A Health Podyssey

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....

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 middl...

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 Healt...

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 dra...

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...

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 ec...

BONUS EPISODE As 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...

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 , Abiga...

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 havin...

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 addit...

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 Podyss...

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 insuranc...

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 effec...

BONUS EPISODE As 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 w...

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 conce...

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...

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...

"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 Silvestri Cancer 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 ac...

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 e...

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 sur...

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...

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 g...

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...

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 ....

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...