Podcasts about state health policy

Rita Condon, Program Manager for obesity, nutrition, and physical activity with the Department of Health in New Mexico, discusses the agency's annual child obesity update and the new initiatives in place to promote healthy eating; Andy Baker-White, Senior Director for State Health Policy at ASTHO, reports a new legislative trend of banning certain food dyes and additives in states across the country; ASTHO's INSPIRE Readiness webinar on the importance of regional data in decision-making takes place May 22nd; Dr. Anne Zink, ASTHO past president and former Alaska State Health Officer, was appointed to the Steering Committee for the Vaccine Integrity Project. New Mexico Childhood Obesity 2024 Report ASTHO: States Moving to Prohibit Additives and Dyes in Food ASTHO: INSPIRE: Readiness - Building a Data-Ready Ecosystem for Public Health Response Vaccine Integrity Project

Dr. Sameer Vohra, Director of the Illinois Department of Public Health and an ASTHO Member, tells us how Illinois worked to successfully reduce opioid overdoses; and Beth Giambrone, ASTHO Senior Analyst of State Health Policy, recaps some of the efforts across the country to combat tobacco use. ASTHO Blog Article: Tobacco Policy Roundup – Smoking Rates Down but Youth E-Cigarette Use Rising ASTHO Web Page: Stay Informed  

Medicaid, the largest health insurance program in the country, provides critical coverage for more than 79 million Americans—including children, pregnant women, seniors, and people with disabilities. As Congress considers ways to achieve $2.5 trillion in deficit reduction, Medicaid is at risk of significant changes and proposals that could seriously harm patient care.In this episode, Chip Kahn sits down with Hemi Tewarson, Executive Director of the National Academy for State Health Policy, to discuss the potential impact of Medicaid cuts on patients, hospitals and providers, and state governments. Key topics include: The current state of Medicaid and its economic impact;What's on the legislative agenda, including, proposed changes like work requirements, per capita caps, and shifts in state-directed payments; and,The role of data, policy decisions, and the future of Medicaid at the state level.Guest Bio: Hemi Tewarson, JD, MPH is the executive director of the National Academy for State Health Policy (NASHP), a nonprofit and nonpartisan organization committed to improving the health and well-being of all people across every state. At NASHP, Hemi leads an organization that is at the forefront of engaging state leaders and bringing together partners to develop and advance state health policy innovations. Under her direction, NASHP is leading efforts with states in areas including state COVID-19 recovery, health care costs and value, coverage, child and family health, aging, family caregiving, health care workforce, behavioral health, social determinants of health, health equity, and public health modernization. Previously, Hemi worked at the Duke-Margolis Center for Health Policy as a senior fellow and served as the director of the Health Division at the National Governors Association's Center for Best Practices. She also served as senior attorney for the Office of the General Counsel at the U.S. Government Accountability Office addressing Medicaid and related health care topics for members of Congress.  She holds a JD from George Washington University, an MPH from George Washington University, and a BA in Psychology, University of Pennsylvania. She lives in Maryland with her husband and two daughters.

Dr. Sejal Hathi, Director of the Oregon Health Authority, tells us that to achieve Oregon's bold health goals we have to work together; Beth Giambrone, ASTHO Senior Analyst for State Health Policy, explains how some states are addressing food deserts and food insecurity; and apply today to be part of the Leadership Exchange for Adolescent Health Promotion Plus Community of Practice. Oregon Health Authority Web Page: Oregon Health Forward ASTHO Blog Article: State Policies Aim to Eliminate Food Deserts  ASTHO Web Page: Leadership Exchange for Adolescent Health Promotion Plus (LEAHP+) Community of Practice  

Maggie Davis, ASTHO Director of State Health Policy, dives into ASTHO's Legal Mapping Project which was one of the most popular resources on ASTHO's website in 2024; and Carolyn Mullen, ASTHO's Senior Vice President of Government Affairs and Public Relations, recaps how last year's legislative session ended and gives an outlook for 2025 in this week's View From Washington D.C. Report. ASTHO Web Page: ASTHO's Public Health Legal Mapping Center ASTHO Web Page: ASTHO's Most Popular Resources of 2024  

Melissa Magstadt, Secretary of Health in the South Dakota Department of Health, tells us how the state is using a recently awarded maternal health innovation grant; Maggie Davis, ASTHO Director of State Health Policy, previews legislative trends for the upcoming year; and a recent Public Health Review episode explores how cloud technology, open-source tools, and data standards transform public health data systems. South Dakota Department of Health News Release: South Dakota Department of Health Receives Maternal Health Innovation Grant to Improve Maternal Care ASTHO Blog Article: Likely Public Health Legislative Trends for 2025 ASTHO Podcast Episode: Improving Public Health by Modernizing Data Exchange ASTHO Web Page: Stay Informed  

Qiana Thomason draws from over twenty years of leadership at the intersections of health and behavioral healthcare, corporate healthcare payment, health policy, health philanthropy and business. This aerial command of the political, private market, and social factors that shape health uniquely positions Qiana to impact the wellbeing and prosperity of communities. Qiana's “self to systems” leadership practice, her commitment to organizational care and accountability, and her practice of centering people in driving change and managing transitions makes her a trusted executive in ensuring the effectiveness and sustainability of the organizations and movements she supports. Further, Qiana's prowess in strategy, enterprise risk management, regulatory and compliance agility, human capital optimization, organizational sustainability, ESG facility and DEI expertise makes her an effective partner on boards. As President & CEO of Health Forward Foundation, Qiana guides the $1B foundation in stewarding diverse capital investments, leadership in public policy, and institutional social capital that fosters health and economic equity throughout Missouri and Kansas. Qiana's leadership has positioned Health Forward as a national model for health equity through trust-based public, private, and philanthropic partnerships, spanning resident and faith leaders, grassroots to large non-profits, Chambers of Commerce and business councils, municipal and state government. Qiana's leadership in governance and civic spheres is multi-level. Nationally, Qiana is a board member of Grantmakers in Health, the National Association of State Health Policy, and the National Rural Health Resource Center. Regionally, Qiana is as a board member of the Greater Kansas City Chamber of Commerce and William Jewell College. She is a member of the International Women's Forum, a global organization of preeminent leaders and Women of Influence. Qiana's impact is recognized broadly. The Greater Kansas City Chamber of Commerce recognized Qiana with the international ATHENA Award (2024) and the national Business Journal recognized Qiana on its inaugural listing (2022) of BizWomen making an impact in their local business communities. The Urban League of Greater Kansas City recognized Qiana with its Difference Maker award (2024), Kansas City University bestowed upon Qiana an honorary doctorate in Humane Letters (2023), and Kansas City Friends of Alvin Ailey conveyed its Race, Place, and Diversity award (2022). https://healthforward.org/Citations:Glover Blackwell, A. (n.d.). The Curb-Cut Effect. PolicyLink. Retrieved December 3, 2024, from https://www.policylink.org/resources-tools/curb-cut-effectHosts: MaryAnne Metheny, and Tina Johnson If you are in an emergency, call or text 9-1-1.For information about our services and how Hope House can help, call our 24-Hour Hotline at 816-461-HOPE (4673) or the National Domestic Violence Hotline 800-799-7233.hopehouse.net

Karl Ensign, ASTHO Vice President for Island Support, tells us why braiding and layering funding can be beneficial as ASTHO launches a learning module on the subject; Beth Giambrone, ASTHO Senior Analyst for State Health Policy, discusses the EPA setting limits on PFAS chemicals in drinking water; and ASTHO is looking for its next Chief Medical Officer. ASTHO Learning Module: Braiding and Layering Funding ASTHO Blog Article: States' Growing Efforts to Eliminate PFAS ASTHO Web Page: Chief Medical Officer ASTHO Web Page: Stay Informed  

November 1, 2024: As part of our ongoing conversation on health care, we discuss Reference Based Pricing. Today's guests, Marilyn Bartlett, CPA and senior fellow with the National Academy for State Health Policy, and Mark Hage from the VT-NEA share their insights on how RBP works and how the state can potentially use it to reduce costs.A 2023 presentation to the Green Mountain Care Board on RBP by Marilyn Bartlett: https://gmcboard.vermont.gov/sites/gmcb/files/documents/Referenced%20Based%20Pricing%20presentation%20-%2005.03.2023%20-%20Marilyn%20Bartlett%2C%20Chris%20Deacon%2C%20Mark%20Hage.pdfTheme music by Red Heart the Ticker: http://rhtt.net

Maggie Davis, ASTHO's Director of State Health Policy, examines recent state-level funding changes for public health; Dr. Pamela Mink, Director of Health Services Research at the Minnesota Department of Health, tells us about a report on the impact of the 2021 Minnesota Telehealth Act; and apply today to be part of ASTHO's next DELPH cohort. Minnesota Department of Health Web Page: MDH study finds telehealth continues to benefit Minnesotans ASTHO Blog Article: State Efforts to Bolster Funding for Core Public Health Services ASTHO Web Page: Stay Informed ASTHO Web Page: DELPH Applications  

Dr. Lisa Richardson, Division Director of Cancer Prevention and Control at the CDC, breaks down a recent ASTHO report on cancer messaging; Andy Baker-White, ASTHO Senior Director for State Health Policy, tells us about two ASTHO webinars focused on public health agency rulemaking; and Dr. Umair Shah, Secretary of Health for the Washington State Department of Health and an ASTHO Member, was recently featured on an episode of the podcast “Reimagining Government for the Digital Age”. ASTHO Report: Improving Public Health Messaging: Exploring the Reach and Effectiveness of Cancer Prevention Communications ASTHO Webinar: Navigating the Rulemaking Process Podcast Episode: Reimagining Public Healthcare with globally renowned innovator, Dr. Umair A. Shah, M.D., MPH  

Maggie Davis, ASTHO Director of State Health Policy, updates us on movements that could reshape public health authority; Emily Fine, School and Youth Survey Manager at the Colorado Department of Public Health and Environment, discusses the results of the Healthy Kids Colorado survey; and a new ASTHO guide shows how health equity metrics help island areas understand community issues and improve health equity. ASTHO Blog Article: State Legislatures Reshape Public Health Legal Authority Colorado Department of Public Health and Environment News Release: CDPHE releases the latest Healthy Kids Colorado Survey data ASTHO Report: Using Health Equity Indicators to Guide Community Health Improvement in U.S. Territories and Freely Associated States ASTHO Web Page: Stay Informed  

Andy Baker-White, ASTHO Senior Director for State Health Policy, discusses the ongoing discussion over legal tools needed to ensure public health during outbreaks and emergencies; Maggie Davis, ASTHO Director of State Health Policy, says funding and standards for peer support specialists are the focus of a new ASTHO legal map now online; Arnaldo Machado, Director of Public Health Workforce Development and Resilience at the Massachusetts Department of Public Health, tells us virtual open house events might help your agency build new connections; a new ASTHO blog article examines lessons learned during the Zika outbreak; and ASTHO has new report sharing how three states have worked to improve nutrition for infants, young children, and their families. ASTHO Webpage: Public Health Authority Toolkit Journal of Public Health Management and Practice Webpage: Recommended Strategies to Prioritize Evidence-Based Public Health Authority ASTHO Webpage: Peer Support Specialist Credentialing Legal Map ASTHO Blog Article: PHIG Success Story: In Massachusetts, Building Public Health Infrastructure Starts with a Strong Workforce ASTHO Blog Article: Preparing for Maternal and Child Health Crises with Lessons from the Zika Outbreak ASTHO Report: Early Childhood Nutrition Security  

Maggie Davis, ASTHO Director of State Health Policy, explains why some states had difficulty getting access to new immunization products; the newly announced implementation centers wouldn't be possible without key partners; Dr. Manisha Juthani, Commissioner of the Connecticut Department of Public Health, tells us about Connecticut's recent adoption of the FDA Food Code; an ASTHO webinar allows you to hear from leaders at ASTHO and the CDC about how to properly communicate with policymakers; and an ASTHO brief examines how Puerto Rico strengthened its grant management functions. ASTHO Blog Article: State Policies Impact Access to New Immunization Products ASTHO News Release: Public Health Infrastructure Partners Launch National Implementation Center Program to Support Data Modernization  Public Health Review Podcast: Improving Retail Food Safety with the FDA Food Code ASTHO Webinar: Disease Forecasting Learning Series - Communicating with Policymakers ASTHO Report: A Framework for Linking PRAMS with Administrative Data  

The 30-year fixed-rate mortgage is as American as apple pie. But it wasn’t always this way, and it’s putting the housing market in a tough spot lately.  A substantial amount of homeowners with low-rate mortgages are choosing to stay put in their homes rather than selling and buying a new one at higher rates. It’s created what’s known as a lock-in effect. On the show today, Andra Ghent, professor of finance at the University of Utah, explains how a 30-year fixed-rate mortgage became the norm in the United States, why it’s now putting the housing market in a bind, and how our mortgage system perpetuates inequality. Plus, could the Danish mortgage model work here? Then, we’ll get into why the Federal Trade Commission is eyeing pharmacy benefit managers, the third-party companies that negotiate drug prices between health insurance providers and drugmakers. And, an editor at The Points Guy shares the story of a travel lesson learned. Here’s everything we talked about today: “Why do we have a 30-year mortgage, anyway?” from Marketplace “A Huge Number of Homeowners Have Mortgage Rates Too Good to Give Up” from The New York Times “A 30-Year Trap: The Problem With America's Weird Mortgages” from The New York Times “Denmark’s genius housing fix” from Business Insider “Homeowners Don't Want to Sell, So the Market for Brand-New Homes Is Booming” from The Wall Street Journal “FTC Releases Interim Staff Report on Prescription Drug Middlemen” from the Federal Trade Commision “F.T.C. Slams Middlemen for High Drug Prices, Reversing Hands-Off Approach” from The New York Times “State Pharmacy Benefit Manager Legislation” from the National Academy for State Health Policy “Prescription Drugs: Selected States’ Regulation of Pharmacy Benefit Managers” from the U.S. Government Accountability Office “Fed Chair Powell talks up progress on inflation but says rate cuts not imminent yet” from CNN Business “Software and social media to grab Congress’ attention” from Marketplace We love to hear from you. Send your questions and comments to makemesmart@marketplace.org or leave us a voicemail at 508-U-B-SMART.

The 30-year fixed-rate mortgage is as American as apple pie. But it wasn’t always this way, and it’s putting the housing market in a tough spot lately.  A substantial amount of homeowners with low-rate mortgages are choosing to stay put in their homes rather than selling and buying a new one at higher rates. It’s created what’s known as a lock-in effect. On the show today, Andra Ghent, professor of finance at the University of Utah, explains how a 30-year fixed-rate mortgage became the norm in the United States, why it’s now putting the housing market in a bind, and how our mortgage system perpetuates inequality. Plus, could the Danish mortgage model work here? Then, we’ll get into why the Federal Trade Commission is eyeing pharmacy benefit managers, the third-party companies that negotiate drug prices between health insurance providers and drugmakers. And, an editor at The Points Guy shares the story of a travel lesson learned. Here’s everything we talked about today: “Why do we have a 30-year mortgage, anyway?” from Marketplace “A Huge Number of Homeowners Have Mortgage Rates Too Good to Give Up” from The New York Times “A 30-Year Trap: The Problem With America's Weird Mortgages” from The New York Times “Denmark’s genius housing fix” from Business Insider “Homeowners Don't Want to Sell, So the Market for Brand-New Homes Is Booming” from The Wall Street Journal “FTC Releases Interim Staff Report on Prescription Drug Middlemen” from the Federal Trade Commision “F.T.C. Slams Middlemen for High Drug Prices, Reversing Hands-Off Approach” from The New York Times “State Pharmacy Benefit Manager Legislation” from the National Academy for State Health Policy “Prescription Drugs: Selected States’ Regulation of Pharmacy Benefit Managers” from the U.S. Government Accountability Office “Fed Chair Powell talks up progress on inflation but says rate cuts not imminent yet” from CNN Business “Software and social media to grab Congress’ attention” from Marketplace We love to hear from you. Send your questions and comments to makemesmart@marketplace.org or leave us a voicemail at 508-U-B-SMART.

The 30-year fixed-rate mortgage is as American as apple pie. But it wasn’t always this way, and it’s putting the housing market in a tough spot lately.  A substantial amount of homeowners with low-rate mortgages are choosing to stay put in their homes rather than selling and buying a new one at higher rates. It’s created what’s known as a lock-in effect. On the show today, Andra Ghent, professor of finance at the University of Utah, explains how a 30-year fixed-rate mortgage became the norm in the United States, why it’s now putting the housing market in a bind, and how our mortgage system perpetuates inequality. Plus, could the Danish mortgage model work here? Then, we’ll get into why the Federal Trade Commission is eyeing pharmacy benefit managers, the third-party companies that negotiate drug prices between health insurance providers and drugmakers. And, an editor at The Points Guy shares the story of a travel lesson learned. Here’s everything we talked about today: “Why do we have a 30-year mortgage, anyway?” from Marketplace “A Huge Number of Homeowners Have Mortgage Rates Too Good to Give Up” from The New York Times “A 30-Year Trap: The Problem With America's Weird Mortgages” from The New York Times “Denmark’s genius housing fix” from Business Insider “Homeowners Don't Want to Sell, So the Market for Brand-New Homes Is Booming” from The Wall Street Journal “FTC Releases Interim Staff Report on Prescription Drug Middlemen” from the Federal Trade Commision “F.T.C. Slams Middlemen for High Drug Prices, Reversing Hands-Off Approach” from The New York Times “State Pharmacy Benefit Manager Legislation” from the National Academy for State Health Policy “Prescription Drugs: Selected States’ Regulation of Pharmacy Benefit Managers” from the U.S. Government Accountability Office “Fed Chair Powell talks up progress on inflation but says rate cuts not imminent yet” from CNN Business “Software and social media to grab Congress’ attention” from Marketplace We love to hear from you. Send your questions and comments to makemesmart@marketplace.org or leave us a voicemail at 508-U-B-SMART.

Maggie Davis, ASTHO Director of State Health Policy, updates us on public health policy updates from state legislatures across the country; Cody Kinsley, North Carolina Secretary of Health and Human Services, says North Carolina will continue to build a network of behavioral health urgent care centers; and Moses E. Pretrick, Assistant Secretary for Health at the FSM Ministry of Health and Social Affairs, celebrates Asian American and Pacific Islander Heritage Month. ASTHO Blog Article: ASTHO's 2024 Legislative Session Update – Part Two ASTHO Blog Article: ASTHO's 2024 Legislative Session Update – Part One North Carolina Department of Health and Human Services News Release: Investment in Strengthening North Carolina's Behavioral Health Crisis Response System  ASTHO Webpage: Stay Informed  

Dr. Lonnie Robinson from Regional Family Medicine in Mountain Home, Arkansas explains the challenges surrounding prior authorization faced by both practices and insurance providers, and how this inspired him to become involved in state health policy advocacy. Hear how Dr. Robinson, drawing inspiration from Texas' “gold card” approach, worked with Aledade's policy committee and state legislators to pass similar legislation in Arkansas to reduce administrative workloads.   Submit your questions, comments, or episode ideas to acoshow@aledade.com

Our EJB Talks podcast this week features Joel Cantor⁠, Distinguished Professor of Public Policy and Director of the Rutgers Center for State Health Policy and Kathe Newman, Professor and Director of the Ralph W. Voorhees Center for Civic Engagement. They are part of a new Rutgers initiative, the Housing and Health Equity Cluster, which aims to address health equity issues through interdisciplinary collaboration across university departments. Professor Newman discusses how, through her urban planning work, she became interested in the connection between lack of affordable housing and poor health. Professor Cantor's research into the health conditions of vulnerable populations utilizing Medicaid was often linked to long-term chronic homelessness. They explain how housing and health issues are deeply intertwined, with one constantly impacting the other in a cycle that is difficult to break. The work of the HHE cluster seeks to better understand these relationships and challenges through data analysis informing policy solutions for a better future for permanent supportive housing. --- Send in a voice message: https://podcasters.spotify.com/pod/show/ejbtalks/message

Dr. Debra Bogen, Acting Secretary of Health for the Pennsylvania Department of Health and ASTHO Member, discusses Pennsylvania's work to expand overdose training to many different populations; Beth Giambrone, ASTHO Senior Analyst for State Health Policy, discusses the part Public Health plays in helping transportation partners; and an ASTHO webinar will explain more about how TEFCA will help public health.  Pennsylvania Webpage: Department Of Health Offers New Training To Fight The Overdose Crisis  ASTHO Blog Article: Stroads? Where We're Going, We Don't Need Stroads  ASTHO Webinar: TEFCA Overview and Perspectives from the Field  ASTHO Webpage: Stay Informed  

J.T. Lane, ASTHO Senior Vice President for Population Health and Innovation, previews the HIMSS Global Health Conference that kicks off today; Maggie Davis, ASTHO Director of State Health Policy, tells us how routine lead level screenings in North Carolina began an international investigation; and an ASTHO blog article outlines changes the USDA is considering making to nutrition standards. HIMSS 24 Webpage ASTHO Blog Article: Lead, Food Safety, and Public Health's Power and Responsibility to the People ASTHO Blog Article: USDA Takes Long-Term Look at Nutrition Standards ASTHO Webpage: Stay Informed  

Dr. Mike Fraser, ASTHO CEO, and Dr. Brian Castrucci, de Beaumont Foundation President and CEO, tell us why their new book is beneficial for all public health professionals; Maggie Davis, ASTHO Director for State Health Policy, says states are beginning to assess the use of AI in public health and beyond; ASTHO has a course to teach best practices for building and understanding data visualization through a health equity lens; and ASTHO launches a three-part video series to showcase how public health can build program sustainability into their Healthy Brain Initiative work. ASTHO Webpage: Building Strategic Skills for Better Health – A Primer for Public Health Professionals ASTHO Blog Article: States Assessing and Mitigating Risks of Agencies Using Artificial Intelligence ASTHO Webpage: Designing Data Dashboards Using a Health Equity Lens ASTHO Webpage: Integrating Sustainability into Healthy Brain Initiative Implementation

Andy Baker-White, ASTHO Senior Director for State Health Policy, previews the state of the legislative calendar this year; Omar Khalid, ASTHO Director of Workforce Development, says leaders can support their teams by adopting a trauma-responsive approach; and prescription opioid use during pregnancy is the subject of a new ASTHO infographic. ASTHO Webinar: Investing in Public Health Infrastructure – Indiana's Success Story ASTHO Webpage: 2024 Legislative Prospectus Series ASTHO Blog Article: Supporting the Public Health Workforce with Trauma-Responsive Leadership Skills ASTHO Brief: Prescription Opioid Use During Pregnancy in 34 Jurisdictions ASTHO Webpage: Stay Informed

For a full transcript of this episode, click here. Here's a quote from Ann M. Richardson, MBA. She wrote it on LinkedIn, and I love it: Quiet the noise that doesn't add value. Surround yourself with intelligent and respectful people who can deliver endless opportunities. Celebrate brilliance and new beginnings. Together, we've got this. Thanks for this beautifully stated call to action (I wish I would have written it myself) because it is also precisely the goal of Relentless Health Value and my hope for the Relentless Health Value Tribe—those of you who have connected with each other by way of this podcast vis-à-vis LinkedIn, or maybe you've met each other at an online or live event. For sure, subscribe to the weekly email to get notified of such goings-on. Now, this aspirational vision doesn't mean putting the onus on just any given individual to fix the systemic failings that get talked about on the podcast, but we can start somewhere. We can sit with ourselves; we can ask ourselves some big questions. We can decide the legacies we want to leave and what we want our life's work to add up to. That is what this show should, I hope, help you accomplish. And, yeah … together, we've got this. In this healthcare podcast, I am speaking with Peter Hayes; and we talk about five realities of 2024 for hospital chains, integrated delivery networks, health systems. Now, to make one thing very clear, as I have said many times on many Relentless Health Value shows: Not all hospital chains or hospitals are the same. There are large, consolidated, extremely rich, extremely politically and economically powerful organizations who are called health systems. And then there are rural or urban institutions that are barely scraping by and serving huge vulnerable patient populations. And despite the many aforementioned names for hospital chains and their associated outpatient facilities and owned physician groups and urgent care centers, all these names for these big care delivery entities are flabbergastingly meaningless because they do not separate the consolidated rich ones from the very desperately not rich ones. Today on the show, we're talking about the first kind of health systems: the big rich consolidated ones which are taking over every geography where there's money to be made. These are the ones where you read about their bad behavior in the New York Times or hear about them in YouTube videos like this one. Peter Hayes talks about the five things that these behemoth entities may really need to start thinking hard about, even in the face of their fierce and often-unrelenting market power and the political hold that they have over many local communities and all the regulatory capture that goes along with that. So, here's Peter's list in a nutshell—the five things to get real about: 1. Health systems need to get real about the CAA (Consolidated Appropriations Act) and its implications that plan sponsors only pay “fair and reasonable” prices for medical services. Now, before I dig in on this, jargon alert: When we say plan sponsors, that means entities such as self-insured employers—sponsors of health plans, if you will (the purchasers, the ones who are actually paying the bills). Peter explains the quick version of what the Consolidated Appropriations Act is in the show that follows, so do listen. But for more info on this really, really meaningful bit of legislation that is the law as of 2021, go back and listen to the episodes with Chris Deacon (EP342 and EP408) or check out the myriad of LinkedIn posts from Jeff Hogan. Also, others like Darren Fogarty, Justin Leader, Jamie Greenleaf, and others have some great words of wisdom that you will be able to find that really explain what the point is of the CAA, the Consolidated Appropriations Act, and its sprawling implications. 2. To survive on reduced commercial reimbursements, health systems need to get real about becoming ruthlessly aggressive in driving administrative and technology efficiencies. 3. They need to get real about pivoting from fee-for-service reimbursement to episode-based care based on taking real downside risks for good clinical outcomes. They need to pivot from a mindset of maximizing patient revenue to maximizing patient health. They need to move from a sick care reimbursement model to a healthcare reimbursement model based on health. 4. They need to get real about being completely transparent and accountable in reporting how they are using the value of their tax-exempt status. Similarly, they need to account for and report how they're using the estimated $55 billion in net margins that they're realizing off the 340B drug program. 5. They need to get real about quality and patient safety. We still have about 46% of our hospitals that have a C or lower Leapfrog rating. And, by the way, the chance of having a fatality on an avoidable error is 90% higher at a C or lower-rated Leapfrog entity versus a Leapfrog entity that has an A or a B. Now, some of you—and by some of you, I mean practically everybody listening—are thinking of reasons why any one of these “get real about” things is arguable or how one of the above is not holding up in some market. I think Peter would tell you the same thing that I would: You're not wrong. But trying to predict a zeitgeist or the next pet rock never works well because it's always a confluence of right time/right place where the whole is way more than the sum of its parts. Think about Malcolm Gladwell's The Tipping Point. It's about how small changes can have enormous effects if the context is right. So, now contemplate these five things that Peter brings up. All these forces are pushing in the same direction. Put it all into a stew where 48% of Americans have delayed or forgone care due to cost. Listen to the show with Wayne Jenkins, MD (EP358) for more on that. Or, you have the article John Tozzi just wrote in Bloomberg. Here's a quote: “In one California community, teachers have to pay an extra $10,000 a year to upgrade to insurance that covers the local hospitals. Teachers who can't afford it … give birth outside the county.” Meanwhile, insurers are making record profits, along with hospital CEOs and C-suites. At the same time, you know who I think is the third-biggest group with medical debt in this country? Yeah, it's people who work in hospitals—nurses, others. There's this frothing lack of trust for hospitals and what goes on there: 30% of physicians do not trust the leadership of their health system. And no wonder. There are examples of healthcare executives sitting up there in their palatial offices acting more like mobsters than the nuns they took over the hospital from. So, to orient your context, you are here. Peter Hayes is the newly retired former president and CEO at the Healthcare Purchaser Alliance of Maine. He is a national presence in healthcare strategy, innovation, and a keynote speaker. For more on the wild-ass problems with hospital pricing, check out this list of shows. But, spoiler alert, some of these are hair-raising. Encore! EP249: The War on Financial Toxicity in North Carolina as a Case Study Everybody Should Be Keeping Their Eye On, With Dale Folwell, North Carolina State Treasurer EP395: Consolidated Hospital Systems and Cunning Anticompetitive Contracts, With Brennan Bilberry EP390: What Legislators Need to Know About Hospital Prices, With Gloria Sachdev, PharmD, and Chris Skisak, PhD EP389: The Clapback When Hospitals Cannot Constrain Their Own Prices, With Mike Thompson EP346: How Did Health Systems Get Addicted to the Inflated Prices They Charge Employers and Some Patients? 2021 Update, With Peter Hayes, President and CEO of the Healthcare Purchaser Alliance of Maine EP394: Spoiler Alert: It Is Counterintuitive Which Hospitals Offer the Most Charity Care, With Vikas Saini, MD, and Judith Garber, MPP Also mentioned in this episode are Ann M. Richardson, MBA; Chris Deacon; Jeffrey Hogan; Darren Fogarty; Justin Leader; Jamie Greenleaf, AIF, CBFA, C(k)P; Wayne Jenkins, MD; John Tozzi; NASHP (National Academy for State Health Policy); Gloria Sachdev, PharmD; Chris Skisak, PhD; Leon Wisniewski; Cora Opsahl; Rik Renard; John Rodis, MD; Rob Andrews; Al Lewis; Eric Bricker, MD; Vikas Saini, MD; Judith Garber, MPP; Lown Institute; RAND Corporation; Dale Folwell; Brennan Bilberry; and Mike Thompson. You can learn more by following Peter on LinkedIn.   Peter Hayes recently retired as the president and CEO of the Healthcare Purchaser Alliance of Maine and formerly a principal of Healthcare Solutions and director of associate health and wellness at Hannaford Supermarkets. He has been recognized as a thought leader in innovative, strategic benefit design for the past 25+ years. He has received numerous national awards in recognition of his commitment to working collaboratively with healthcare providers and vendors in delivering health benefits that are focused on value (high-quality efficient care). He has been successful in this arena by focusing on innovative solutions for patient advocacy, chronic disease management, and health promotion programs. Peter has also been involved in healthcare reform leadership roles on both the national and regional levels with organizations like Center for Health Innovation, Care Focused Purchasing, and Leapfrog. He's also co-founder of the Maine Health Management Coalition and has been appointed by two different Maine Governors to serve on Health Care Reform Commissions to recommend public policies to improve the access and affordability of healthcare for Maine citizens.   08:04 Why do hospitals need to get real about the implications of the Consolidated Appropriations Act? 10:09 What is considered fair pricing for hospitals? 13:00 EP390 with Gloria Sachdev, PharmD, and Chris Skisak, PhD. 15:59 The medical transparency tool, Billy. 16:34 How does lowering prices become more challenging with consolidated hospital systems? 18:07 What is one of the solutions available to combatting this now? 19:31 Why do hospital systems need to get real about administrative and technology efficiencies? 22:27 EP373 with Cora Opsahl. 26:51 Why do hospitals need to get real about pivoting from fee-for-service reimbursement to episode-based care? 30:16 EP415 with Rob Andrews. 30:53 Why do hospitals need to get real about the 340B program and their tax-exempt status? 35:38 EP394 with Vikas Saini, MD, and Judith Garber, MPP. 38:19 What are the ethical and moral issues that are coming to a head with healthcare costs? 39:03 Why do hospitals need to reexamine their care quality and patient safety? 40:05 “We just need to make sure that the health industry is as accountable as some of our other industries.” 42:53 Why does Peter think it's going to take regulation to move the dial?   You can learn more by following Peter on LinkedIn.   @pefhayes discusses #hospitalsystems and what their executives need to do on our #healthcarepodcast. #healthcare #podcast #pharma #healthcareleadership #healthcaretransformation #healthcareinnovation   Recent past interviews: Click a guest's name for their latest RHV episode! Joey Dizenhouse, Benjamin Jolley, Emily Kagan Trenchard (Encore! EP392), Cora Opsahl (Encore! EP372), Jodilyn Owen, Ge Bai, Andreas Mang, Karen Root (Encore! EP381), Mark Cuban and Ferrin Williams, Dan Mendelson (Encore! EP385)

Dr. Jerome Adams, the 20th U.S. Surgeon General and current Executive Director of Health Equity Initiatives at Purdue University, who was the Surgeon General during the pandemic discusses his new book; Maggie Davis, ASTHO Director of State Health Policy, guides us through some of the family and reproductive health policy developments across the country; and ASTHO has a blog article about one approach to address the concern known as trauma-responsive leadership. Crisis and Chaos: Lessons from the Front Lines of the War Against COVID-19 ASTHO Webpage: Family and Reproductive Health – Supporting Holistic Care Across All Stages of Life ASTHO Blog Article: Supporting the Public Health Workforce with Trauma-Responsive Leadership Skills ASTHO Webpage: Stay Informed

Dr. Anne Zink, ASTHO Immediate Past President and Chief Medical Officer for the Alaska Department of Health, says policies can help address the fact that the number of babies born with syphilis is ten times higher than in 2012; JoAnne McClure, ASTHO Senior Analyst for State Health Policy, outlines the different ways states and territories have reacted to xylazine being in the illicit drug supply; and Amani Echols, Policy and Government Affairs Manager for the Association of Maternal and Child Health Programs, discusses an online webinar revealing an article ASTHO worked on about public health approaches to perinatal substance use. ASTHO Webpage: Supporting a Syndemic Approach – Preventing Sexually Transmitted Infections ASTHO Blog Article: How the Emergence of Xylazine Impacts Overdose Prevention Policy ASTHO Webinar: Unveiling of the Perinatal Substance Use Special Issue in the Maternal and Child Health Journal Association of Maternal and Child Health Programs News Release: AMCHP and ASTHO Release Maternal and Child Health Journal Special Issue: Public Health Approaches to Perinatal Substance Use  

Dr. Manisha Juthani, Commissioner of the Connecticut Department of Health, outlines the continued challenges to public health legal authority; Maggie Davis, ASTHO Director of State Health Policy, discusses a big win for Indiana as funding for public health will jump by 1500 percent; and learn how to protect your agency from a cyber-attack in an ASTHO video discussion. ASTHO Webpage: Containing and Preventing the Spread of Infectious Disease: A Cornerstone of Public Health ASTHO Report: Investing in Indiana's Public Health Infrastructure Through Community-Driven Policy Change Politico News Article: A red state boosted public health funding by 1,500 percent. This is how they did it. ASTHO Blog Article: Public Health's Silent Defender – Cybersecurity  

On today's episode, we are talking healthcare from AHCCCS to KidsCare, to the healthcare marketplace open enrollment period. Joining us today are Claudia Maldonado from the Arizona Alliance of Community Health Centers, and our newest team member here at Vitalyst, Ana Roscetti, Director of State Health Policy and Advocacy. We discuss the Cover Arizona Coalition, Medicaid Redetermination, the Healthcare Marketplace and open enrollment. We hope it's an informative conversation.   Notes / Links To speak with an assister about your health insurance options, visit www.coveraz.org or call 2-1-1. Medicaid/AHCCCS members can update their information on www.healthearizonaplus.gov.

In this Complex Care Journal Club podcast episode, Dr. Mark Brittan discusses a qualitative study of stakeholders in a family-certified nursing assistant program in Colorado. He describes the limitations of the paid family caregiver model, opportunities for advocacy, and the next steps from this work. SPEAKER Mark Brittan, MD, MPH Associate Professor of Pediatrics, University of Colorado Anschutz Medical Campus Section of Pediatric Hospital Medicine, Children's Hospital Colorado HOST Kilby Mann, MD Assistant Professor of Pediatrics, University of Colorado Anschutz Medical Campus Pediatric Rehabilitation Medicine, Children's Hospital Colorado DATES Initial Publication: October 9, 2023 CITATION JOURNAL ARTICLE REFERENCED Brittan MS, Chavez C, Blakely C, Holliman BD, Zuk J. Paid Family Caregiving for Children With Medical Complexity. Pediatrics. 2023;151(6):e2022060198. doi:10.1542/peds.2022-060198 OTHER ARTICLES REFERENCED Foster CC, Kwon S, Blakely C, Carter K, Sobotka SA, Goodman DM, Agrawal R, Brittan M. Paying Family Medical Caregivers for Children's Home Healthcare in Colorado: A Working Medicaid Model. J Pediatr. 2023 Feb 10;261:113347. doi: 10.1016/j.jpeds.2022.12.043. Epub ahead of print. PMID: 36775189; PMCID: PMC10412725. Kaye N, Teshale S. Medicaid Supports for Family Caregivers. National Academy for State Health Policy. October 2020. Accessed September 22, 2023. https://www.nashp.org/wp‐content/uploads/2020/10/Medicaid‐Supports‐for‐Family‐Caregivers.pdf TRANSCRIPT https://op-docebo-images.s3.amazonaws.com/Transcripts/Financial+Compensation+of+Family+Caregivers_Brittan_100923.pdf Clinicians across healthcare professions, advocates, researchers, and patients/families are all encouraged to engage and provide feedback! You can recommend an article for discussion using this form: https://forms.gle/Bdxb86Sw5qq1uFhW6 Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access and thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu

Dr. Marcus Plescia, ASTHO's Chief Medical Officer, says health departments are working to create effective vaccine messaging for this fall; Maggie Davis, ASTHO's Director of State Health Policy, shares policies aimed at reducing barriers to vaccines; and a new ASTHO webinar explains how to manage data in the Pregnancy Risk Assessment Monitoring System.   ASTHO Webpage: Policymakers Boosting Public Health Readiness for Respiratory Illness Season ASTHO Webinar: It's a Weighty Matter: Exploring PRAMS Weights  

Beth Giambrone, ASTHO's Senior Analyst of State Health Policy, says the EPA has proposed regulations on certain forever chemicals; Jamie Pina, ASTHO's Vice President of Public Health Data Modernization, explains how AI can be a public health tool; ASTHO has a new Congenital Syphilis Technical Package; and sign up for ASTHO's Public Health Weekly email newsletter   ASDWA, ECOS, and ASTHO Send Letter to President Biden Seeking Support from Federal Agencies to Remove Sources of PFAS ASTHO Webpage: State and Federal Actions to Reduce Per-and Polyfluoroalkyl Substances' Impact on Public Health ASTHO Webpage: AI in Public Health—ASTHO Has Entered the Chat ASTHO Webinar: Artificial Intelligence in State and Territorial Public Health ASTHO Webpage: Effective Public Health Approaches to Reducing Congenital Syphilis ASTHO Newsletter

Maggie Davis, ASTHO Director of State Health Policy, outlines ASTHO's new Public Health Legal Mapping Center tool aimed to highlight policies that may prevent overdose; Liljana Baddour, ASTHO's Senior Director for Workforce Development, says challenges to expanding public health workforce go beyond recruiting; ASTHO's new Project ECHO: Overdose Fatality Investigative Techniques aims to improve reporting; and sign up for ASTHO's Public Health Weekly email newsletter   ASTHO Webpage: ASTHO Legal Mapping Center Launches Maps of Harm Reduction Policies to Prevent Overdose ASTHO Webpage: Workforce Policy Spotlight: Successfully Raising FTE Caps in Rhode Island ASTHO Webpage: Creating Effective Virtual Trainings for Medical Examiners and Coroners ASTHO Newsletter

Andy Baker White, ASTHO's Senior Director of State Health Policy, outlines three new policy recommendations on Public Health Legal Authority; Dr. Georgina Peacock, the Director of the Immunization Services Division in the National Center for Immunization and Respiratory Diseases at the CDC, says vaccine coverage among kindergarten children is at a decade low; an ASTHO blog explains how Rhode Island was able to add 28 permanent staff positions; and sign up for ASTHO's Public Health Weekly email newsletters.   ASTHO Webpage: Public Health Legal Authority to Prevent and Mitigate the Spread of Communicable and Infectious Diseases and Other Public Health Threats CDC: Back to School with Routine Vaccines ASTHO Webpage: Workforce Policy Spotlight: Successfully Raising FTE Caps in Rhode Island ASTHO Webpage: Public Health Weekly email newsletters

Mariah Pokorny, Director of Accreditation & Reporting for the South Dakota Department Of Health, explains the importance of vital records and health statistics accreditation; Chantell Reed, Interim Deputy Director Of Operations at the Multnomah County Oregon Health Department, discusses how public health infrastructure grants impact health agencies' community partnerships; Maggie Davis, ASTHO Director of State Health Policy, shares state policies supporting therapeutic Psilocybin use; and registration is open to attend ASTHO's tobacco endgame webinar on June 27th.    South Dakota Department Of Health: Vital Records ASTHO Webpage: State Policies Supporting Evidence-Based Therapeutic Psilocybin Use ASTHO Webinar: Building State Readiness for the Tobacco Endgame       

JoAnne McClure, ASTHO Senior Analyst for State Health Policy, details a new report written to help public health leaders address rising rates of congenital syphilis; Alex Kearly, ASTHO's Director of Medicaid and Value-Based Payment, breaks down recent direction from the Centers for Medicare and Medicaid Services regarding social services and Medicaid dollars; an ASTHO blog article highlights the importance of proper leadership strategies when building a high-performing team; and a virtual edition of ASTHO's Public Health TechXpo and Futures Forum is set for June 15th. ASTHO Report: Policy Considerations for Reducing Congenital Syphilis ASTHO Blog Article: Addressing Health-Related Social Needs through 1115 Demonstrations ASTHO Blog Article: Three Key Leadership Strategies for Building a High-Performing Team ASTHO Webpage: TechXpo and Futures Forum Registration

Dr. Marissa Levine, Director of the Center for Leadership in Public Health Practice at the University of South Florida, says the PHEARLESS Initiative launching today aims to bring public health and community members together;  Maggie Davis, ASTHO Director of State Health Policy, highlights a new interactive database that provides data about new laws that impact public health authority; Dr. Edward Ehlinger, Former Commissioner of Health for Minnesota and Former Past President of ASTHO, outlines the challenges related to the collection of public health data about American Indian and Alaska Native mothers and their babies; and sign up for ASTHO's Legislative Alerts email list.   USF Health: The PHEARLESS Initiative  Temple University: Laws Addressing Public Health Authority to Respond to Emergencies ASTHO Newsletter: Legislative Alerts Email List

Katherine Palm, Senior Program Analyst for Injury and Violence Prevention with the National Association of County and City Health Officials, details a new clinical fall prevention guide; Carolyn Mullen, ASTHO Senior Vice President, Government Affairs and Public Relations, explains frustrations with the ongoing debt ceiling debate; Maggie Davis, ASTHO Director of State Health Policy, takes part in an ASTHO webinar to discuss the need to preserve laws that enable agencies to protect communities; and Kimberly Henderson, Harris County Public Health Department Deputy Chief of Staff, shares advice in a new ASTHO blog article.    NACCHO: Developing the Capacity to Support Clinical Older Adult Fall Prevention ASTHO Webinar: Protecting Public Health Authority: Law, Equity & the Public Health Workforce ASTHO: Four Questions with Public Health Communications Expert Kimberly Henderson  

Maggie Davis, ASTHO's Director of State Health Policy, explains an amicus brief ASTHO filed in a North Carolina court case; Jeffrey Ekoma, ASTHO's Senior Director of Government Affairs, reports on progress with the reauthorization of the Pandemic and All-Hazards Preparedness Act; Dr. Mark Levine, Commissioner of Health at the Vermont Department of Health, says that COVID-19 has become like many other infectious diseases; and a new ASTHO report tells you how to connect Health in All Policies strategies with State Health Improvement Plans.   ASTHO statement on Amicus Brief ASTHO Comments on the Pandemic and All-Hazards Preparedness Act WHO Declares Covid-19 Pandemic Emergency Over Making the Connection Between Health in All Policies and State Health Improvement Plans

The public health emergency ends today; ASTHO CEO Dr. Mike Fraser says ASTHO members are prepared; Maggie Davis, ASTHO's Director of State Health Policy, explains that public health is adopting emergency measures into local statute and policies; ASTHO President Dr. Anne Zink looks ahead to improve systems for those who continue to suffer from COVID-19; Dr. Brannon Traxler, Director of Public Health for the South Carolina Department of Health and Environmental Control, outlines how South Carolina will handle sharing COVID-19 data following the end of the public health emergency; AJ Pearlman, Director of Public Health AmeriCorps, explains how the organization works to build up the public health workforce; Dr. Micky Tripathi, National Coordinator for Health Information Technology at HHS, shares what COVID-19 taught public health about data management; online tickets to attend TechXpo are still available for the next two weeks; and an invitation to sign up for ASTHO's legislative alert emails.   Alaska's COVID-19 situation has flattened out, but what should Alaskans do if they test positive now? AmeriCorps and CDC Award $90 Million to Public Health AmeriCorps Programs Public Health AmeriCorps Leadership Trailblazer Spotlight: Micky Tripathi, HHS's Office of the National Coordinator for Health Information Technology Public Health TechXpo and Futures Forum Legislative Alerts  

Jennifer Moss, author of The Burnout Epidemic, says self-care alone is not a solution to employee fatigue; Moss will speak at ASTHO's TechXpo and Futures Forum later this month, where online tickets remain available; Maggie Davis, ASTHO's Director of State Health Policy, outlines public health policy wins so far this year; follow legislative actions across the states and territories with ASTHO's legislative alert emails; and a new ASTHO blog article recommends podcasts on public health.   Public Health TechXpo and Futures Forum ASTHO Unveils Top 10 Public Health Policy Issues to Watch in 2023 Legislative Alerts Seven Public Health Podcasts to Check Out      

Maggie Davis, ASTHO Director of State Health Policy, discusses policies that have been considered or approved across the country since January;  Dr. Gabriel Seidman, Director of Policy at the Lawrence J. Ellison Institute for Transformative Medicine, says agencies need to move pilot data projects to full implementation status; there's still time to reserve an online seat at ASTHO's TechXpo and Futures Forum in Chicago; and Dr. Luigi Ferrucci, Scientific Director of the National Institute on Aging at NIH, says public health leaders need to think of ways to make cities more accessible to an aging population. 2023 Legislative Session Update: Part One Public Health TechXpo and Futures Forum Older Americans Month 2023 Want to live to be 100? Here's what experts recommend.  

Dr. Anne Zink, ASTHO President and Alaska Chief Medical Officer, testifies before a House appropriations subcommittee in Washington D.C. seeking sustainable and flexible public health funding; Maggie Davis, ASTHO's Director of State Health Policy, explains how health agencies can use policy as a tool to build a stronger workforce; ASTHO's PH-HERO Workforce Resource Center offers resources to help agencies build successful teams; and a new blog article celebrates women who have made a difference in ASTHO history.  Anne Zink Testimony in Regards to Sustainable and Flexible Public Health Funding State and Territorial Policies to Strengthen the Public Health and Healthcare Workforce PH-HERO Workforce Resource Center ​​ASTHO Celebrates Women's History Through the Decades  

Dr. Christopher Rizzo, Senior U.S. Medical Director for Sanofi, is working on a passive immunization for RSV that could help protect young infants from the virus; Lana McKinney, ASTHO Senior Policy Analyst for State Health Policy, encourages ASTHO members to ask their lawmakers to support the life-saving tools of CPR techniques and AED devices; and the deadline to apply for ASTHO's Diverse Executives Leading in Public Health program is Feb. 28th. ASTHO Blog Article: State Policies Promote the Importance of Defibrillators and CPR ASTHO Webpage: Diverse Executives Leading in Public Health ASTHO Webpage: Be in the Know

Julie Wernau, Health and Science Reporter at The Wall Street Journal, has been reporting on the opioid crisis for more than a year but says it's still a difficult story to write; Andy Baker-White, ASTHO Senior Director of State Health Policy, says ASTHO members are working to prepare for the end of the COVID-19 public health emergency declarations; and sign up for the Public Health Weekly email newsletter. The Wall Street Journal News Article: Fentanyl Test Strips on the Dance Floor? Partygoers Face New Reality ASTHO Webpage: Be in the Know

Dr. Nancy Messonnier, Dean of the UNC Gillings School of Global Public Health, says there's still a need for sustained investment in public health three years after the pandemic; Beth Giambrone, ASTHO Senior Analyst for State Health Policy, explains how economic hardship can cause many problems for children; and find a link to sign up for ASTHO's Public Health Weekly email newsletter. University of North Carolina at Chapel Hill Webpage: Nancy Messonnier named dean of Gillings School of Global Public Health ASTHO Blog Article: States Stepping Up to Support Families and Reduce Adverse Childhood Experiences ASTHO Webpage: Be in the Know  

For the past few shows and in a few coming up, we are circling our wagons around a theme: In healthcare in this country, there are two teams. One team is employers, taxpayers, patients … those trying to keep healthcare prices down. Then on the other team, we have those looking for healthcare prices to continue to go up, meaning, as just one example, some health systems and some hospitals. There was a New York Times article recently, and Peter Hayes wrote an interesting comment about it on LinkedIn. He wrote: “This article is troubling on so many levels and clearly demonstrates that patient health and well-being are not the top priority of many in healthcare leadership in our hospitals. Unfortunately, it is much more about patient revenue than patient health. … The non-profit status of our health facilities is a huge hidden tax and wealth transference from every taxpayer that is estimated to be about $39 billion annually.” Look, for sure, not talking about everybody in healthcare leadership here, and increasingly I'm kinda thinking we need to maybe have more than one word for hospitals and their leadership because lumping them all together into a homogenous blob is really unfair to those rural and safety net organizations contending with all kinds of adversities—which is very, very different in circumstance to those so-called “well-resourced” hospital chains in suburban markets really raking in the cash and virtue signaling in very well-resourced press campaigns. And the irony of this whole thing is that a reason hospitals (that want to) get away with doubling down on profit-centric business models is actually their nonprofit status. This is a major loophole. If you are a nonprofit, you get to be excluded from some of the powers of the FTC (Federal Trade Commission), for example. But then there's also the lack of financial discipline, as Mike Thompson puts it in the show today. These nonprofit organizations have never had to run efficiently. They have never been asked to justify the new building or the other adds to their infrastructure that ultimately increase their costs of doing business in ways that, on the whole, might not benefit patient care. And I say “might not benefit patient care” fairly confidently because there is absolutely no correlation between high prices and high quality in healthcare. In fact, it can just as easily be the opposite. But if you overbuild and you buy too many MRI machines or whatever, then you gotta feed the beast. And then the downward spiral starts, and the anticompetitive, financially toxic behavior really kicks into high gear—which, again, is tough to regulate because our laws and legislation expect nonprofits to, you know, behave like nonprofits. In this healthcare podcast, I am thrilled to speak with Mike Thompson, who is the CEO and president of the National Alliance of Healthcare Purchasers. Interestingly, Mike is an actuary by background; and I am sure that that has come in handy as more and more data is becoming available for purchasers and also regulators. The National Alliance has created a playbook to help employers get a fair price from hospitals. In short, the playbook's five strategies to do so include (1) looking up what the fair commercial price is for your local hospital, which is really easy to see if you go to dashboard.sagetransparency.com. This Sage Transparency dashboard was created by the Employers' Forum of Indiana. Not to drown you in acronyms, but the Sage Transparency dashboard very elegantly combines RAND data showing what hospitals are actually charging employer plans and compares that to what's called the NASHP commercial break-even price. NASHP is the National Academy for State Health Policy, who crunched a lot of numbers to figure out this commercial break-even price. Once you know the fair commercial price for hospitals in your area, then one way to go could be (2) using an RBP (reference-based pricing) strategy and paying based on the fair commercial price plus a markup. Another strategy is to (3) start monitoring your ASO/TPA (administrative services organization/third-party administrator) carefully and see that they are paying this fair price and getting performance guarantees to hold them accountable to do so. Yet another strategy is to (4) gang up with other employers in coalitions, which is often necessary, given how much market power some of these hospitals have consolidated and all the anticompetitive practices they've managed to tuck into their FTC-exempt quiver. And last is to (5) regulate through legislation. One point that Mike makes very clear is that if nonprofit hospitals cannot remain true to their mission and if they are also not subject to market dynamics, that's a lose-lose for their communities. At that point, a very viable option is to regulate them like utilities. This is also what I talk about next week with Chris Skisak and Gloria Sachdev. The sad part about this whole thing is that hospitals and communities really should be sitting on the same side of the table working together to improve the health and well-being of their communities. And that should include—according to me, at least—keeping financial toxicity in check, especially just given everything we know for sure about how financial toxicity negatively impacts patient health. Oh, hey, here's a thing: Turns out I had a fever when I recorded this show, so yeah, Mike deserves a little extra kudos for very eloquently just going with it when occasionally my questions sort of ended without, you know, actually asking a question. You can learn more at nationalalliancehealth.org. Michael Thompson is the president and CEO of the National Alliance of Healthcare Purchaser Coalitions (National Alliance), the only nonprofit, purchaser-led organization with a national and regional structure dedicated to driving health and healthcare value across the country. Prior to joining the National Alliance, Mike was a Principal at PricewaterhouseCoopers (PwC) for 20 years. He is a nationally recognized thought leader for business health strategies and health system reform. Mike has worked with major employers and other stakeholders on sustainable cost reduction, integrated health, wellness and consumerism, retiree health, private health exchanges, and health reform. Known for developing and promoting collaborative cross-sector health industry initiatives, Mike participated on the steering board of the World Economic Forum's “Working toward Wellness” initiative and co-founded the Private Exchange Evaluation Collaborative. Prior to PwC, Mike served as an executive with diverse roles with Prudential Healthcare for over 17 years. Mike is a Fellow of the Society of Actuaries, serving on the Health Practice Council, and chairs the Medicare Sub-Committee of the American Academy of Actuaries. He is board president of the Innovation and Value Initiative. He is also widely recognized as a leading national advocate for mental health and well-being and was past president of the New York City chapter of the National Alliance for Mental Illness. 05:37 Check EP372 with Cora Opsahl; EP358 with Wayne Jenkins, MD; EP388 with Merrill Goozner; and EP346 with Peter Hayes for a deep dive. 05:48 Why should an employer health plan be concerned about how much area hospitals are spending? 07:01 How are hospitals quantifying their prices? 08:10 “I think we're not paying a fair price is the end game.” 10:45 How do we bring rigor back into the market? 11:12 What is NASHP? 15:10 What does the NASHP commercial breakeven take into account? 18:24 Why are hospitals conflicted when it comes to building a health system based on value and health? 20:17 Why is the onus on hospitals to defend the way they've spent the money they have? 21:58 “Where there are market dynamics, we typically see prices in that fair price range.” 25:06 What can employers do from a market standpoint, a program design point, and a policy standpoint? 27:11 What is the National Alliance of Healthcare Purchaser Coalitions playbook? 30:15 Why is changing the dynamics in the press important to changing hospital pricing? 33:02 How fundamental is the employer's role in making sure that they're paying a fair price for the healthcare services their employees are receiving?   You can learn more at nationalalliancehealth.org.   @IWLMikeT of @ntlalliancehlth discusses #hospitalpricing on our #healthcarepodcast. #healthcare #podcast #hospitals #healthcarepricing   Recent past interviews: Click a guest's name for their latest RHV episode! Dr Rishi Wadhera (Encore! EP326), Ge Bai (Encore! EP356), Dave Dierk and Stacey Richter (INBW37), Merrill Goozner, Betsy Seals (EP387), Stacey Richter (INBW36), Dr Eric Bricker (Encore! EP351), Al Lewis, Dan Mendelson, Wendell Potter, Nick Stefanizzi, Brian Klepper (Encore! EP335), Dr Aaron Mitchell (EP382), Karen Root, Mark Miller, AJ Loiacono, Josh LaRosa, Stacey Richter (INBW35), Rebecca Etz (Encore! EP295), Olivia Webb (Encore! EP337), Mike Baldzicki, Lisa Bari, Betsy Seals (EP375), Dave Chase, Cora Opsahl (EP373), Cora Opsahl (EP372), Dr Mark Fendrick (Encore! EP308), Erik Davis and Autumn Yongchu (EP371)

In today's episode, Jeiri is joined by Shayla Collins and Maureen Johnson. Shayla Collins is a staff member at AUCD and a wife and mother of two. Maureen Johnson is a program specialist at AUCD and provides technical support to university based interdisciplinary training and research programs. Furthermore, Maureen works on leadership and professional development activities for early career professionals, family advocates, and self advocates through the Emerging Leaders community. She was also selected as an Emerging Leader of Color Fellow at the National Academy of State Health Policy in April of 2022. Shayla kicks off the episode by sharing her journey at AUCD, and Maureen shares her vision for the emerging leader spot. Maureen also shares her experience in the emerging leader space and what she hopes to leave behind as part of her legacy as Shayla shares why her passion as an emerging leader is what she hopes to leave behind. Jeiri, Shayla, and Maureen have a conversation about both their individual advocacy style, their leadership journey, as well as opportunities for leadership development within AUCD.This podcast episode is provided in partial fulfillment of tasks outlined in a cooperative agreement (#UA5MC11068) between AUCD and the Maternal and Child Health Bureau (MCHB). The contents do not necessarily reflect the views or policies of MCHB, the Health Resources Services Administration, U.S. Department of Health and Human Services, or the U.S. Government. Produced by Adode Media; a full-service podcast production agency.

Suzanne speaks to Marilyn Bartlett about the National Academy for State Health Policy's (NASHP) Hospital Cost Tool and her role in creating it. NASHP's interactive Hospital Cost Tool provides anyone from policymakers to researchers with insights into how much hospitals spend on patient care services. The tool also shows how those costs relate to both the hospital charges (list prices) and the actual prices paid by health plans.

Dr. Anne Zink, ASTHO President and Chief Medical Officer of the Alaska Department of Health, shares some encouraging words to celebrate Public Health Thank You Day; Mike Fraser, ASTHO CEO, appreciates the significance of Public Health Thank You Day, but says we shouldn't limit our thanks to a single day; and Beth Giambrone, ASTHO Senior Analyst for State Health Policy, says all 50 states and Washington D.C. have cottage food laws in place, noting some are considering changes. ASTHO Blog Article: Do Cottage Foods Really Come from a Cottage?

Dr. Anne Zink, ASTHO President, releases a statement addressing the response to a spike in respiratory infections; Dr. Jose Romero, Director of the National Center for Immunization and Respiratory Diseases at the CDC, addresses the latest concerns about the rise in respiratory infections across the country; Jeanne Ayers, former State Health Officer for the Wisconsin Department of Health Services and now the Executive Director for Healthy Democracy Healthy People, explains the connections between voting and public health on the eve of the Nov. 8th election; JoAnne McClure, ASTHO Senior Analyst for State Health Policy, has a blog article summarizing steps some states and territories are taking to stem the rising tide of overdose fatalities; and Public Health Thank You Day is Monday, November 21st. ASTHO News Release: State Health Officials Urge Families to Take Preventive Measures During Current Respiratory Virus Surge Healthy Democracy Healthy People Webpage: Health & Democracy Index ASTHO Blog Article: Harm Reduction Policies Can Prevent Overdose Fatalities

This episode of On the Evidence explores lessons from contact tracing for COVID-19 that should inform current and future efforts to rebuild the public health field, particularly its workforce, after the public health emergency ends. This episode features the following guests: • Elinor Higgins, a policy associate at the National Academy for State Health Policy • Shelley Fiscus, a pediatrician and senior policy consultant at the National Academy for State Health Policy • Rachel Brash, a strategist in the Mayor's Office of Employment Development who helped oversee the Baltimore Health Corps Initiative • Shan-Tia Danielle, who worked as a contact tracer and led a team of contact tracers for the Washington State COVID-19 Contact-Tracing Partnership • Candace Miller, a principal researcher at Mathematica who directed the Washington State COVID-19 Contact-Tracing Partnership • Shaun Stevenson, an advisory services analyst at Mathematica who supported the Baltimore Health Corps Initiative Episode transcript: https://www.mathematica.org/blogs/charting-a-course-for-public-health-based-on-lessons-from-contact-tracing-during-the-pandemic Learn more about the Washington State COVID-19 Contact-Tracing Partnership between the Washington State Department of Health, Mathematica, Comagine Health, and Allegis: https://mathematica.org/news/mathematica-partners-with-comagine-health-allegis-and-washington-state-on-contact-tracing Read Mathematica's interim (https://mathematica.org/publications/baltimore-health-corps-initiative-a-transitional-jobs-program-to-improve-public-health) and final issue briefs about lessons from Mathematica's coaching of career navigators who supported more than 300 community health workers under the Baltimore Health Corps Initiative: https://mathematica.org/publications/lessons-learned-from-the-baltimore-health-corps-initiative-a-transitional-jobs-program-to-improve Read an independent evaluation of the Baltimore Health Corps Initiative, prepared by Abt Associates: https://moed.baltimorecity.gov/news/press-releases/2022-08-19-evaluation-baltimore-health-corps-pilot-economic-and-public-health Explore a dashboard developed by Mathematica and the Public Health Foundation to present key demographic characteristics of (1) contact tracing trainees who received training through the TRAIN Learning Network and (2) the communities they serve: https://www.mathematica.org/dataviz/building-community-based-contact-tracing Read a blog explaining the purpose behind the contact-tracing dashboard developed by Mathematica and the Public Health Foundation: https://mathematica.org/blogs/insights-for-building-a-community-based-contact-tracing-workforce Explore an interactive map and table developed by Mathematica and the National Academy for State Health Policy that tracks state approaches to contact tracing for COVID-19: https://www.nashp.org/state-approaches-to-contact-tracing-covid-19/ Explore a Mathematica data visualization showing the importance of demographics and other community characteristics in informing approaches to contact tracing: https://www.mathematica.org/dataviz/grounding-state-contact-tracing-efforts-in-context Listen to an episode of On the Evidence about the variation in state approaches to contact tracing: https://www.mathematica.org/blogs/understanding-the-variation-in-states-covid-19-contact-tracing-approaches Listen to an episode of On the Evidence about the importance of building a community-based contact-tracing workforce: https://www.mathematica.org/blogs/contact-tracing-workforce-driving-equitable-sustained-risk-mitigation-in-a-post-pandemic-world Listen to an episode of On the Evidence about the importance of equity in implementing effective contact tracing: https://www.mathematica.org/blogs/early-lessons-for-effective-and-equitable-contact-tracing

Dr. Brooke Cunningham, Assistant Commissioner for the Health Equity Bureau with the Minnesota Department of Health, details a report that examined maternal deaths from 2017 to 2018; an ASTHO blog article explains how states and the federal government have taken steps to improve health outcomes for pregnant people; Maggie Davis, ASTHO's Director of State Health Policy, explains a new report to help agencies better serve pregnant people and infants during a crisis; and ASTHO examines the value of primary care offices in a conversation with Alisa Druzba, the Chair of the Primary Care Office National Committee. Minnesota Department of Health News Release: First-ever Minnesota maternal mortality report reveals opportunities to prevent maternal deaths ASTHO Blog Article: Leveraging State and Federal Policy to Reduce Maternal Illness and Death ASTHO Webpage: Considerations for Maternal Child Health Policies and Public Health Emergencies ASTHO Webpage: National Preparedness Month Webinar Series ASTHO Blog Article: State Primary Care Offices Expand Access to Care and Improve Health Equity

Lance Gregory, Environmental Health Division Director with the Virginia Department of Health, discusses Septic Smart Week and the demand for the agency's Septic and Well Assistance Program; Joel Cantor, Director of the Rutgers Center for State Health Policy, explains a project to study population health concerns in New Jersey; and this week is also Falls Prevention Awareness Week. ASTHO Blog Article: Promoting Successful Onsite Wastewater Treatment Programs Health IT Analytics Webpage: NJ Launches Statewide Population Health Data Project Rutgers Center for State Health Policy Webpage: Integrated Population Health Data Project Falls Free Checkup Webpage

On this episode of On the Evidence, guests Gloria Sachdev of the Employers' Forum of Indiana, Maureen Hensley-Quinn of the National Academy for State Health Policy, and Evelyn Li and Guru Rasukonda of Mathematica discuss the value of new online tools for making sense of large sets of hospital cost and pricing data being made available in response to new federal regulations. A full transcript of the episode is available here: https://www.mathematica.org/blogs/using-data-transparency-to-control-hospital-costs Explore Sage Transparency, a free online tool developed by the Employers' Forum of Indiana and Mathematica. The tool draws on data from the RAND 4.0 Hospital Price Transparency Study, Centers for Medicare & Medicaid Services, and other health databases to show the real prices that employers pay for health care across the country: https://employerptp.org/sage-transparency/ Explore the Hospital Cost Tool, a dashboard designed by the National Academy for State Health Policy and Mathematica, which helps bridge the information gaps on costs and pricing: http://d3g6lgu1zfs2l4.cloudfront.net/

Dylan George, the Director of Operations for the Center for Epidemic Forecasting and Outbreak Analytics with the CDC, discusses what could happen with COVID-19 infection rates in the fall and winter; Maggie Davis, ASTHO's Director of State Health Policy, previews a new ASTHO report addressing maternal child health policy considerations during public health emergencies; ASTHO's process for setting legislative priorities is outlined in a new blog article; and ASTHO highlights three job openings this week. COVID-19 Scenario Modeling Hub Webpage CDC Webpage: COVID-19 Forecasting and Mathematical Modeling Public Health Law Practitioners Convening Webpage ASTHO Blog Article: Advocating for Success: ASTHO's Federal Legislative Priorities ASTHO Webpage: Careers at ASTHO

Maggie Davis, ASTHO's Director of State Health Policy, discusses a project to survey recent changes in laws governing public health authority; Dr. Harry Chen, the former Commissioner of Health for Vermont, tells us about some of the lessons learned concerning the collection and use of public health data during the pandemic; Shelbi Davis, ASTHO's Senior Climate Change Analyst, says lack of funding and competing priorities are keeping many agencies from doing more to address the public health impacts of climate change in a Pew Stateline article; and you can still sign up to attend the 2022 National Conference on Health Communication, Marketing and Media starting today. The Policy Surveillance Program Webpage: Sentinel Surveillance of Emerging Laws Limiting Public Health Emergency Orders Temple University Webpage: Nearly Half Of All States Have Now Passed Laws Limiting Authority To Respond To Public Health Emergencies PEW Stateline Article: Public Health Agencies Lack Money to Combat Climate Threats NPHIC Webpage: 2022 National Conference on Health Communication, Marketing and Media  

Join Health Affairs Insider.Listen to Health Affairs' Rob Lott and Vabren Watts discuss the federal and state aftermath following the Supreme Court overturn of Roe v. Wade.Currently, more than 70 percent of our content is freely available — and we'd like to keep it that way. With your support, we can continue to keep our digital publication Forefront and podcasts free for everyone.Related Links: Women's Live and Health: Mere Abstractions In The Leaked Dobbs Abortion Opinion (Health Affairs Forefront) As Mississippi Debates Abortion, Maternal Mortality Remains High (Jackson Free Press) HHS Secretary Letter to Health Care Providers About Emergency Medical Care  FACT Sheet: President Biden To Sign Executive Order Protection Access to Reproductive Health Care Services (White House) Biden Admin to Pharmacies: Refusing to Fill Contraception and Abortion Pill Prescriptions Could Break Federal Law (Politico) Subscribe: RSS | Apple Podcasts | Spotify | Castro | Stitcher | Deezer | Overcast

Andy Baker-White, ASTHO's Senior Director for State Health Policy, discusses the impact of this week's federal court ruling striking down the mask requirement for people using public transportation; Phillip Talboy, Senior Advisor with the CDC's Division of TB Elimination, examines the drop in tuberculosis cases in 2020 and emphasizes the importance of TB awareness among providers; ASTHO publishes a blog article detailing how the Louisiana Department of Health launched a mentorship program during the pandemic; and we link ASTHO's statement on environmental health policy in recognition of Earth Day today! Public Health Communications Collaborative: Answers to Tough Questions Public Health Communications Collaborative: Talking Points and Answers to Tough Questions CDC Webpage: Tuberculosis Data and Statistics CDC Communications Campaign: Think. Test. Treat TB ASTHO Blog Article: Louisiana Department of Health Mentorship Program Thriving During COVID Response ASTHO Statement: Environmental Public Health Policy Statement

Robin Matthies, Director of Public and Behavioral Health Integration at ASTHO, explains why it's important to consider restorative justice approaches to discipline in schools; Andy Baker-White, ASTHO's Senior Director of State Health Policy, says jurisdictions have policy options when promoting vaccinations among workers; and ASTHO is hiring for several open positions. ASTHO Reports: Restorative Justice in Schools – An Upstream Approach for Addressing Inequities in the Risk of Incarceration ASTHO Webpage: Job Opportunities in Public Health and at ASTHO

Maggie Davis, ASTHO's Director of State Health Policy, provides an overview of a new ASTHO report about restorative justice in schools; Annie Evans, a senior analyst of disability integration and preparedness at ASTHO, marks the first anniversary of a program that sent disability experts to help several jurisdictions better serve people living with disabilities; and an ASTHO blog article examines two top policy issues to watch in 2022, health equity and rural health, while another rounds up the top online resources of 2021. ASTHO Reports: Restorative Justice in Schools – An Upstream Approach for Addressing Inequities in the Risk of Incarceration ASTHO Blog Article: ASTHO Policy Watch – Health Equity and Rural Health ASTHO Blog Article: ASTHO's Most Used Resources of 2021

Andy Baker White, ASTHO's Senior Director of State Health Policy, discusses immunization proposals scheduled for consideration in legislatures across the nation; Caroline Chen, a journalist writing for ProPublica, connects syphilis to the public health funding roller coaster and health care needs in rural America; and ASTHO announces new job openings. ASTHO News Release: ASTHO Unveils Top 10 Public Health State Policy Issues to Watch in 2022 ASTHO Blog Article: Proposed Vaccination Laws to Watch in the New Year ProPublica Report: Babies Are Dying of Syphilis. It's 100% Preventable ASTHO Webpage: Job Opportunities in Public Health and at ASTHO

ASTHO Chief Medical Officer Dr. Marcus Plescia says even though everyone is tired of the pandemic, we can't give up fighting the virus now; ASTHO CEO Mike Fraser, along with two other public health leaders, says the pandemic has been difficult but also has offered several valuable lessons; and ASTHO's Director of State Health Policy, Maggie Davis, previews ASTHO's annual series of policy papers for member states and territories due out in January. NPHIC webpage: Public Health Speaks podcast ASTHO Statement: Lessons From the First Year of COVID-19 Vaccination, and What's Next ASTHO News Release: State and Territorial Health Officials Urge Americans to Help Stop Delta and Omicron's Spread ASTHO News Release: ASTHO Unveils Top 10 Public Health State Policy Issues to Watch in 2022

Maggie Davis, ASTHO's Director of State Health Policy, examines the flurry of lawsuits and court orders resulting from legislative and executive prohibitions of school masking policies; Lindsey Myers, ASTHO's Vice President of Social and Behavioral Health, says public health departments can help kids who've lost a parent or grandparent to COVID-19 by pursuing a population health approach to their response; ASTHO wins the Public Policy Award from the National Forum for Heart Disease and Stroke Prevention; and Dr. Nicole Alexander Scott, Director of the Rhode Island Department of Health, tells us what she's thankful for this Thanksgiving season. ASTHO Blog Article: Courts Considering Challenges to States Blocking School Mask Requirements ASTHO Blog Article: The Children COVID-19 Left Behind – A Public Health Call to Action APHA webpage: Public Health Thank You Day

Dr. Joshua Starr, CEO of PDK International, explains how polling parents of school children can inform public health messaging; Andy Baker-White, ASTHO's Senior Director for State Health Policy, discusses the impact of new state laws rolling back authorities used to protect public health; and we highlight an ASTHO Brief examining the healthcare digital divide. PDK International Webpage: PDK poll of the public's attitudes toward the public schools Kaiser Health News: Over half of states have rolled back public health powers in pandemic ASTHO Brief: Bridging the digital divide in healthcare to improve access to care

The Connecticut Department of Health has extended its contact tracing program ContaCT to May 2022, after which the program will transition entirely to local health departments, a move originally planned for Aug 27, 2021. The department's move comes at a time when the state's positivity rate is at 3.10%, and is expected to climb during the coming winter months. Connecticut has reported 372,069 positive cases since the start of the pandemic, with 380 hospitalizations currently. COVID-19 deaths rose to 8,355 as of Aug 30, 2021. Today on Where We Live, we talk about State and town health departments using people and data to keep us safe from the delta and other variants. How well is it working? GUESTS: Michael Luongo -Investigative reporter and former contact tracer, New York City Lea Zimany - Contact tracer, Connecticut Department of Public Health. Hemi Tewarson - Executive Director, the National Academy for State Health Policy. Emily DiSalvo - Reporter, CT News Junkie Kevin Elak: Acting Director, Middletown Department of Health Support the show: http://wnpr.org/donate See omnystudio.com/listener for privacy information.

The Connecticut Department of Health has extended its contact tracing program ContaCT to May 2022, after which the program will transition entirely to local health departments, a move originally planned for Aug 27, 2021. The department's move comes at a time when the state's positivity rate is at 3.10%, and is expected to climb during the coming winter months. Connecticut has reported 372,069 positive cases since the start of the pandemic, with 380 hospitalizations currently. COVID-19 deaths rose to 8,355 as of Aug 30, 2021. Today on Where We Live, we talk about State and town health departments using people and data to keep us safe from the delta and other variants. How well is it working? GUESTS: Michael Luongo -Investigative reporter and former contact tracer, New York City Lea Zimany - Contact tracer, Connecticut Department of Public Health. Hemi Tewarson - Executive Director, the National Academy for State Health Policy. Emily DiSalvo - Reporter, CT News Junkie Kevin Elak: Acting Director, Middletown Department of Health Support the show: http://wnpr.org/donate See omnystudio.com/listener for privacy information.

ASTHO CEO Michael Fraser discusses whether the FDA's decision to give the Pfizer BioNTech COVID-19 vaccine full approval will win over people still uncertain about vaccination; ASTHO's Senior Director for State Health Policy, Andy Baker-White, discusses changing guidance and requirements on masks in schools; and a look at ASTHO's support for a statement urging COVID-19 vaccines for pregnant women. FDA: FDA approves first COVID-19 vaccine Blog post: The changing guidance and requirements on masks in schools Statement of strong medical consensus for vaccination of pregnant individuals against COVID-19    

Today Jen Covich Bordenick, CEO of the eHealth Initiative, helps us assess the Biden administration’s ambitious 100-day agenda for combating COVID-19. She joins Change Healthcare’s Deanne Kasim, Angela Evatt, and Steve Brennan to discuss how COVID-19 is now central to everything happening with healthcare policy legislation and executive orders at the federal and state government levels. Our panel: Deanne Kasim is executive director of Healthcare Policy, and Angela Evatt and Steve Brennan are senior managers of State Health Policy at Change Healthcare. They’re joined by Jen Covich Bordenick, the CEO of the eHealth Initiative. Topics discussed on today’s show: Progress on vaccine distribution and related public health issues Vaccination appointments and the healthcare digital divide Legislation to address disparities in access to care Momentum for permanent waivers expanding telehealth access and payment The potential for “asynchronous” remote care coverage Privacy issues with COVID-19 tracking data and apps Public health infrastructure weaknesses exposed State healthcare bills and policy focus State budget challenges and federal funding uncertainty Episode Resources Jen Covich Bordenick’s bio Deanne Kasim’s bio Angela Evatt’s bio Steve Brennan’s bio eHealth Initiative CDT and eHI Release Proposed Consumer Privacy Framework for Unprotected Health Data Change Healthcare Government Affairs Change Healthcare Industry Insights COVID-19 Updates and Resources COVID-19 Updates Newsletter Change Healthcare Insights Newsletter Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Suggest or become a guest Contact Change Healthcare

Employers are clashing with hospitals, insurers and even their own workers over high health care prices. We meet some of the businesses, unions and advocates on the frontlines of this battle that could determine the fate of employer-based insurance.Listener warning: This episode does contain sensitive languageGuests:Marilyn Bartlett, CPA, CMA, CFM, Senior Policy Fellow, National Academy for State Health Policy, and former administrator of Montana state employee health planMike Chernew, PhD, Leonard D. Schaeffer Professor of Health Care Policy, Harvard Medical SchoolWill Haynes, 32BJ union memberElizabeth Mitchell, CEO, Purchaser Business Group on HealthSara Rothstein, Director, 32BJ Health FundGloria Sachdev, PharmD, President and CEO, Employers’ Forum of IndianaCandace Shaffer, Senior Director of Benefits, Purdue UniversityBob Smith, MBA, Executive Director, Colorado Business Group on HealthYou can find more of our research online: https://tradeoffs.org/2021/02/18/the-high-price-of-lowering-health-costsSign up for our weekly newsletter to see what research health policy experts are reading right now, plus recommendations from our staff: bit.ly/tradeoffsnewsletterSupport this type of journalism today, with a gift: https://tradeoffs.org/donateFollow us on Twitter: https://twitter.com/tradeoffspod See acast.com/privacy for privacy and opt-out information.

Last week, a Virginia House of Delegates committee halted legislative proposals that would have created exceptions for people who don’t want to get a COVID-19 vaccine. Gov. Ralph Northam’s office says that he does not plan for the state government to mandate that Virginians get vaccinated. If and when an approved vaccine were available, would you get it?

Dr. Pennell and Dr. Jennifer Tsui discuss the processes that lead to suboptimal EOL care within Medicaid populations and among racial/ethnic minority groups.     Hello, and welcome to the latest JCO Oncology Practice podcast, brought to you by the ASCO Podcast Network, a collection of nine programs covering a range of educational and scientific content and offering enriching insight into the world of cancer care. You can find all recordings, including this one, at podcast.asco.org. My name is Dr. Nate Pennell, medical oncologist at the Cleveland Clinic and consultant editor for the JCO OP. I have no conflicts of interest related to this podcast, and a complete list of disclosures is available at the end of the podcast. Aggressive care at the end of life for cancer patients is widely recognized as poor-quality care. And by aggressive care, I don't mean aggressive supportive care or hospice, but rather inappropriate interventions, like chemotherapy or hospital and ICU admissions, near the end of life that rarely improve outcomes and often actually worsen quality of life. Efforts are being made to educate physicians and cancer patients to try to minimize aggressive treatments near the end of life and to help as many patients as possible benefit from things like hospice benefits and appropriate end-of-life care. However, not all patients receive high-quality end-of-life care, and there may be differences in end-of-life care in various populations. For example, how do race and things like Medicaid status impact aggressive care at the end of life? With me today to discuss this topic is Dr. Jennifer Tsui, Assistant Professor in the Division of Population Science at Rutgers Cancer Institute of New Jersey. We'll be discussing her paper "Racial Disparities in Health Care Utilization at the End of Life Among New Jersey Medicaid Beneficiaries With Advanced Cancer," currently in press for the JCO OP. Welcome, Dr. Tsui, and thank you for joining me on the podcast. Thanks so much. Thanks for having me. I have no conflicts of interest with this study whatsoever. Dr. Tsui, can you please tell me a little bit about what exactly constitutes high or low-quality end-of-life care? Sure. I mean, I think that, in this study in particular, we wanted to focus on guideline-related end-of-life care. So we wanted to see if it was possible to take a look at patterns at the end of life for breast and colorectal cancer and stage cancer cases and see sort of what the patterns were in relation to adherence to guideline adherence and what they should be receiving at the end of life. And so that included a set of measures around aggressive care related to hospitalization in the last 30 days, emergency department visits in the last 30 days of life, an ICU admission in the last 30 days of life, and chemotherapy in the last 14 days of life. These are guidelines that have been discussed and published by national organizations. And we also looked at hospice enrollment. So we looked at whether there was any hospice enrollment and whether there was hospice enrollment in the last 30 days of life, I'm sorry. Are there already data existing for various disparities in end-of-life care among different racial groups or patients of different socioeconomic status? There are. So there have been a few prior publications before our study that have shown that Medicaid patients frequently-- not just for end-of-life care, but cancer care in general-- that Medicaid patients receive lower quality of care. And there were studies done prior to ours that did show, I think, in New York, for example, that Medicaid patients had lower-quality end-of-life care compared to Medicaid and privately insured patients. We have seen other studies also mentioning disparities by race in terms of quality of end-of-life care. However, I don't think-- some of these studies have focused on different populations and cancer sites. So some of the studies I mentioned looked at AYA, adolescent and young adult cancer survivors. Other studies have focused on other cancer sites. And also, these were studies that were conducted in earlier time period. And what we know is that, given all that's happened since the Affordable Care Act and Medicaid expansion in several states, sort of the Medicaid population has changed, but sort of health care delivery has been redesigned in different ways. And so that was really why we wanted to look at this issue sort of in more recent years and during a period that spanned Medicaid expansion within New Jersey. You know, that's helpful to understand what sort of prompted you to do this. So why don't you tell our listeners basically how you designed your study. Sure. So this was a large data linkage that we established within the state of New Jersey to better understand cancer care quality for breast and colorectal cancer patients in general, so beyond just the stage IV cancer patients, the patient's diagnosis at stage IV, but breast and colorectal cancer patients in general. So we worked with our New Jersey State Cancer Registry, identified all our breast and colorectal cancer cases that were diagnosed between 2011 and 2015, and then we linked those with our New Jersey Medicaid enrollment and claims files. So this was a study that was done in partnership with our Rutgers Center for State Health Policy. It was conducted sort of with ongoing input and feedback from both our State Cancer Registry as well as our Medicaid program. They've seen sort of findings related to this and other research questions we've had throughout the process. And what we really ended up with was a very rich data set that not only gave us all the tumor characteristics that are available in the cancer registry, but also the health care utilization patterns and Medicaid enrollment characteristics that are available on the Medicaid claims and Medicaid program data side. And how well did this database capture all of these measures of aggressive end-of-life care, so ED visits and chemotherapy and such? Since we did focus on those who were continuously enrolled in our state Medicaid program, we were able to go through our claims data and be able to, using billing codes, identify things like ED visits, et cetera. This data set only includes cancer cases up to age 64. So we didn't include people who may be dual enrolled in Medicare or have Medicare claims. We also tried to create some other restrictions so that we can get at just the people where we had a definitive diagnosis month and year and follow them through their death. And so we did use the prior studies that I mentioned earlier to see what kind of codes were used there. We have quite a multidisciplinary team of collaborators. I worked with quite closely the first author here, Annie Yang. Soon-to-be Dr. Annie Yang is in medical school here at the New Jersey Medical School. And so we did try to be as comprehensive as we could with the codes we used to identify those utilization patterns. OK, so why don't you tell us some of your findings? So I would say that the overall finding is that 62% of these stage IV breast and colorectal cancer patients received at least one measure of aggressive end-of-life care. So out of those four individual measures, 2/3 received at least one, which seems quite high. They ranged from 27% having at least one hospitalization to 34% receiving chemotherapy within the last 14 days of life. What we found is alarming, and it's sort of a call to action for addressing racial and ethnic disparities in health care, is that we found that our non-Hispanic Black patients had a higher odds of receiving any one of those aggressive end-of-life care measures after controlling for other factors. So we did find this racial/ethnic disparity in non-Hispanic Black patients having more aggressive end-of-life care compared to our non-Hispanic white patients, even though these are all the same Medicaid program. This is within one state. And so it did point to some need to better understand what is going on within the health care system, within the health care encounter between patients and physicians towards the end of life and what needs to be done to address these disproportionate rates in end-of-life care among racial/ethnic minority patients. When you talk about these numbers, like 2/3 of patients having aggressive end-of-life care and 39% enrolling in hospice, how does that compare to what would be considered a more appropriate level, say, the private insured patients? So we didn't compare it to privately insured in our state, but we did look at what was published in other states. In New York, for example, I think we had a slightly higher proportion of Medicaid enrollees with stage IV breast and colorectal cancer having more aggressive care. So we did see higher rates. So while we can't compare within our state alone, we do see that the rates are slightly higher than other published studies. Well, I guess I'm just trying to figure out, is aggressive end-of-life care something that commonly happens to all Americans in general, or is this vastly more in this population than what we would expect? In the general population? Yeah, in the general-- You know, I don't-- yeah, I don't have those rates and what our bar should be at baseline, to be honest. I do think that what we see in the end-of-life hospice literature is that there is suboptimal use of hospice care. And what we found was, again, here also sort of suboptimal use of hospice care in this diverse, low-income, Medicaid population. No, clearly, clearly, definitely so. What are some reasons why Medicaid patients would be more likely to have aggressive end-of-life care, do you think? I think Medicaid patients sort of broadly often have higher rates of comorbid conditions when they're diagnosed with cancer. There are complex social factors related to the Medicaid population in terms of being low-income, in terms of other social determinants of health and social needs that increase barriers to care or barriers to high-quality care or continuity of care. In another paper that we published that focuses on this data linkage in the population and this data linkage, there was a lack of primary care utilization prior to cancer diagnosis as well as a lot of the cancer patients in Medicaid enrolling in Medicaid upon diagnosis, right? So I think that there are sort of just several multi-level factors that contribute to why there may be higher rates of aggressive end-of-life care. I think, from a patient perspective, there is a literature out there on the need for communication tools and sort of interaction and inclusion of caregivers that are a part of the decision-making in end-of-life care. Certainly, we've seen in the literature for a while the issue of providers and providers not only being sort of culturally competent or racial and ethnic concordant, but having the tools that they need, both for the physician or the health care team, to have these end-of-life discussions. So I think it's very multi-level and certainly not just either on the patient or the physician. Even within the Medicaid population, so independent just of the, say, the financial pressures that would lead one to enroll in Medicaid, what you showed was that non-Hispanic Black patients had a much higher rate of aggressive end-of-life care even than the overall Medicaid population. And why do you think that would be true? Yeah, so after we finished the analysis for this, we definitely did reach out to other colleagues who have worked in the communities more closely within New Jersey, within the non-Hispanic Black population across New Jersey. We've also talked to our state Medicaid program to, one, think of sort of action items for how to better understand what we're seeing in the quantitative administrative data here, and then two, how to engage communities to understand what to do next about this. So from the literature and from sort of racial/ethnic disparities literature, we do know that there is often mistrust of the medical system. There's underutilization of preventive screenings, and there are physician biases and structural biases that occur along the way, so again, the multi-level factors that impact why there may be disproportionate aggressive end-of-life care in the non-Hispanic Black population. You know, we can't answer those questions with Medicaid claims and enrollment files. We can identify these patterns. And I think what our research team has been in communication with our state Medicaid program to do next is then figure out, how do we talk with some of these communities across the state to figure out what the appropriate community-level education tools might be needed to improve an understanding of what end-of-life options are, but also to focus on the hospitals and health care systems that may be disproportionately seeing some of the-- that may be seeing higher proportions of non-Hispanic Black patients, and how can we engage the health care teams within those settings to figure out what can be done at the health care delivery level? Do you think we have enough information to make interventions now? I mean, are there-- how do you think, aside from further study and trying to understand it better, we might, in the short term, improve rates of quality end-of-life care in these high-risk patients? We've seen-- and we've talked about this, I think, in this field somewhat-- is, one, there are guidelines. And just having health care teams, providers, hospitals understand where they are, sort of tracking where they are in rates of aggressive end-of-life care and in hospice enrollment, and having that feedback and audit loop to kind of look introspectively within the health care delivery setting, I think is one option that we've seen in terms of trying to increase quality and increase adherence to guidelines for other things. And then I certainly think that there might be a need for community-level interventions around, what are the barriers to hospice enrollment? Or where is the lack of awareness and knowledge around end-of-life care options? And what does it mean to reduce interventional care, right? And what does it mean for communities? I think that targeting those aspects and having a dialogue that is responsive to the community-level needs are probably ways that we can start. I think that makes sense. I mean, as an oncologist, a city with a high minority population, I think improving the cultural competence and being able to establish a level of trust with patients who may have an inherent distrust of the medical system, especially when you're talking about something like that's as counterintuitive as trying to recommend not doing more aggressive care, it's certainly a complex conversation and definitely would require a level of trust and communication in order to do that properly. So I completely agree with you that I think, on the community level, the interventions will have to involve that if it's going to be effective. So Dr. Tsui, thanks so much for joining me on the podcast today. Thank you for having me. And until next time, thank you to our listeners for listening to this JCO Oncology Practice podcast. If you enjoyed what you heard today, don't forget to give us a rating or a review on Apple podcasts or wherever you listen. While you're there, be sure to subscribe so you never miss an episode. JCO OP podcasts are just one of ASCO's many podcasts programs. You can find all the recordings at podcast.asco.org. The full text of this paper will be available online at ascopubs.org/journal/op. This is Dr. Nate Pennell for the JCO Oncology Practice, signing off.   The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. For more original research, editorials, and review articles, please visit us online at jco.org. This production is copyrighted to the American Society of Clinical Oncology. Thank you for listening.

Even if you don’t have short-term limited duration insurance (STLDI), you should still be worried about changes to these policies. Once reserved for temporary coverage lapses, recent policy changes could make these plans seem like a good option for those looking to purchase inexpensive health coverage. Pati McCandless, BCBSTX Vice President of State Health Policy, joins Dr. McCoy and co-host Ross Blackstone, BCBSTX Director of Strategic Influence, to talk about the limitations of STLDI policies and the impact they could have on the health insurance market as a whole. You can view these discussions in video format on YouTube (bit.ly/2JO2xbS). Blue Promise is an online video blog and podcast that aims to address complicated health issues with candid conversations from subject matter experts. New editions are published regularly and are hosted by Dr. Dan McCoy, President of Blue Cross and Blue Shield of Texas.

With the latest Open Enrollment Period underway for the Affordable Care Act, statistics reveal that since the policy’s arrival, the portion of nonelderly adults without insurance in New Jersey has fallen by almost 40 percent, with over 670,000 state residents having gained coverage. At the same time, a fog of uncertainty has enveloped the Affordable Care Act, due to national events. A series of decisions on the near horizon could affect directly hundreds of thousands of New Jersey citizens, while also triggering ripples across the marketplace and broader economy. Guiding New Start New Jersey through the complexity and uncertainty of the Affordable Care Act’s future is Dr. Joel Cantor, Director of the Center for State Health Policy at Rutgers University.

With the enrollment period for the Affordable Care Act having recently opened, we look back to June of 2015, when the Supreme Court of the United States issued a six-to-three decision in the matter of King vs. Burwell. Most significantly, that ruling ensured the continuation of tax-credit subsidies for New Jersey’s residents, enabling thousands of citizens to retain their coverage. Statistics indicate the implementation of the Affordable Care Act has decreased the number of New Jersey’ uninsured citizens to the lowest percentage in 25 years, while also delivering several other benefits to our population. Joining New Start New Jersey for a discussion of the Affordable Care Act’s past, present and future is one of the state’s and the nation’s leading experts on the subject, Dr. Joel Cantor, Director of the Center for State Health Policy and Distinguished Professor of Public Policy at Rutgers University.

Alan Weil is the executive director of the National Academy for State Health Policy in Washington, DC. Stephen Morrissey, the interviewer, is the Managing Editor of the Journal. A. Weil. The Value of Federalism in Defining Essential Health Benefits. N Engl J Med 2012;366:679-81.