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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

18:43

Concierge Medicine Helps Physicians But at What Costs...

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

2014/03/06

Listen NowConcierge medicine (also termed membership medicine, direct pay or cash only practice) has become a rapidly-growing care model moreover among primary care physicians. In concept, physicians charge patients a monthly or annual fee that can vary widely from approximately $50 per month to $25,000 per year (or accept cash only per visit). In exchange patients are promised greater access, longer appointment times and possibly services not typically reimbursed by payers. The current number of

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21:45

Primary Care Medical Homes, What Are They and Are...

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

2014/02/20

Listen NowThe term "medical home" was first introduced in the 1960s by the pediatric profession. Still to date this model of care emphasizes team-based comprehensive, continuous and coordinated care. The care model is intended to improve primary care generally via improved patient communication, care quality, safety and outcomes. In several ways the ACA encouraged the adoption of the, now termed, Primary Care Medical Home/PCMH for both the Medicaid and Medicare programs and among private health

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20:00

The Debate Over ACA-Mandated Contraceptive Coverage:...

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

2014/02/06

Listen NowIn late January in a case involving a Catholic charity, the US Supreme Court issuesd a ruling temporarily exempting religious-affiliated non-profits from providing ACA-required contraceptive coverage. (The ACA coverage requirement was based on an IOM recommendation that found birth control is "medically necessary." The requirement took effect January 1st). While churches and houses of worship are exempt, owned or controlled religious organizations can opt out of the contraceptive

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25:31

What's Being Done in the Clinical Practice Setting to...

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

2014/01/20

Listen Now(This podcast is a companion to the November 13th interview with Infectious Diseases Society of America's Amanda Jezek.) As previously noted, conservative estimates show hospital-acquired infections (HAIs) alone sicken two million Americans, directly kill 23,000 and contribute to a total of 100,000 deaths each year. The bacterial infection C. diff (Clostridium difficile) alone causes 250,000 people to be hospitalized annually. The US has some one of the highest infection resistant rates

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15:39

Will An Emergency Room Really Treat Everyone...

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

2014/01/10

Listen Now The Emergency Medical Treatment and Labor Act (EMTALA) was passed in 1986 under the Reagan administration to help prevent patient dumping. The law requires hospitals to provide emergency medical treatment to anyone regardless of citizenship, legal status or ability to pay. In recent years however hospitals have begun to impose upfront emergency room fees. Today approximately half of all hospitals do so. Hospital executives claim these fees reduce ER overcrowding by diverting patients

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21:29

Life (and Death) as a Hospice Physician: A...

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

2013/12/21

Listen NowOf the two and a half million Americans that die annually, less than half, or 45%, die under hospice care. About one-third of these deaths are cancer related the remainder are moreover from heart and lung disease and dementia. Of the over 5,000 hospice providers nearly two-thirds are for profit. Over 80% of all hospice care is paid for by Medicare. While hospice care is ever-increasingly becoming accepted by the public, the program's benefits are compromised largely due to the fact that

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21:05

The Mind-Body-Heart Connection in Health and Evidence...

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

2013/12/18

Listen Now Transcendental Meditation (TM) has long been studied as an approach to improving health status generally and lowering blood pressure specifically. For example, the American Heart Association published research in 2012 that found African Americans who practiced TM regularly over five years were almost half as likely to have a heart attack or stroke or die from all causes compared to African Americans who attended health education classes due to lowered blood pressure and improved anger

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19:36

Declining Heart Rate Variability as a Predictor of...

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

2013/12/09

Listen NowHuman physiology or biological functioning exhibits fractal or irregular patterns. When heart rate, (or respiration rate, blood pressure, brain waves and even walking stride length) begins to lose its fractal dimension or there is a loss of heartbeat variability, this is an indication of illness. In order to respond best to environmental circumstances, adaptative variability (not homeostasis) is what organisms strive toward. Measuring therefore the decline in heart rate variability over

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22:03

Will The 100,000 (& counting) Mobile Medical...

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

2013/11/22

Listen NowAccording to Information Week there are now approximately 100,000 mobile medical applications (double the number from last year) and the market for these applications is expected to grow from $500 million in 2010 to $8 billion by 2018. These applications promise to provide the consumer with everything from health and wellness information to cancer diagnoses. What do we know about who uses mobile medical applications or digital therapeutics, why and to what effect? During this 22

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23:54

Are Medical Errors the Third Leading Cause of Death...

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

2013/11/21

Listen NowIn 1999 the Institute of Medicine published "To Err Is Human," a report that shocked the medical establishment because it concluded as many as 98,000 Americans die annually from hospital caused medical errors. In 2000 the highly respected scholar Dr. Barbara Starfield estimated medical errors or adverse events actually amount to 225,000 deaths annually making them the 3rd leading cause of death after heart disease and cancer. Most recently a study published this past September in the

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17:03

Reforming Graduate Medical Education to Address the...

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

2013/11/14

Listen NowIt's estimated in the next few years the Affordable Care Act will add 25 million Americans to the health care insurance rolls. In addition, 10,000 Americans age into Medicare every day. Current estimates by the Health Resources and Services Administration and others show the country already has a shortage of health care providers, particularly primary care physicians, and the shortage is projected to grow substantially worse by 2025. Since we can neither meet the demand nor improve

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24:43

Hospital-Acquired Infections Contribute to 100,000...

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

2013/11/13

Listen NowConservative estimates show hospital-acquired infections (HAIs) sicken two million Americans, directly kill 23,000 and contribute to a total of 100,000 deaths each year. The bacterial infection C. diff (Clostridium difficile) alone causes 250,000 people to be hospitalized annually. Healthcare costs associated with these infections are estimated at over $50 billion. These illnesses and deaths are largely the result of an overuse or misuse of antibiotics that causes bacteria to

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22:34

How Best Can Medical Malpractice Policy Be Reformed:...

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

2013/10/16

Listen NowUS medical malpractice policy is considered to be substantially flawed. Only a small percent of patients harmed file claims, awards even for similar injuries vary widely, and "defensive" medicine that leads to over-testing and treatment inflate health care costs by as much as $55 billion annually. What reforms can be made to "medmal" policy to improve patient safety, reduce health care costs and create greater trust between the public and the health care industry. During this 22-minute

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21:37

Interview with Robb Cohen on Proposed Changes to...

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

2013/10/11

Listen NowFor nearly four decades, Maryland's “all payer” system has set hospital prices for the state's 53 hospitals. The state regulates prices for every insurer including Medicaid, Medicare and patients who pay their own bills. Last week the state proposed to substantially alter how it pays state hospitals by creating over time a capitated payment system (a hard cap) that would increase overall spending using a ten year rolling average. Maryland would save a minimum projected $300 million over

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22:48

Enroll America's Efforts to Maximize ACA Insurance...

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

2013/10/04

Listen NowThis past October 1st uninsured Americans who qualify for coverage under the Affordable Care Act could begin choosing a health care insurance plan offered via their state's healthcare insurance marketplace or exchange. The CBO estimates about 14 million Americans will buy health care insurance for 2014 and about 25 million will do so by the end of the decade (still leaving about 20 million Americans uninsured). Those that make more than the Federal Poverty Level/FPL but less than four

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22:27

What Progress Did the Congressionally-Appointed Long...

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

2013/09/27

Listen NowAs part of last year's "fiscal cliff" agreement the Congress created a Long Term Care/LTC Commission tasked to make recommendations to improve LTC delivery. (The Commission was created largely as a result of the demise of the ACA's CLASS Act. See the related August 5th interview with Connie Garner.) Today more than 12 million Americans rely on LTC services and this number will grow dramatically as baby boomers age. Currently however only impoverished older Americans and the disabled

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26:13

How Safe Are Medical Devices: A Conversation with...

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

2013/09/25

Medical devices, everything from tongue depressors to pace makers and defibrillators, are regulated by the FDA. How competently or effectively the FDA regulates these products has been questioned for several years in part due to the substantial increase in recent years in product recalls, for example the recall of certain hip implant devices. More specifically is the question whether the FDA's 510(k) process, that reviews or “clears for the market” medical devices, is adequate. An IOM study of

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21:43

Do Workplace Wellness Programs Work and For Whom: A...

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

2013/09/20

Listen NowToday nearly all large employers offer a workplace wellness programs and most small employers that offer health benefits also offer at least one wellness program. Typically these programs consist of health risk assessments, biometric screenings, health coaching and lifestyle management education. Program popularity is not surprising considering the epidemic in what's termed "lifestyle diseases" due to, in part, poor nutrition and tobacco use. To encourage employee participation in

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21:12

Implementing (and Improving) the ACA: A Conversation...

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

2013/09/08

Listen NowDuring this 21-minute interview, Professor Nichols discusses the reasons for the decline in health care cost growth and whether its slowing will persist, alternative payment models (to fee for service) that contribute to this decline, how worrisome or not health care market consolidation is as well as the prospect of employers dropping employee health care coverage, why Congressional Republicans (moreover House Republicans) oppose the ACA, ways of improving the law via moroever price

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26:37

Improving Chronic Care Means Improving Functional...

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

2013/08/05

Listen NowThe most expensive Medicare beneficiaries are not those with multiple chronic conditions. They are those with chronic conditions AND functional impairment (i.e., those needing help with routine life activities). For example, the 15% of Medicare enrollees with both chronic conditions and functional limitations disproportinally account for one-third of Medicare spending. Alternatively, Medicare enrollees with three or more chronic conditions but no functional impairment (48%) account for

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