanic whites are half as likely as non-Hispanic whites to receive treatment. Primary care practices, more than any other setting, are the cite for behavioral health treatment. Despite federal parity legislation to improve

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25:30

The Contributions Made and Challenges Faced By...

The Healthcare Policy Podcast ® Produced by David... ·

2018/06/13

Listen NowResearch published by the Association of American Medical Colleges (AAMC) this past April estimated the US could see a shortage of up to 120,000 physicians by 2030. AAMC estimates the shortage would be particularly acute in primary care, i.e., upwards of 50,000 primary care physicians would be needed. The primary care shortage is already acute. The federal Health Research and Services Administration (HRSA) estimates there are currently over 5,900 Primary Care Shortage Areas (PCSAs) in

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24:32

Oral Health America's Latest "State of Decay" Report:...

The Healthcare Policy Podcast ® Produced by David... ·

2018/06/05

Listen NowRecently, Oral Health America (OAH), published the fourth volume in its series, "State of Decay." The current volume, is subtitled, "Are Older Americans Coming of Age Without Oral Healthcare?" (The series dates back to 2003.) Among other findings, the current report again concludes the state of oral health in this country is, in a word, poor. For example, one-third of older adults have lost six or more teeth, one in five have lost all their teeth (or are edentulous), disparities in

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26:59

CMS Proposes Direct Provider Contracting: A...

The Healthcare Policy Podcast ® Produced by David... ·

2018/05/31

Listen NowThis past week public comments were due in response to a CMS Request for Proposal (RFI) that would potentially lead to the agency fielding a Medicare a direct primary care (DPC) demonstration. The demo would pay Medicare physicians directly a predetermined fixed per-beneficiary-per-month fee to provide primary care services to participating beneficiaries. The demo would try to replicate private, commercial DPC contracts physicians have with individuals or through self-insured

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26:37

The Current State of Nursing Care: A Conversation...

The Healthcare Policy Podcast ® Produced by David... ·

2018/05/18

Listen NowNurses, today numbering over four million, represent the largest segment of the healthcare workforce and deliver the majority of direct patient care. Their role in determining care quality (and safety) cannot be under-estimated. Absent adequate nursing care patients can face a long list of nonfatal and fatal outcomes. The profession however suffers a number of challenges due in part to both an aging population and one that is increasingly co-morbid. For example, not only are hospital

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28:32

Dr. Tim Williams Discusses the Use of Patient...

The Healthcare Policy Podcast ® Produced by David... ·

2018/05/09

Listen NowHealthcare payment models have been increasingly evolving to include quality performance in determining reimbursement. For example, the Medicare program, including Medicare Advantage, is today littered with quality performance measurement. Measuring quality in healthcare is, however, not as simple or straight forward as frequently assumed. Among other challenges, measures developed to date overwhelming measure healthcare process, not outcomes. Providers typically report on measure

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32:02

Kip Sullivan Discusses the Flaws and Future of the...

The Healthcare Policy Podcast ® Produced by David... ·

2018/04/18

Listen NowThe Medicare Shared Savings Program's Accountable Care Organization (ACOs), created by Section 3022 of the 2010 Affordable Care Act constitutes the flagship Medicare pay for performance (P4P) program. Though there are other P4P (also termed pay for value) models, for example two bundled payment models (Bundled Payments for Care Improvement and Comprehensive Care for Joint Replacement), they are short-lived CMS demonstrations. If the federal government is to bend the Medicare spending

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27:07

Pediatrician Dr. Niran Al-Agba Discusses Gun Violence...

The Healthcare Policy Podcast ® Produced by David... ·

2018/04/13

Listen NowIncluding the February 14th shooting at Marjory Stoneman HS in Parkland Florida that killed seventeen students and teachers, there have now been over 130 shootings in elementary, middle and high schools in 43 states since 2000 and another 58 shootings in US colleges and universities. Gun violence in this country is in a word, obscene. It is, for example, 96 times higher than in Japan and 55 times higher in the UK. It is largely explained by gun prevalence. The US accounts for

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31:52

The Reverend Patricia Lyons Discusses the...

The Healthcare Policy Podcast ® Produced by David... ·

2018/03/27

Listen NowIn January the Trump administration published a proposed DHHS rule titled, "Protecting Statutory Conscience Rights in Health Care, Delegations of Authority." For decades the federal government, via several legislative amendments, has protected healthcare providers who object to performing, or object to assist in performing, certain medical procedures based on their freedom of conscience and religious exercise. While these protections moreover concern abortion they have been gradually

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29:18

Author Timothy Hoff Discusses His Latest Work: "Next...

The Healthcare Policy Podcast ® Produced by David... ·

2018/03/15

Listen NowDuring this 29-minute interview, Professor Timothy Hoff discusses moreover what market factors explain or are driving the degradation of the therapeutic relationship between the physician and the patient, or what he terms the doctor-patient dyad, these include the "retailing" of medicine, whether "next in line" retail medicine, where we've traded relational trust for calculative trust, is economically rationale, the (negative) effect it is having on physicians and possible solutions to

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30:59

Author Jonathan Engel Discusses His Recent Work,...

The Healthcare Policy Podcast ® Produced by David... ·

2018/03/11

Listen NowDuring this 30-minute interview Professor Engel discusses moreover why, as he notes, US healthcare is "uniquely dysfunctional," and "laden with profit taking" largely due to induced demand, provides an overview of efforts to contain spending growth via HMOs both in the commercial and the Medicare market, the success of Medicaid HMOs, and discusses his disappointments with the Affordable Care Act (ACA) actually making healthcare more affordable. Jonthan Engel is Professor of Health

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28:44

Unpacking BPCI, CMS' New Bundled Payment...

The Healthcare Policy Podcast ® Produced by David... ·

2018/03/04

Listen NowThis past January 9th CMS announced Bundled Payment for Care Improvement (BPCI) Advanced. This five-year Medicare bundled or episode-based payment demonstration, that begins this October 1st, will succeed the agency'a five-year BPCI demonstration that sunsets this September 30th. BPCI Advanced, also voluntary, will be considerably less expansive than its predecessor in that, among other things, it will include just 32 clinical episodes (29 inpatient and three outpatient), and offer only

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20:20

The Trump Administration's Decision to Require...

The Healthcare Policy Podcast ® Produced by David... ·

2018/02/22

Listen NowIn a letter last March to state Medicaid directors by then DHHS Secretary Tom Price and CMS Administrator Seema Verma telegraph the administration's intent to radically redefine the Medicaid program. Believing the ACA's expansion of the Medicaid program was, per the March letter, a "clear departure from the core, historical mission of the program," administration officials telegraphed they were preparing to reinvent the program by, in part, requiring work or community engagement for

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35:48

Misuse of Antipsychotics Continues to Harm and Kill...

The Healthcare Policy Podcast ® Produced by David... ·

2018/02/16

Listen NowIn early February the Human Rights Watch (HRW) published, "'They Want Docile': How Nursing Homes in the US Over-medicate People with Dementia." The inappropriate or misuse of antipsychotics, e.g., Haldol, Seroquel and Risperdal, in nursing facilities to chemically restrain nursing home patients, moreover frail and elderly seniors, has been practiced for decades. The HRW report found in 2016-2017 "massive use" or abuse, i.e., the report estimated in an average week over 179,000 long-stay

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27:37

Mitigating the Opioid Crisis Via Abuse Deterrent...

The Healthcare Policy Podcast ® Produced by David... ·

2018/02/11

Listen NowFatalities related opioid use now account for over two-thirds of all drug overdoses annually, over 60,000, in the US. Approximately 115 Americans die every day from an opioid overdose. This number represents a five-time increase over the past two decades. Opioid-related fatalities have become so prevalent, according to the National Center for Health Statistics, they have caused a decrease in US life expectancy for the past two consecutive years. (The last time life expectancy dropped

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21:25

Will Trump's Global Gag Rule Lead to More Abortions...

The Healthcare Policy Podcast ® Produced by David... ·

2018/01/30

Listen NowA year ago last week the President Trump signed an executive order reinstituting the so called global gag rule (more formally termed the Mexico City policy). The policy was first implemented by President Reagan and has gone in and out of effect depending on whether a Republican or Democrat holds the White House. The initial policy only applied to abortions, i.e., in order to obtain US family planning funding aid, not for profits or non-governmental organizations (NGOs) had to certify

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24:47

Kristen O'Brien Discusses the Final 2018 MACRA Rule...

The Healthcare Policy Podcast ® Produced by David... ·

2017/12/19

Listen NowThis past November 16 CMS published the agency's final 2018 MACRA (Medicare Access and CHIP Reauthorization Act) rule (at 661 federal register pages). MACRA, authorized in 2015, formulates how approximately 1.5 million Medicare Part B physicians and other eligible clinicians are reimbursed. Annual MACRA proposed and final rule making is closely monitored since the law's MIPS (Merit-Based Incentive Payment System) and Advanced Payment Model (APM) pathway are the two formulas CMS uses to

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24:37

Clay Richards Discusses Medicare's Bundled Payments...

The Healthcare Policy Podcast ® Produced by David... ·

2017/12/12

Listen NowCMS has been experimenting with Medicare bundled payment arrangements, where the provider is reimbursed a total fee (either prospectively or reconciled retrospectively), for three decades. Under ACA authority CMS' Center for Medicare and Medicaid Innovation (CMMI) has launched several five-year bundled payment demonstrations, most notably BPCI that began in 2013. The BPCI demo allows providers to voluntary accept a bundled payment for any one of 48 Diagnosis Related Groups (DRGs), for

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30:00

Myra Christopher Discusses Under Treated Chronic Pain...

The Healthcare Policy Podcast ® Produced by David... ·

2017/12/07

Listen NowDespite the fact an estimated 100 million Americans suffer from chronic pain costing approximately $640 billion annually in medical expenses and lost productivity, the disease remains widely under treated. This is all the more true for ethnic and racial minorities independent of age, gender, education, wealth and pain intensity. Despite recent efforts by the Institute of Medicine, the DHHS, i.e., its 2016 "National Pain Strategy," and new payment models designed to improve care quality,

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