Podcast appearances and mentions of mark pauly

Wharton Health Management Professor, Mark Pauly, joins the show to discuss the current state of healthcare in the United States and how each presidential candidate's healthcare policies will impact Americans. Hosted on Acast. See acast.com/privacy for more information.

US healthcare spending is extreme currently at approximately $4.3 trillion.  The single largest payer of healthcare services is Medicare at roughly $900 billion annually or 21% of total healthcare spending.   In this edited volume, recently published by Johns Hopkins University Press, Dr. Moffit along with eleven other contributors including Joe Antos, Douglas Holtz-Eakin, Brian Miller, Mark Pauly and Gail Wilensky, lay out the conservative version of Medicare reform.  In sum, the authors argue federal policymakers reinvent Medicare as a defined contribution or premium support program or at minimum substantially expand the Medicare Advantage program (Medicare Part C), or Medicare coverage provided by private insurance companies.  The interview begins by Dr. Moffit commenting on whether healthcare services can be defined as a market commodity. He discusses the problem of healthcare pricing, measuring for value in healthcare, improving Medicare Advantage benchmarking, remedying Medicare Advantage coding intensity via retrospective risk adjustment and risk transfer pools and competing fee for service Accountability Care Organizations (ACOs) against Medicare Advantage. Dr. Robert Moffit is a Senior Fellow in Domestic Policy Studies at The Heritage Foundation specializing in health care and entitlement programs, moreover Medicare. Dr. Moffit also serves on the Maryland Health Care Commission as an appointee of Gov. Larry Hogan and he is a member of the advisory board of the Buckley School of Public Speaking in Camden, South Carolina. He brings to the reform effort experience as a senior official of the U.S. Department of Health and Human Services (HHS) and the Office of Personnel Management (OPM) during the Reagan administration. Dr. Moffit is a co-author of “Why Obamacare Is Wrong for America,” (Harper Collins, 2011). He was a contributor to “A Time for Governing: Policy Solutions From the Pages of National Affairs” (Encounter Books, 2012) and “Controversial Issues in Social Policy” (Allyn and Bacon, 2003), a university textbook on public policy. He has published in numerous professional and specialty journals among them Health Affairs, Health Systems Review, Harvard Health Policy Review, Inquiry, Journal of Law, Medicine and Ethics, National Affairs, New England Journal of Medicine, Postgraduate Medicine, and Journal of Medicine and Philosophy. His analysis and commentary have been cited or published by The New York Times, The Wall Street Journal, The New York Post, The Washington Post and The Washington Times. He holds a master's degree and a doctorate in Political Science from the University of Arizona. He received his bachelor's degree in Political Science from LaSalle University in Philadelphia. Information on “Modernizing Medicare,” is at: https://www.press.jhu.edu/books/title/12839/modernizing-medicare. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

Walmart is moving forward with plans to open more health centers across the country. But Wharton's Mark Pauly says the retailer isn't set up to provide continuity of care. Hosted on Acast. See acast.com/privacy for more information.

Mark Pauly, Wharton Professor Emeritus of Healthcare Management, joins the show to discuss the rising costs of insulin on the heels of Eli Lily's announcement that it will cap insulin prices at $35 per month. Hosted on Acast. See acast.com/privacy for more information.

Dr. Sherry Glied is dean of the New York University Wagner Graduate School of Public Service. Dr. Mark Pauly is a professor of health care management at the Wharton School of the University of Pennsylvania. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. S. Glied. Health Policy in a Biden Administration. N Engl J Med 2020;383:1501-1503. M.V. Pauly. Health Policy after a Trump Election Victory. N Engl J Med 2020;383:1503-1505.

Wharton's Mark Pauly and Genevieve Kanter a professor at Penn's medical school discuss potential changes to the rules on preventing physician kick-backs. See acast.com/privacy for privacy and opt-out information.

Vermont Senator Bernie Sanders has announced his candidacy for President of the United States in 2020. His policy agenda includes a single payer healthcare system, "Medicare for All.” Under this plan, the current system, including Medicare and Medicaid, would go away, with some exceptions for elective procedures. This proposal has been controversial because of the high costs of implementing such a government program that covers all Americans. But could a national health insurance program work for the United States? Host Dan Loney talks with Mark Pauly, a Professor of Health Care Management and Professor of Business Economics and Public Policy at the Wharton School, and Rob Field, a Professor of Law and Professor of Health Management and Policy at Drexel University and lecturer in Wharton’s Healthcare Management Department, to find out more about the possibilities of shaking up US health care systems on Knowledge@Wharton. See acast.com/privacy for privacy and opt-out information.

We're featuring a series this month called “2019: A Look Ahead” and continue with a look at the future of the Affordable Care Act. In the first two years of the Trump Administration and a Republican-controlled Congress, the ACA was challenged on a variety of fronts including the tax bill. Passed just over a year ago, the bill removed the health insurance mandate leading to the recent ruling by a federal judge in Texas that the ACA was unconstitutional. A coalition of 17 Democratic State Attorneys General is appealing that ruling and the new Democrat-controlled House is looking at ways to protect the healthcare law. Host Dan Loney examines all sides of the arguments with Mark Pauly, Health Management Professor at Wharton, Eric Clemons, Professor of Operations, Information and Decisions at Wharton, and Robert Field, Professor of Law and of Health Management and Policy at Drexel University, on Knowledge@Wharton. See acast.com/privacy for privacy and opt-out information.

A key question in debates over Obamacare is whether its community rating provisions are necessary to provide complete risk protection to consumers. A new study of one insurer by Anthony LoSasso and colleagues finds that the insurer did increase premiums for small employers whose expected claims were above average, but the increase in premiums only ranged from 5 percent to 43 percent of the increase in expected costs. These findings suggest that even before Obamacare, the market for small-employer coverage did a lot to protect high-cost employees from having to pay premiums that reflect their higher health risk. Come hear leading scholars on the economics of health insurance, Mark Pauly and Anthony LoSasso, discuss these findings and their implications. See acast.com/privacy for privacy and opt-out information.

Listen NowThe Medicare Shared Savings Program's Accountable Care Organization (ACOs), created by Section 3022 of the 2010 Affordable Care Act constitutes the flagship Medicare pay for performance (P4P) program.  Though there are other P4P (also termed pay for value) models, for example two bundled payment models (Bundled Payments for Care Improvement and Comprehensive Care for Joint Replacement), they are short-lived CMS demonstrations.   If the federal government is to bend the Medicare spending curve or make the program more financially sustainable it will likely be due moreover to the success of ACOs.  Though provider participation in ACOs is substantial, this year there are 561 ACOs providing care to 10.5 million Medicare beneficiaries, the program has to date achieved marginal success.  Over four performance years (2013-2016), ACOs have saved substantially less than one percent of annual Medicare spending (now over $700 billion) - which is why the DHHS Secretary Alex Azar recently admitted candidly ACO performance has been "underwhelming" and "lackluster."  Even before the Medicare ACO program formally began there have been questions and criticism about the model's design.  Perhaps no one has written more about the model's flaws than Kip Sullivan.    During this 32 minute conversation Mr. Sullivan discusses the genesis of ACOs including results from its predecessor, the Physician Group Practice demonstration, assumptions made in the the design of the model, e.g., the relationship between cost and quality and the effectiveness of financially incenting physicians, and moreover the problem of addressing care quantity instead of pricing.  In sum, Mr. Sullivan argues the Medicare ACO model is fatally flawed and will not achieve meaningful success. Mr. Kip Sullivan is currently a member of the board of the Minnesota chapter of Physicians for a National Health Program.  Mr. Sullivan began his career as a staff attorney for the New York Legal Aid Society and as a researcher for Citizens Action League in California.  Form 1980 through 2000 he researched universal health insurance and a single payer system for Minnesota COACT (Citizens Organized Acting Together).   He also served as a consumer representative on the Minnesota Governor's Health Plan Regulatory Reform Commission in the 1980s.  From 2000 to 2007 Mr. Sullivan was a health system analyst for the Minnesota Universal Health Care Coalition.  Mr. Sullivan has written over 150 health policy articles for the American Journal of Public Health, the Journal of Health Politics, Policy and Law, the LA Times, The Nation, The New England Journal of Medicine, The New York Times, and others.  He published 2006 "The Health Care Mess: How We Got Into It and How We'll Get Out of It."  Mr. Sullivan earned his undergraduate degree from Pomona College and his law degree the Harvard School of Law.   Mr. Sullivan's latest essay, "Curb Your Enthusiasm," is at: http://thehealthcareblog.com/blog/2018/04/16/curb-your-enthusiasm/.The Lawton Burns and Mark Pauly essay titled, "Transformation of the Health Care Industry: Curb Your Enthusiasm," in the the recent Milbank Quarterly, that is noted during this discussion is at: https://onlinelibrary.wiley.com/doi/full/10.1111/1468-0009.12312. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

Hosts Nicolaj Siggelkow and Harbir Singh talk with the authors of the new book “Managing Discovery in the Life Sciences: Harnessing Creativity to Drive Biomedical Innovation” on Mastering Innovation. Authors are: Philip Rea, Professor of Biology at the University of Pennsylvania, Mark Pauly, Professor of Health Care Management and of Business Economics and Public Policy at the Wharton School, and Lawton R Burns (Rob), Professor of Health Care Management at the Wharton School. See acast.com/privacy for privacy and opt-out information.

The most fundamental discoveries often occur when an experiment doesn’t turn out as planned. Authors Lawton R. Burns, Mark Pauly, and Philip Rea discuss the element of serendipity in the life sciences. Read more: https://mackinstitute.wharton.upenn.edu/2018/life-sciences-burns-pauly-rea/ See acast.com/privacy for privacy and opt-out information.

HHS Secretary Alex Azar laid out an ambitious plan to promote value-based care this week, pledging that there's "no turning back" when it comes to reforming how hospitals and doctors get paid. What does it all mean? Karen Murphy's in position to know: She's the Chief Innovation Officer at Geisinger Health System, but she also previously worked in the Obama administration, helping to oversee value-based care efforts, and served as Pennsylvania's Secretary of Health too. Karen discussed how value-based care is playing out at the provider level, what she makes of Azar's comments on value-based care and medical marijuana, what Geisinger is doing on the biggest public health challenges and why she thinks every health care worker needs to do a stint in government. (Starts at the 18:20 mark.) But first: POLITICO's Sarah Karlin-Smith and Rachana Pradhan joined Dan Diamond to discuss the latest Trump administration changes to Medicaid, the most recent developments related to the opioid crisis and HHS' evolving communication strategy (Starts at the 1:50 mark). We'd appreciate your help: Please share PULSE CHECK and rate us on your favorite podcast app! Have questions, suggestions or feedback? Email ddiamond@politico.com. Referenced on the podcast: Sarah's story on Donald Trump's suggestion of using the death penalty to stop the opioid epidemic: https://www.politico.com/story/2018/03/01/donald-trump-death-penalty-suggestion-opioid-crisis-376176 HHS Secretary Alex Azar's remarks on value-based care: https://www.hhs.gov/about/leadership/secretary/speeches/2018-speeches/remarks-on-value-based-transformation-to-the-federation-of-american-hospitals.html Penn professors Lawton Burns and Mark Pauly's article on value-based care: https://www.milbank.org/quarterly/articles/transformation-health-care-industry-curb-enthusiasm/

CVS is merging with AETNA in a $69 billion deal that could change the health care industry. The drug store giant's plans reportedly include pushing the health insurance company's 22 million enrollees towards their clinics rather than hospitals. Host Dan Loney speaks with Mark Pauly, Professor of Health Care Management and Professor of Business Economics and Public Policy at the Wharton School, and Robert Field, Health Care Management Department Lecturer at the Wharton School and Professor of Law and Public Health at Drexel University's Thomas R. Kline School of Law and Dornsife School of Public Health, to discuss the merger's potential impacts on Knowledge@Wharton. See acast.com/privacy for privacy and opt-out information.

Open enrollment started last week for the Affordable Care Act, and it may be one of the toughest in the last five years. The enrollment period has been shortened to 45 days, advertising for the law has been cut drastically as has staffing for those helping people understand which plans are best for them, and rates for those who don't qualify for subsidies have gone up significantly. Host Dan Loney talks with Mark Paul, Professor of Health Care Management at the Wharton School, and Katherine Hempstead, Senior Advisor at the Robert Wood Johnson Foundation, to discuss what these changes mean for those who get their insurance on the private market on Knowledge@Wharton. See acast.com/privacy for privacy and opt-out information.

Peter Van Doren joins us this week to talk about health care economics. We talk about risk aversion, risk neutrality, expected value statements, guaranteed renewable care, the ACA as a health care redistribution program, and health-status insurance. How much should we spend on health care, and how would we know the answer to that question?Show Notes and Further ReadingVan Doren mentions “The Market for Lemons,” (1970) a fascinating concept and paper by George Akerlof.Mark Pauly’s 2003 paper “Incentive-Compatible Guaranteed Renewable Health Insurance” is mentioned several times in the episode.Van Doren also talks about John Cochrane’s writings on health-status insurance. Here is a Cato Policy Analysis from 2009 on the topic. See acast.com/privacy for privacy and opt-out information.

Some thought Obamacare would mean the end of employment-based insurance. While that did not happen the threat has not fully lifted according to Wharton's Mark Pauly. See acast.com/privacy for privacy and opt-out information.

Prof. Mark Pauly is a Professor of Health Care Management, Business Economics, and Public Policy at the Wharton School of the University of Pennsylvania. Stephen Morrissey, the interviewer, is the Managing Editor of the Journal. M.V. Pauly and A.A. Leive. The Unanticipated Consequences of Postponing the Employer Mandate. N Engl J Med 2013;369:691-3.