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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

24:38

Lowering Medicare eligibility may improve cancer...

A Health Podyssey ·

2021/05/18

"I think we need to step back first before we even ask the policy question and ask this simple question, is it okay in the United States to die of cancer simply because you don't have health insurance?" - Dr. Gerard SilvestriCancer is a leading cause of death in the United States. Although there have been declines in cancer deaths in recent years, improvements have not been equally distributed across the population.The risk of cancer increases with age and nearly a quarter of all new

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21:06

Breaking down how pharmacy deserts and access relate...

A Health Podyssey ·

2021/05/11

Many think of pharmacies primarily as places to get prescription medications, but pharmacists are highly trained clinicals who offer other important health care services. Pharmacies are a valuable health care resource, and access to pharmacies may be an overlooked contributor to health inequities. Individuals who live in pharmacy deserts aren't able to easily obtain prescription medications or essential health care services. While the overall number of pharmacies in the US has increased

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29:03

Understanding private equity investment in hospitals

A Health Podyssey ·

2021/05/04

To say the role of private equity investment in the health care system is growing would be an understatement. In 2018, the valuation of private equity deals in the US health care sector surpassed $100 billion, a 20-fold increase from 2000 when it was less than $5 billion. Now, many are concerned that the incentive structures built into private equity financing have exacerbated trends such as surprise medical billing and contribute to increasing health care prices.Despite the increased

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28:11

Should social risks factor into health care quality...

A Health Podyssey ·

2021/04/27

A central tenant of the move to value-based payment in health care is that quality can be measured and high quality providers should be rewarded for their excellence. But efforts to define and measure quality of care can run into challenges.It's considered benign to take certain types of risk factors, such as disease severity, into account when measuring quality of care. But accounting for social risk factors, like poverty or housing instability, is a lot more controversial.It's also the

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20:05

ACA closed health coverage gaps for pregnant women....

A Health Podyssey ·

2021/04/20

The Affordable Care Act (ACA) has been the law of the land in the U.S. for 11 years and helped more than 20 million Americans gain health coverage. Still, some are losing it, even at times when they arguably need it most. There are demonstrated health benefits for the mother and baby to having insurance before and during pregnancy and after giving birth. But a patchwork of programs leaves care gaps for this population. Typically, Medicaid only covers eligible pregnant women until they’re 60

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21:44

Urgent care centers cost more than you think

A Health Podyssey ·

2021/04/13

The number of urgent care centers grew significantly in the last decade, thanks in part by private equity investments. They seek to lower health costs and be cheaper than the ER by conveniently providing on-demand care for easily treatable conditions. But, when looking at the economics, urgent care clinics may increase net health care spending.In a new research article published in the April 2021 edition of Health Affairs, Dr. Ari Friedman, assistant professor of emergency medicine, medical

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23:28

The ACA led to an increase in the contraceptive-curious

A Health Podyssey ·

2021/04/06

The Affordable Care Act requires all private health insurance to fully cover birth control. According to new research published in the April 2021 edition of Health Affairs, this contraception mandate led to increased use of long-acting reversible contraceptives (LARCs) among women enrolled in high-deductible health plans. LARCs, such as IUDs, previously had high one-time, out-of-pocket expenses.This is a positive development for women, according to Dr. Nora Becker, the lead researcher and

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23:24

Nursing homes have a staff turnover crisis – even...

A Health Podyssey ·

2021/03/30

Nursing homes are challenging places to work. As David Grabowski, a professor of health care policy at Harvard Medical School, notes in today's episode of A Health Podyssey, "we knew the nursing home system was broken before the COVID-19 pandemic."Grabowski recently co-authored two papers in the March 2021 edition of Health Affairs on the topic of nursing home staffing using a new Medicare data set (Payroll Based Journal) that spanned 2017-2019 and is a game changer for measuring quality

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21:27

Do teams work better than solo providers? Spoiler...

A Health Podyssey ·

2021/03/23

Medical training has historically focused almost exclusively on the skills and actions of individual physicians. Increasingly, clinical training is incorporating an understanding of how team-based care affects patient outcomes.For patients with chronic disease such as diabetes, hypertension and high cholesterol, can teams provide better care? Maximilian Pany and Lucy Chen, both MD-PhD candidates in health policy at Harvard Medical School, and coauthors recently published research on that

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23:39

Examining the telehealth digital divide for patients...

A Health Podyssey ·

2021/03/16

The COVID-19 pandemic has prompted an increase in telehealth utilization. Since that growth, researchers have made calls to ensure that telehealth's subsequent growth does not exacerbate disparities in care. Evidence of the “digital divide,” or differences in the technology or skills needed to access telehealth care, is widely documented. Race, age, geography, health coverage, and more can all impact how and if one adopts and uses telehealth services. English language proficiency is one

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24:55

Commercial insurers take note: bundled payments can...

A Health Podyssey ·

2021/03/09

Bundled payments have long been an experiment in the Medicare program to help reduce health care spending. The Affordable Care Act (ACA) gave the Centers for Medicare and Medicaid Services broad authority to test bundled payments, or paying providers for episodes of care instead of for each service provided. Research has found savings associated with participating in the Bundled Payment for Care Improvement (BPCI) initiative. While there have been encouraging results, Medicare has

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25:06

What new pandemic unemployment benefits taught us...

A Health Podyssey ·

2021/03/02

The COVID-19 pandemic caused an enormous wave of disruption to the U.S. economy, leading the unemployment rate to rise to a record high of 14.7% in April 2020. While unemployment has since improved — the unemployment rate in January 2021 was 6.3% — America has yet to reach the employment levels it held before the pandemic.In response to so many out of work, the Coronavirus Aid, Relief, and Economic Security (CARES) Act in March 2020 expanded eligibility for unemployment benefits. Within

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26:43

Yes, COVID-19 changed telemedicine use — but it's...

A Health Podyssey ·

2021/02/23

There's no doubt that the COVID-19 pandemic spurred an increase in telemedicine use. As Americans were reluctant to venture out of their homes in the pandemic's early months, both public and private payers were quick to change telehealth reimbursement policies as admissions plummeted.According to new research published in the February edition of Health Affairs, 30.1% of all outpatient visits were provided via telemedicine from January 2020 to June 2020. The weekly number of telemedicine

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22:11

Building the next generation of American Indian doctors

A Health Podyssey ·

2021/02/16

"Quite honestly, it is not easy to be a nerd on the reservation." - Dr. Donald WarnePathways are not predetermined in life. But, without readily available role models to point to, it can be difficult for young people to know what options may be available as they advance toward adulthood.Currently, there's a shortage of health care providers for Indigenous populations, which have been linked to limited access to care and higher rates of chronic health conditions. As native physicians are

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27:45

What the Biden administration urgently needs to...

A Health Podyssey ·

2021/02/09

In the February 2021 edition, Health Affairs presented a collection of papers from the National Academy of Medicine (NAM) for their Vital Directions for Health and Health Care project.While originally established in 2016, NAM reassessed its priorities and found a vastly different health care landscape in 2020. Not only had the COVID-19 pandemic ripped through the health care ecosystem nationwide, but issues regarding maternal health, mental health, and elder care surfaced as pressing

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21:10

Auditing the admission practices for opioid use...

A Health Podyssey ·

2021/02/02

The opioid epidemic has ravaged American life.It has claimed more than 750,000 lives as a result of a drug overdose since 1999. In 2018 alone, more than 2 million people had an opioid use disorder and more than 800,000 people used heroin.To alleviate these deaths of despair and get people the treatment they need, many individuals are looking to short-term residential facilities for substance use treatment programs, commonly referred to as rehabilitation, or rehab.But, as a paper in the 2021

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26:18

Health economists may be getting the...

A Health Podyssey ·

2021/01/25

Have health economists been underestimating supply-side constraints when making predictions regarding cost and utilization for universal health coverage programs, such as Medicare For All? That's certainly what Dr. Adam Gaffney, a pulmonary specialist from Cambridge Health Alliance and Harvard Medical School, and colleagues posit in a new policy paper published in the January 2021 issue of Health Affairs.As Gaffney and co-authors note in their paper, "focusing only on the impact of health

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21:36

If you give people coverage, they use it

A Health Podyssey ·

2021/01/19

More than 500,000 individuals in the U.S. experience homeless at any given time, and many of those individuals qualify for Medicaid in states that expanded the program under the Affordable Care Act.Medicaid expansion can be helpful for individuals unable to afford private health insurance. Medicaid expansion has been found to slow rates of health decline for some low-income adults, for example. But to date, little is known about the relationship between those experiencing homelessness

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20:32

And the value of an additional star for physicians...

A Health Podyssey ·

2021/01/12

For better or worse, online platforms and social media have enabled individuals to publicly post their opinions of businesses online. As a result, business are at the mercy of public feedback, which can have an impact on their success. Hospitals and physicians are not immune to this trend. The Centers for Medicare and Medicaid Services has pushed the idea of consumerization through price transparency policies and the Five-Star Quality Rating System so that patients can rate their providers,

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25:59

Value-based care isn’t transforming healthcare spending

A Health Podyssey ·

2021/01/05

Every year, Health Affairs publishes a retrospective look at national healthcare spending. In 2020, Anne Martin and colleagues from the CMS Office of the Actuary found that U.S. healthcare spending increased 4.6% to $3.8 trillion in 2019. The rate of health spending declined slightly from 2018, which noted a growth rate of 4.7%. Hospital care, physician and clinical services, and retail purchase of prescription drugs, which accounted for 61% of total national health spending, saw faster

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