The Healthcare Policy Podcast ® Produced by David Introcaso

Substack Post #6, "CMS and the Masquerade of Equality" (September 26th)

Is at: https://substack.com/inbox/post/75107864. 

It opens with: In summarizing Professor Jedediah Purdy’s recent book, Two Cheers for Politics, The New Yorker’s Adam Gopnik recently wrote, “He [Purdy] is angry at the elites who supervise the bureaucratic capitalist state on behalf of their overlords while keeping up an elaborate masquerade of equality of opportunity.”   “Keeping up the masquerade of equality” accurately defines CMS’s continuing pretense to value or prioritize health equity.

 

 

Substack Post: What to Make of the House Ways and Means Climate and Health Hearing (September 19th)

This morning I posted this: https://davidintrocasophd.substack.com/p/what-to-make-of-the-house-ways-and. 

It opens with:

This past Thursday the House Ways and Means Committee, with jurisdiction over the Medicare program, held a hearing titled, “Preparing America’s Health Care Infrastructure for the Climate Crisis.”  The hearing, the first and only climate crisis-related hearing Ways and Means will hold this Congressional session, was motivated in part by Democratic majority staff’s release of findings resulting from three requests for information (RFIs) majority staff forwarded to industry providers, trade associations and group purchasing organizations earlier this year to help majority staff “better understand how climate events have impacted the health sector, as well as steps the health care industry is taking to address its role in mitigating the climate crisis.”   

The hearing and accompanying RFI findings are notable for at least five reasons.

Matthew Albright Discusses Hospital and Insurer or Payer Price Transparency (September 13th)

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Over the past few years federal policymakers have instituted healthcare price transparency.  Until last year, healthcare prices were largely, if not altogether, unknown to patients.   As of this past July 1 most group health plans and issuers of group or individual health insurance are required to publicly disclose pricing information.  As of this past January 1, providers were no longer able to surprise or balance bill patients for care they unknowingly received from providers outside their insurer’s network.  As of January 1, 2021 hospitals have been required to provide clear & accessible pricing information about the items and services they provide.  Though price transparency is sound in theory, what effect, if any, it will have on patient or consumer decision making, reducing price growth and influencing care delivery and innovation are largely unknown.    

During this 36 minute conversation , Mr. Albright begins by briefly describing work done by Zelis.  He moves on to discuss/explain why healthcare price transparency took so long, what specific price data are hospitals and payers required to publicly disclose, how will employer-based insurers use the transparent data, he comments on hospital compliance or lack thereof, related state price transparency efforts and concludes with a comment regarding how and why price transparency will finally be realized.       

Mr. Matthew Albright is currently Chief Legislative Affairs Officer at Zelis.  Prior to joining Zelis, Matthew oversaw the certification program at the Center for Affordable Quality Healthcare (CAQH) and Committee on Operating Rules for Information Exchange (CORE) to ensure conformance with the requirements of the Patient Protection and Affordable Care Act (PPACA).  He also served as Director of the Administrative Simplification Group for the Centers for Medicare and Medicaid Services (CMS).  In this role, Matthew was responsible for drafting the regulations that implemented Section 1104 of PPACA which specifies the requirements of the Health Insurance Portability and Accountability Act (HIPAA) administrative transactions.   Matthew is a published author on bioethics, has written numerous state and federal regulations, and taught as adjunct faculty at St. Martin's University and Pierce College in Washington State.   Mr. Albright earned a Master of Divinity from Harvard University with an emphasis in Bioethics, a BA in Religion Studies from the College of Santa Fe and a BA in Print Journalism from the University of Southern California.

 

Substack Post: "How To Solve HHS’s Failure To Address The Climate Crisis" (September 12th)

For this week's post I noted my essay posted this past Friday by Health Affairs and titled, "How To Solve HHS's Failure to Address the Climate Crisis."  It is at: https://www.healthaffairs.org/content/forefront/solve-hhs-s-failure-address-climate-crisis.   It also appears via Substack at: https://davidintrocasophd.substack.com/p/how-to-solve-hhss-failure-to-address. 

It opens with: 

"From an anthropocentric perspective the climate crisis is fundamentally a threat to human health if not survival. The World Health Organization defines it as “the single biggest health threat facing humanity.” Logic dictates that the Department of Health and Human Services (HHS) take the lead in mitigating climate-related health harms. President Joe Biden immediately recognized this reality in a January 2021 executive order that stated because the US has a “narrow moment” to take action he directed HHS to, in sum, decrease climate-related risks among the elderly, children, and people with disabilities.

However, after two rule-making cycles, the Centers for Medicare and Medicaid Services (CMS) has failed to take any regulatory action requiring Medicare and Medicaid providers to reduce their considerable carbon footprint. CMS’s last 2023 opportunity was via the hospital inpatient prospective payment rule finalized August 1."

 

Substack Post: The Inflation Reduction Act Offers the Healthcare Industry an Opportunity to Save Itself (Sept. 5th)

This writing makes note of the fact that the likely, if not definitively, more significant healthcare provisions of the Inflation Reduction Act are the new law's tax credits - because tax exempt entities, like the 60% of hospitals that are non-profit, can exploit them.  

At: https://davidintrocasophd.substack.com/p/the-inflation-reduction-act-offers. 

 

Please read and as always feel free to comment.