The Healthcare Labyrinth

With vital agent-broker compensation reform now stayed by a federal judge, CMS and Congress need to work together to pass these needed reforms. The status quo hurts Medicare Advantage and enrollees. Episode Teaser: With vital agent-broker compensation reform now stayed by a federal judge, CMS and Congress need to work together to pass these needed reforms. The status quo hurts Medicare Advantage a...

Opponents of Medicare Advantage (MA) have opened a new line of attack on the program, arguing supplemental benefits are more of a marketing scam than a true value. MA plans need to take the issue very seriously and reform their programs. About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.   Between out-of-control costs, countless i...

While hospitals oppose them, there is a strong need to enact comprehensive site neutral payment policies to lower costs in the healthcare system and to protect Americans hit by very high out-of-pocket payments. About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affo...

The Supreme Court struck the "Chevron Deference" precedent after it stood for 40 years. The decision will upend regulatory rulemaking in America, especially in healthcare. The decision has its pros and cons. About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.   Between out-of-control costs, countless inefficiencies, a lack of affor...

In a major example of a regulatory agency ignoring explicit regulations, the Centers for Medicare and Medicaid Services' (CMS) TukeyGate ended in embarrassment for the agency, recalculation of 2024 Medicare Advantage Star scores, and resubmission of 2025 MA bids and benefits for winning plans. About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthc...

Affordable universal access to healthcare is a critical component of healthcare reform. America should keep its employer-based healthcare system but create one single social safety net for those disenfranchised from employer-sponsored coverage.    About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.   Between out-of-control costs, c...

Care management/population health is a critical component of healthcare reform. I propose that America end its obsession with utilization management and prior authorization and pivot to care management and population health. Much more savings and better outcomes would result. About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.   Be...

Price reform is a critical component of healthcare reform. I propose that the nation adopt a national and/or regional uniform price-setting system for hospitals and providers. It would save tens of billions, if not hundreds of billions, on services and administrative costs. About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.   Betw...

While I know healthcare reform will not happen this year, I offer my modest proposal for healthcare reform to show how there would be something in it for Democrats, Republicans, and healthcare consumers. About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.   Between out-of-control costs, countless inefficiencies, a lack of affordabl...

As with the past two presidential elections, Election 2024 appears to be very close in terms of the presidency and control of Congress.   Healthcare could still play a role in some of the counties, districts, and states that will decide the overall outcome. About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.   Between out-of-contro...

With all the major talk of risk-adjustment overpayments coming from numerous regulators, lawmakers, and MA detractors, MA plans should ready for changes to risk adjustment submissions.   About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.   Between out-of-control costs, countless inefficiencies, a lack of affordable universal acces...

Marc concludes his podcasts on health plan economics with a look at major healthcare trends and their impact on health plan economics and finance. About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.   Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prev...

Medicaid managed care plans did well during COVID and during the disenrollment period, but could be in store for some challenges with less federal aid flowing to states and major new mandates coming. About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.   Between out-of-control costs, countless inefficiencies, a lack of affordable un...

If the enhanced premium subsidies were to lapse, the Marketplace Exchanges could see financial troubles again.   About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.   Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in d...

While the No Surprises Act is saving patients from huge bills, the badly crafted bill will drive healthcare costs up dramatically over time. About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.   Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention...

There are a lot of major changes in store for Medicare Advantage plans in 2025, from another very tight rate announcement and a myriad of policy changes. About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.   Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness a...

My courageous daughter just had brain surgery. Hear about her surgery, her recovery, and why we think she is so lucky to have had strong health insurance. We are blessed. Not everyone is so lucky and we want you to know about it. About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.   Between out-of-control costs, countless inefficie...

Episode Teaser: The drug and PBM transparency movement is rising due to the opaqueness and exorbitant prices in the current system.   It is something we need to embrace and push along. About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.   Between out-of-control costs, countless inefficiencies, a lack of affordable universal access,...

About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change. Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcas...

About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.   Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change.   Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Po...

King Charles has been diagnosed with cancer.  It has led to a debate within the U.K. about access to cancer and other treatment.  What does his cancer tell us about access around the world, including the United States?  Listen in to learn more on the latest Healthcare Labyrinth Podcast.   Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.   Between...

Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change. Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible...

Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change. Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible...

Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change. Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible...

Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change. Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible...