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4 posts from January 2013


Interview with Dr. Jessie Gruman on What Does "Patient Engagement" Mean and Why It's Essential in Improving Health Care Delivery and Patient Outcomes (January 29, 2013)

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During this 28 minute podcast Dr. Gruman explains briefly the mission of the Center for Advancing Health.  She then defines what is patient engagement or patient participation by identifying ten categories that add up to 43 specific patient engagement behaviors.  Dr. Gruman then explains why patients are all too frequently unengaged in their own health care due to, for example, low literacy or health literacy, disability, etc.  She discusses how patients can actively engage in their own care using her own experiences as a cancer survivor as an example and what health care providers and regulators are doing to improve patient decision making and patient engagement measurement.  The interview concludes with comments on the work of the ACA-mandated Patient Centered Outcomes Research Institute (PCORI) and the role of family or informal caregivers.  

Dr. Jessie Gruman is President of the Center for Advancing Health, aGruman[1] nonpartisan, Washington-based policy institute dedicated to advancing patient engagement in health care delivery, i.e., the Center advocates for policies and practices to overcome the challenges people face in finding good care and getting the most from it.   Dr. Gruman is also a Professorial Lecturer in the School of Public Health and Health Services at The George Washington University.  She serves on the board of trustees of the Center for Medical Technology Policy and the Technical Board of the Milbank Memorial Fund.   She too is a fellow of the Society for Behavioral Medicine and a member of the Academy of Arts and Sciences, the Council on Foreign Relations and the NY Academy of Medicine.  Among other works, Dr. Gruman is the author of The Experience of the American Patient: Risk, Trust and Choice (Health Behavior Media, 2009).  She was graduated from Columbia University with a Ph.D. in Social Psychology.   


Dr. Joanne Lynn Discusses Improving Care Transitions to Avoid Hospitalizations and Re-hospitalizations (Janurary 23, 2013)

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This 35 minute interview begins with Dr. Lynn describing the work of her Center in addressing how to improve care for the frail elderly.  Dr. Lynn then explains in some detail a three-year quality improvement intervention undertaken by 14 QIOs (Medicare Quality Improvement Organizations) that reduced hospitalizations and re-hospitalizations by almost six percent, i.e., she summarizes today's JAMA-published article she co-authored, "Association Between Quality Improvement for Care Transitions in Communities and Re-hospitaliations Among Medicare Beneficiaries."  Dr. Lynn explains what is "quality improvement" research or moreover how/why it differs from more traditional clinical practice improvement research.  She addresses generalizability in context of QI research, how hospitals may reconcile reduced hospitalizations and rehospitalizations and how this improved care transitions work is being extended via several other federal programs.  Finally, Dr. Lynn discusses how and why we need  to re-engineer health care delivery to create reliable, supportive services, not necessarily medical services, to assist and support an ever increasing population of frail elderly that will experience lenghty periods of disability.  

Dr. Joanne Lynn leads the Center on Elder Care and Advanced Illness for the Altarum Institute.   She previously has served as a consultant to the administrator of the Centers for Medicare and Medicaid Services, as a faculty member of the Institute for Healthcare Improvement, and a clinical expert in improvement for the Care Transitions project at the Colorado Foundation for Medical Care.  She has also been a senior researcher at RAND and a professor of medicine and community health at Dartmouth Medical School and at The George Washington University. 

Dr. Lynn has published more than 250 professional articles. Her dozen books include The Handbook for Mortals, a guide for the public; The Common Sense Guide to Improving Palliative Care, an instruction manual for clinicians and managers seeking to improve quality; and, Sick to Death and Not Going to Take it Any More!, an action guide for policymakers and advocates.  She is a member of the Institute of Medicine and of the National Academy of Social Insurance, a fellow of the American Geriatrics Society and The Hastings Center, and a master of the American College of Physicians.  She received her MD from Boston University.


Dr. Paul Van de Water Discusses Recommendations to Stabilize the Federal Debt, Including Recommendations for Reforms to Medicare and Social Security (January 17, 2013)

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In this 34 minute podcast Dr. Paul Van de Water explains the Center on Budget and Policy Priorities' recent call for an additional $1.5 trillion in budgetary savings to stabilize the federal debt at 73% of the GDP.  He discusses the revenue option of limiting individual tax deductions.  On the spending side, savings from Medicare drug pricing and greater beneficiary means testing are discussed and more generally whether Medicare cost growth, comparatively modest over the past three years, will pesist as the national economy recovers.  Dr. Van de Water explanis the merits of applying chained CPI (Consumer Price Index) to index Social Security benefits (to generate additional federal savings) and raising Social Security taxes without limit on annual earnings (currently annual income is taxed up to $113k).  Finally, Dr. Van de Water discusses the problem/s with applying "dynamic scoring" to Congressional Budget Office scoring.            

Dr. Paul N. Van de Water is a Senior Fellow at the Center on Budget and Policy Priorities where he Pvandewater_standard[1] specializes in Medicare, Social Security, and health coverage issues.  Previously he was Vice President for Health Policy at the National Academy of Social Insurance and from 2001 to 2005 served as Assistant Deputy Commissioner for Policy at the Social Security Administration.  Dr. Van de Water worked for over 18 years at the Congressional Budget Office in a variety of capacities.  He was graduated from the Massachusetts Institute of Technology with a Ph.D. in economics.


Interview With Sarah Kliff and Amy Lotven on What Medicare and Medicaid Reforms Might We See in 2013 (January 8, 2013)

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Since the remedy to the "fiscal cliff" did not include structural reforms to Medicare and Medicaid and since Congressional Republicans will call for entitlement savings during the upcoming debt ceiling debate and beyond, Ms. Sarah Kliff, Health Reporter for The Washington Post and Ms. Amy Lotven, Editor/Reporter for Inside Health Policy, discuss what reforms to Medicare and Medicaid are on the table during this session of the 113th Congress. During this 32 minute podcast raising the Medicare eligibility age from 65 to 67, Medicare means testing, the Medicare Independent Payment Advisory Board, the Medicare Sustainable Growth Rate (the "doc fix"), reforms to the Medicaid program and other related issues to reduce federal health care spending are discussed.

Sarah-kliffSarah Kliff covers health policy for the Washington Post. Previously, Sarah wrote for Politico, where she authored Politico Pulse. Prior to Politico, Sarah was a staff writer at Newsweek covering national politics. She is the recipient of fellowships from the Kaiser Family Foundation and USC Annenberg School of Journalism.


Amy-lotvenAmy Lotven has been for the past five years a health policy editor and reporter at Inside Health Policy.  She has worked previously for newspapers in New Mexico, New York and North Carolina. She did her journalism training at Baruch College.