Scan this code to subscribe!

01/28/2015

Upcoming Podcasts: Integrated Health Payment & Delivery and Immigrant Health Care Coverage

On February 10th I'll speak with Alan Murray, President and CEO of North Shore-LIJ Care Connect, a new insurance company that is the first provider-owned health plan in the state of New York.

On February 19th, the National Immigration Law Center's Angel Padilla will discuss immigrant health care coverage.  

 

01/26/2015

Blog Post: "Janitor's Insurance" (January 26, 2015)

Since we recently celebrated Martin Luther King's birthday and since, among numerous memorable comments, Dr. King observed, "of all forms of inequality, injustice in health care is the most shocking and inhumane," this blog post.  

01/14/2015

Announcing an Accompanying Blog Feature: First Posting Is Titled, "Whither Primary Care?" (January 15, 2015)

Beginning today I am launching an accompanying blog feature to complement the podcast interviews.  Please click on the "Blog" tab to read the first posting titled, "Whither Primary Care?"   

To get back to the podcast page just click on "Podcast" on the tool bar.

As with all the podcasts please feel free to offer any comments regarding the blog postings.

Thank you.

David Introcaso 

The Rise of Medical Tourism: An Interview with Renee-Marie Stephano (December 22nd)

Listen Now

Medical tourism has been defined moreover as people traveling from less developed to more developed countries to receive medical treatment.   Today, well over one million Americans travel both within the US and worldwide to receive a wide variety of medical interventions.  Medical tourism originating in the US is growing dramatically, it is today considered one of the fastest growing segments in our health care industry.  The primary reason for its popularity is of course cost or cost savings (though wait times can play a factor as well).  A recent NYT poll found for example 46% of respondents describe paying for health care as a "hardship".  Both self-employed companies as well as private insurance plans have offered tourism coverage for certain procedures for several years.  However, like all medical care, procedures received abroad are not without risk.

During this 22-minute interview Ms. Stephano provides a brief overview of her organization, the range of medical services sought, typically where and at what cost savings, its increasing use among self-insured employers, the quality of care received and what recourse patients have in the event of an error.  

Ms. Renee-Marie Stephano is the President and Co-Founder of the Medical Tourism Association Renee[1]and editor-in-chief of the Medical Tourism Magazine.  She works closely with governments, hospitals, business leaders and travel and tourism entities to develop sustainable medical tourism/international patient programs and strategies throughout the world.  She has authored and co-authored several books, has been a keynote speaker at hundreds of international conferences and is a resource regarding medical tourism initiatives for media outlets worldwide.  She earned her JD degree from the University of Pennsylvania.

For more onthe Medical Tourism Assocation see: http://www.medicaltourismassociation.com/en/index.html

 

11/23/2014

Housing IS Healthcare: A Conversation with Rebecca Morley (November 24th)

Listen Now

Beyond the problem of an estimated 600,000 Americans being homeless each night (and 1.5 million in any given year), homelessness or unstable housing is strongly correlated with high rates of chronic illness, unmet healthcare needs and mortality. Inadequate housing impedes access to health care and  an ability to stay healthy such as caring for injuries or disease and taking medications. For the chronically homeless mortality is four to nine times higher than for the general population.   Though current federal Medicaid rules do not allow states to provide supportive housing, it appears the health care industry is nevertheless beginning to close the gap between health care and housing by recognizing and addressing the fact it is a key social determinate of health.

During this 20 minute interview Ms. Morely discusses the work of the National Center for Healthy Housing, the magnitude of the housing "famine," how housing serves as a health care "vaccine," why health care providers have been slow to recognize its importance as a key social determinate of health and opportunities to better intergrate supportive housing and health care.     

Rebecca Morley is the Executive Director of the National Center for Healthy Housing (NCHH), Rebecca photoa national non-profit dedicated to creating healthy and safe housing for children. Among other
things Rebecca spearheaded NCHH's recovery work in the Gulf Coast after hurricanes Katrina and Rita and she led the development of the National Health Homes Training Center. She is the author of numerous publications including the new book, "Healthy & Safe Homes: Research, Practice and Policy." Before joining NCHH, Ms. Morley worked with ICF Consulting on affordable housing and related issues, at HUD as a Presidential Management Fellow and as a Legislative Fellow for Senator Jack Reed.  She serves on numerous boards and commissions including Health Housing Solutions. Ms. Morley was graduated from Nazareth College (in Rochester, NY) with an undergraduate degree in environmental science and from the Georgia Institute of Technology with a master's in public policy.   

For more on the National Center for Healthy Housing go to: http://www.nchh.org/

11/13/2014

Navigating Healthcare via "The Health Care Handbook:" A Conversation with Co-Author Nathan Moore (November 19th)

Listen Now

Despite signifcant press coverage over the past four and a half years many provisions of the Affordable Care Act remain largely unknown to the American public.  Polling data shows slightly less than half of Americans know the ACA is still law, over half said they've heard nothing about the state marketplaces and over a third do not know there's a penalty for not having health insurance.  More generally, researchers have found Americans have a low health insurance literacy rate.  Less than half of those polled were unable to describe an insurance deductable.   None of this is surprising when you realize how complicated health care financing and delivery is.  For example, the recently published final rule that describes changes to how Medicare will pay physicians in 2015 was well over 1,000 pages.  

During this 20 minute interview Dr. Moore discusses the reasons he and Dr. Askin wrote the book, some of their findings, what he was surprised to learn and how health care is delievered in the US, how research and writing the volume changed his practice, reaction to, and use of, the work and changes in the soon-to-be-released second edition.       

Nathan Moore is an resident physician in internal medicine at Barnes-Jewish Hospital in St. Nathan Moore 2Louis. When he and his colleague Elisabeth Askin were in medical school at Washington University, they wrote The Health Care Handbook, A Clear and Concise Guide to the United States Health Care System. To date, approximately 60 medical schools and hospital residency programs have incorporated this handbook into their core curriculum.  Dr. Moore has been a featured speaker at dozens of medical schools, universities and health professions conferences and is currently working on the 2nd edition of the Handbook.  The 2nd edition is anticipated to be released this month. 

To learn more about "The Health Care Handbook" go to: http://healthcarehandbook.wustl.edu/
 

11/04/2014

Factoring in Bio-Psycho-Social Factors to Improve Patient Care Outcomes: A Conversation with Gretchen Alkema (November 4th)

Listen Now

While it appears obvious a person's health status is directly related to their life circumstances the health care industry has been slow to recognize an individual's bio-psycho-social factors or characteristics in planning and delivering an individual's care.  This critcism is typically phrased as clinicians being over attentive to the "patient" and under attentive to the "person".  For various reasons having in part to do with utilization/cost, reimbursement and population health concerns this is changing.  That is the health care industry is developing a greater appreciation and more sophisticated understanding of the non medical predictors of health care risk.  

During this 21 minute interview Dr. Alkema discusses why the health care industry has been slow to adopt socioeconomic factors in care planning and delivery, non-medical factors that correlate with higher care utilization, how these factors or characteristics can be used for predictive purposes and related related issues.  

Dr. Gretchen Alkema currently serves as Vice President of Policy and Communications for The Gretchen Headshot resized[1]SCAN Foundation.  Prior to joining SCAN Dr. Alkema was the 2008-09 John Heinz Health and Aging Policy Fellow serving in the office of Sen. Blanche Lincoln.  Dr. Alkema earned her PhD at the University of Southern California’s Davis School of Gerontology and and completed her post-doctoral training at the VA Greater Los Angeles Health Services Research and Development Center of Excellence.  Her academic research focused on evaluating innovative models of chronic care management and translating effective models into practice.  She is a Licensed Clinical Social Worker and has practiced in government and non-profit settings including community mental health, care management, adult day health care, residential care and post-acute rehabilitation.

Listeners will recall in August 2013 Dr. Alkema discussed the relationship between Medicare utilization and cost and beneficiary (declining) functional status.  

For more on predictive analytics related to high-risk Medicare beneficiaries see: http://www.thescanfoundation.org/sites/thescanfoundation.org/files/identifying_high_cost_benefits_fact_sheet_1_1.pdf

 

10/28/2014

How Relational Coordination Improves Health Care Delivery and Patient Outcomes: A Conversation with Jody Gittell (October 27th)

Listen Now

Half of the US adult population suffers one or more chronic illnesses and two-thirds of the Medicare population suffers three or more.  Largely for this reason, i.e., the prevalenece of chronic conditions, health care delivery, by necessity, is becoming ever increasingly more team based.   Providing care particularly for the chronically ill therefore places a premium on enhanced relational coordination between and among clinicians of all types (and as well those providing social support services) and by all-too-typically siloed provider organizations.    

During this 22 minute interview Professor Gittell discusses how she developed the relational coordination model or tool, what are its seven elements, how it's applied in improving coordination and communication in health care delivery and patient outcomes, how it's measured and examples of its application both in US health care delivery and health care overseas. 

Jody Gittell is a Professor at Brandeis University's Heller School for Social Policy and Management and an expert on relational coordination and organizational performance.  She founded the Unnamed[4]
Relational Coordination Reserach Collaborative in 2011 and co-founded Relational Coordination Analytics Inc. in 2013.  Her most recent work is "Transforming Relationships for High Performance (Stanford University Press, forthcoming).  Before joining Brandeis, Professor Gittell taught at Harvard for six years.  She has published widely in numerous scholarly journals and among other awards was the winner of the Best Book Award from the Alfred P. Sloan Foundation.  Professor Gittell serves on several boards including the Academy of Management Review's editorial board.  She earned her Ph.D. from MIT Sloan School of Management and her MA from The New School.   

For more on relational coordination go to: http://rcrc.brandeis.edu/.

10/13/2014

Improving Mental/Behavioral Health Services: A Conversation with Joyce Wale (October 14th)

Listen Now

Despite recent efforts to improve care delivery for mental health and substance use conditions, for example, passage in 2008 of the Mental Health Parity and Addiction Equity Act, mental health and substance use conditions remain both woefully under-diagnosed and treated.  For example, one recent study of emergency department patients showed psychiatric illnesses were under-diagnosed in 75 percent of patients.   Compounding under diagnosis is the fact that these conditions are highly correlated with common chronic conditions such as heart disease and diabetes - making successful treatment for these illnesses far more difficult and costly.  With major healthcare delivery and financial reforms now being tested under the Affordable Care Act, for example the Primary Care Medical Home and the Accountable Care Organization, there exists today an opportunity to improve substantially diagnosis and treatment for these conditions. 

During this 22 minute interview Joyce Wale discusses the prevalence of mental and substance use conditions and the extent to which they're undiagnosed, efforts (motivated largely by ACA reforms) currently underway to improve care (moreover in the primary care setting) for these patients and what good mental and behavioral healthcare looks like.           

For the past 18 years Ms. Joyce Wale has served as Chief Behavioral Health Officer and Senior 0[1]Assistant Vice President of New York City's Health and Hospitals Corporation where she is
responsible for behavioral health services at over 10 acute care hospitals and numerous diagnostic treatment centers and long term care facilities throughout New York City.  Prior to Joyce served as the Regional Director to the Bronx Mental Health Center and prior still worked for the Bureau of Children's Services at the New Jersey Division of Mental Health and Hospitals.  Joyce has received numerous awards over her thirty-five year career as well as has served on an equal number of professional boards and committees related to mental and behavioral health.  Ms. Wale is a Licensed Clinical Social Worker having been graduated from the University of Louisville with a Masters of Social Work.    

09/13/2014

What are "Narrow Networks and "Reference Pricing" and Do They Work?: A Conversation with Dan Mendelson (September 12th)

Listen Now

Health care insurance plans and policy makers are constantly working toward improving cost management.  Recently two techniques to do so have reemerged in this effort: narrow networks and reference pricing, techniques that have enjoyed success in the past.  Likely the largest (de facto) user of narrow networks is the integrated health plan Kaiser and CalPERS (the California Public Employees's Retirement System) has saved millions in its use of reference pricing.   What are these practices, to what extent are they successful in saving money (and improving health care quality) both for payers and patients and what are the real and/or potential downside risks associated with these practices.  

During this 21-minute interview Dan Mendelson defines these two cost savings techniques, i.e., how do they work or why they are attractive to plans, do they improve health care quality both within and beyond the ACA insurance marketplaces and how or why these techniques might not be in the best interests of patients (and possibly providers as well).   

Dan Mendelson is CEO of Avalere Health, a DC-based health care research and policy consulting firm.  Dan leads the organization's operations and engages in strategic advisory work for major clients in 1375133683_Mendelson_Dan_233x161life sciences, managed care and in many provider segments.   Prior to founding Avalere in 2000, Dan served as Associate Director for Health at the White House Office of Management and Budget.  Dan also presently serves on the board of two public companies: HMS Holdings; and, Champions Oncology.  He previously served on the boards of Coventry Healthcare and Pharmerica.  Dan is also on the faculty at the Wharton School of Business at the U. of Penn.  He holds a BA in Economics and Viola Performance from Oberlin College and a MPP from the Harvard Kennedy School of Goverment.