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PODCAST

A Health Podyssey

Each week, Health Affairs" Rob Lott brings you in-depth conversations with leading researchers and influencers shaping the big ideas in health policy and the health care industry. A Health Podyssey goes beyond the pages of the health policy journal Health Affairs to tell stories behind the research and share policy implications. Learn how academics and economists frame their research questions and journey to the intersection of health, health care, and policy. Health policy nerds rejoice! This

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All Episodes

22:08

The Burden of Morbidity Among Transgender People

A Health Podyssey ·

2021/09/21

Recent reports suggest about six-tenths of a percent of the United States population, or 1.4 million people, identify as transgender. Transgender individuals are people whose personal and gender identity are different from the gender they were thought to be at birth. Good information about the health status of this group has been hard to come by although research is growing. Some data come from Medicare, which is useful but not representative of the population as a whole.Landon Hughes, a

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32:28

Leemore Dafny on Hospital Prices, Markets, and...

A Health Podyssey ·

2021/09/14

The US government reports that the total spending on hospital care in 2019 was almost $1.2 trillion. High and highly variable hospital prices have been in the news recently in part due to new information made available under the price transparency rules implemented by the Trump administration.Competitive markets are supposed to constrain prices, but in much of the US, there's little competition among hospitals and consolidation throughout the healthcare sector has contributed to that

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30:11

Pushing Against the QALY Criticism in Drug Pricing

A Health Podyssey ·

2021/09/07

The quality-adjusted life-year (QALY) combines the expected effects on longevity and the expected effects on quality-of-life into a single standard measure. QALYs are often used as part of cost effectiveness analysis, particularly when analyzing the effectiveness of drugs.QALY as a measurement has received a lot of criticism. It's been criticized in concept or in the specifics of how it's defined or used. This criticism often forms the basis for opposition to price negotiations or any

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43:09

Julian Harris on the Connection Between Unmet Social...

A Health Podyssey ·

2021/08/31

If you're a regular listener of A Health Podyssey, you know that most episodes revolve around a particular study published in Health Affairs. Every once in awhile, a person's experience as it relates to health care warrants an excursion from the constraints of discussing a single study. For those, we want to offer listeners a broader conversation.Welcome to A Health Podyssey Excursion. Dr. Julian Harris is the CEO of ConcertoCare, a provider of integrated care for seniors living at home

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32:34

Scott Howell on the Very Large Costs of Drug...

A Health Podyssey ·

2021/08/24

While estimates vary, spending on prescription drugs in the United States exceeds $500 billion per year. This makes drug prices a perennial health policy topic.In this context, payers and manufacturers are in a constant battle. Manufacturers seek to expand their market while payers attempt to use their leverage to negotiate lower drug prices. Often, patients and clinicians are caught in the middle and left to navigate increasingly complex pharmaceutical insurance benefit design, tiered

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57:36

LIVE with Chiquita Brooks-LaSure, Centers for...

A Health Podyssey ·

2021/08/17

As part of Policy Spotlight, a new virtual event series from Health Affairs, Editor-in-Chief Alan Weil welcomed Chiquita Brooks-LaSure, the new Administrator of the Centers for Medicare and Medicaid Services (CMS) at the US Department of Health and Human Services for a one-on-one discussion about her priorities at CMS, where she oversees programs including Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and the HealthCare.gov health insurance marketplace.A former policy

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31:45

James Robinson On The Drug Market, Innovation,...

A Health Podyssey ·

2021/08/10

In our multi-payer health care system, the pharmaceutical market involves the complex interplay of manufacturers, insurers, prescribers, and patients. Each seeks to protect its own interest, which can be counterproductive for overall system efficiency.The United States also has a high rate of generic drug use, which is considered a success story as the introduction of generics can rapidly and dramatically reduce drug prices. But we've had much less success with biosimilars, the generic

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28:05

Health Care Gaps For Migrants & Asylum Seekers On The...

A Health Podyssey ·

2021/08/03

Migrants on their way to another country and people seeking asylum are often overlooked in health policy. During the COVID-19 pandemic as immigration and asylum processes stalled, thousands of people were stranded at Mexico's northern border. With limited health care and sometimes crowded and unsanitary living conditions, COVID posed a significant risk.How Mexico's response to COVID-19 took into account the particular needs of in-transit migrants and asylum seekers is the topic of today's

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23:40

Many US Citizen Migrant Children Living In Mexico...

A Health Podyssey ·

2021/07/27

Children born in the United States are born US citizens. Some of these children are born to immigrant parents who returned to their country of origin, either voluntarily or because they were deported.In 2015, more than half a million US citizen children lived in Mexico having returned with their parents. These children may face language and school adjustments, stressful living arrangements and economic and heath challenges. Fewer than half of them report holding Mexican citizenship,

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51:35

LIVE with Micky Tripathi, National Coordinator for...

A Health Podyssey ·

2021/07/22

BONUS EPISODEAs part of Policy Spotlight, a new virtual event series from Health Affairs, The Commonwealth Fund President David Blumenthal welcomed Micky Tripathi, the national coordinator for health information technology (IT), to an in-depth discussion of Biden administration's plans and priorities for health care data.The interview was conducted on July 1, 2021.At the Department of Health and Human Services, Micky Tripathi leads the formulation of the federal health IT strategy and

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22:05

Many US Immigrants May Defer Health Care to Avoid ICE

A Health Podyssey ·

2021/07/20

Sixty-eight percent of undocumented immigrants in the United States come from Mexico or Central America. As a result, deportation policies have a disproportionate effect on people of Hispanic origin.Immigration enforcement activity may influence behaviors like obtaining health care services; the effects of which can be felt throughout the community. On today's episode of A Health Podyssey, Abigail Friedman from the Yale School of Public Health joins the program to discuss the relationship

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22:48

An Aging Immigrant Population and the Health Policy...

A Health Podyssey ·

2021/07/13

Roughly 45 million immigrants live in the United States today, a fourfold increase since the 1960s. Immigrants face unique challenges obtaining health care services. Some of the challenges are caused by explicit policies designed to limit or exclude immigrants from programs and benefits available to people born in the US. Other barriers relate to household income or the greater likelihood of having limited English proficiency.The health of immigrants in the United States is the topic of

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24:31

The importance of mental health workers for mobile...

A Health Podyssey ·

2021/07/06

With the US becoming more focused on addressing mental health, one important topic is how society responds to people experiencing mental health crises. A typical crisis response involves a 911 dispatcher sending a police officer to respond and provide support. However, the vast majority of police officers have little or no training for how to best respond to those in mental health crises. In addition, people with serious mental health disorders are at elevated risk of being harmed in

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22:00

What gun violence does to health

A Health Podyssey ·

2021/06/29

Gun violence harms the health of victims and witnesses, but it also disrupts community social cohesion and behavioral norms. The people in communities that have experienced violence can suffer adverse health consequences, including post-traumatic stress disorder.Exposure to gun violence and the disproportionate burden of that violence in certain communities is the topic of today's A Health Podyssey. Sarah James, a postdoctoral fellow at Cornell University, joins Health Affairs

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23:22

Timing out-of-pocket spending in health care is...

A Health Podyssey ·

2021/06/22

Almost all commercial insurance plans have cost-sharing provisions where patients help pay for their health care services. Annual deductibles — which patients have to meet before insurance pays anything at all — and co-payments — where the patient pays either a fixed amount for or a share of the cost of each service received — are common examples.Cost-sharing generally reduces the health insurance premium by simply shifting a share of the costs to enrollees. But it also affects utilization

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26:19

How biosimilars are affecting the drug markets

A Health Podyssey ·

2021/06/15

Lowering prescription drug prices continues to be a hot topic. Spending on biologic products, which includes most vaccines and gene therapies, was estimated at $125 billion in the United States in 2018, representing about a quarter of total pharmaceutical spending.Biosimilars, follow-on products to biologic drugs with essentially the same molecular composition to produce comparable clinical effects, are viewed by many as a way to promote competition and bring down drug prices. But the

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56:50

LIVE with Liz Fowler, director of the Center for...

A Health Podyssey ·

2021/06/09

BONUS EPISODEAs part of Policy Spotlight, a new virtual event series from Health Affairs, Editor-in-Chief Alan Weil welcomed Elizabeth "Liz" Fowler, the new deputy administrator of the Centers for Medicare and Medicaid Services and director of its Center for Medicare and Medicaid Innovation to an in-depth discussion of Biden administration's plans and priorities for health care.The interview was conducted on June 3, 2021.As chief health council to then-Senate Finance Committee Chair Max

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25:30

Features of a zero-burnout primary care practice

A Health Podyssey ·

2021/06/08

Rates of burnout among primary care physicians is a growing concern in the health care workforce. Major shifts in the practice environment — from truncated office visits and growing documentation requirements to practice consolidation — have changed physicians' sense of efficacy and autonomy, both of which are important factors in work satisfaction. The COVID-19 pandemic has heightened these concerns as many physicians have been working long hours while experiencing supply shortages and

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30:54

How shortening skilled nursing facility stays might...

A Health Podyssey ·

2021/06/01

Skilled nursing care is an important Medicare benefit but it also accounts for significant spending.In Medicare, cost sharing applies to patients' care in skilled nursing facilities after the twentieth day of residence. This prompts a spike in discharges from facilities at that time. But does cutting short these skilled nursing facility stays at day 20 negatively impact patient health?J. Michael McWilliams, a researcher from Harvard Medical School and Brigham and Women's Hospital, and

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27:16

Julia Adler-Milstein on tracking the evolution of...

A Health Podyssey ·

2021/05/25

The HITECH Act, part of the broad American Recovery and Reinvestment Act of 2009, ushered in major changes for health care's information and informatics landscape. The legislation may best be known for "meaningful use" requirements attached to hospital and/or physician funding to support the adoption of electronic health records (EHRs).The law also greatly boosted health information exchanges, or networks that share clinical information across different health care settings.On today's

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