The Healthcare Policy Podcast ® Produced by David Introcaso

Listen NowDuring this 28 minute podcast Dr. Gruman explains briefly the mission of the Center for Advancing Health.  She then defines what is patient engagement or patient participation by identifying ten categories that add up to 43 specific patient engagement behaviors.  Dr. Gruman then explains why patients are all too frequently unengaged in their own health care due to, for example, low literacy or health literacy, disability, etc.  She discusses how patients can actively engage in their own care using her own experiences as a cancer survivor as an example and what health care providers and regulators are doing to improve patient decision making and patient engagement measurement.  The interview concludes with comments on the work of the ACA-mandated Patient Centered Outcomes Research Institute (PCORI) and the role of family or informal caregivers.  Dr. Jessie Gruman is President of the Center for Advancing Health, a nonpartisan, Washington-based policy institute dedicated to advancing patient engagement in health care delivery, i.e., the Center advocates for policies and practices to overcome the challenges people face in finding good care and getting the most from it.   Dr. Gruman is also a Professorial Lecturer in the School of Public Health and Health Services at The George Washington University.  She serves on the board of trustees of the Center for Medical Technology Policy and the Technical Board of the Milbank Memorial Fund.   She too is a fellow of the Society for Behavioral Medicine and a member of the Academy of Arts and Sciences, the Council on Foreign Relations and the NY Academy of Medicine.  Among other works, Dr. Gruman is the author of The Experience of the American Patient: Risk, Trust and Choice (Health Behavior Media, 2009).  She was graduated from Columbia University with a Ph.D. in Social Psychology.    This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

Listen NowThis 35 minute interview begins with Dr. Lynn describing the work of her Center in addressing how to improve care for the frail elderly.  Dr. Lynn then explains in some detail a three-year quality improvement intervention undertaken by 14 QIOs (Medicare Quality Improvement Organizations) that reduced hospitalizations and re-hospitalizations by almost six percent, i.e., she summarizes today's JAMA-published article she co-authored, "Association Between Quality Improvement for Care Transitions in Communities and Re-hospitaliations Among Medicare Beneficiaries."  Dr. Lynn explains what is "quality improvement" research or moreover how/why it differs from more traditional clinical practice improvement research.  She addresses generalizability in context of QI research, how hospitals may reconcile reduced hospitalizations and rehospitalizations and how this improved care transitions work is being extended via several other federal programs.  Finally, Dr. Lynn discusses how and why we need  to re-engineer health care delivery to create reliable, supportive services, not necessarily medical services, to assist and support an ever increasing population of frail elderly that will experience lenghty periods of disability.  Dr. Joanne Lynn leads the Center on Elder Care and Advanced Illness for the Altarum Institute.   She previously has served as a consultant to the administrator of the Centers for Medicare and Medicaid Services, as a faculty member of the Institute for Healthcare Improvement, and a clinical expert in improvement for the Care Transitions project at the Colorado Foundation for Medical Care.  She has also been a senior researcher at RAND and a professor of medicine and community health at Dartmouth Medical School and at The George Washington University. Dr. Lynn has published more than 250 professional articles. Her dozen books include The Handbook for Mortals, a guide for the public; The Common Sense Guide to Improving Palliative Care, an instruction manual for clinicians and managers seeking to improve quality; and, Sick to Death and Not Going to Take it Any More!, an action guide for policymakers and advocates.  She is a member of the Institute of Medicine and of the National Academy of Social Insurance, a fellow of the American Geriatrics Society and The Hastings Center, and a master of the American College of Physicians.  She received her MD from Boston University. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

Listen NowIn this 34 minute podcast Dr. Paul Van de Water explains the Center on Budget and Policy Priorities' recent call for an additional $1.5 trillion in budgetary savings to stabilize the federal debt at 73% of the GDP.  He discusses the revenue option of limiting individual tax deductions.  On the spending side, savings from Medicare drug pricing and greater beneficiary means testing are discussed and more generally whether Medicare cost growth, comparatively modest over the past three years, will pesist as the national economy recovers.  Dr. Van de Water explanis the merits of applying chained CPI (Consumer Price Index) to index Social Security benefits (to generate additional federal savings) and raising Social Security taxes without limit on annual earnings (currently annual income is taxed up to $113k).  Finally, Dr. Van de Water discusses the problem/s with applying "dynamic scoring" to Congressional Budget Office scoring.            Dr. Paul N. Van de Water is a Senior Fellow at the Center on Budget and Policy Priorities where he specializes in Medicare, Social Security, and health coverage issues.  Previously he was Vice President for Health Policy at the National Academy of Social Insurance and from 2001 to 2005 served as Assistant Deputy Commissioner for Policy at the Social Security Administration.  Dr. Van de Water worked for over 18 years at the Congressional Budget Office in a variety of capacities.  He was graduated from the Massachusetts Institute of Technology with a Ph.D. in economics. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

Listen NowSince the remedy to the "fiscal cliff" did not include structural reforms to Medicare and Medicaid and since Congressional Republicans will call for entitlement savings during the upcoming debt ceiling debate and beyond, Ms. Sarah Kliff, Health Reporter for The Washington Post and Ms. Amy Lotven, Editor/Reporter for Inside Health Policy, discuss what reforms to Medicare and Medicaid are on the table during this session of the 113th Congress. During this 32 minute podcast raising the Medicare eligibility age from 65 to 67, Medicare means testing, the Medicare Independent Payment Advisory Board, the Medicare Sustainable Growth Rate (the "doc fix"), reforms to the Medicaid program and other related issues to reduce federal health care spending are discussed.Sarah Kliff covers health policy for the Washington Post. Previously, Sarah wrote for Politico, where she authored Politico Pulse. Prior to Politico, Sarah was a staff writer at Newsweek covering national politics. She is the recipient of fellowships from the Kaiser Family Foundation and USC Annenberg School of Journalism.Amy Lotven has been for the past five years a health policy editor and reporter at Inside Health Policy.  She has worked previously for newspapers in New Mexico, New York and North Carolina. She did her journalism training at Baruch College. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

Listen NowDuring this 30 minute interview Dr. Zuckerman discusses the long-standing and widespread overuse or misuse of anti-psychotics in medicating nursing home residents.  She identifies some of the more commonly known and used anti-psychotics, why their inappropriate usage poses serious dangers and consequences for patients and how they are being over-prescribed despite FDA "black box" warning lablels.  She notes too the similar  misuse in medicating children.  She offers a sobering perspective regarding efforts by the Congress, CMS and the FDA to curb excessive use.   Finally she makes suggestions on how family members can protect their nursing home resident relatives from being administered anti-psychotic medications.Since 1999 Diana Zuckerman, Ph.D., has been the President of the National Research Center for Women and Families, a nonprofit, nonpartisan research and advocacy organization promoting adult and child health and safety.  After academic careers at Yale and Harvard, Dr. Zuckerman worked for many years as a Senate, House and Department of Health and Human Services staffer and as well serving as a senior policy advisor for First Lady Hillary Rodham Clinton and the White House Office of Science and Technology Policy.  Presently, Dr. Zuckerman is also a fellow at the University of Pennsylvania Center for Bioethics and serves on the board of directors for two nonprofit organizations: the Congressionally mandated Reagan-Udall Foundation; and, the Alliance for a Stronger FDA.  This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

Listen NowIn preparation for further federal health care policy reform anticipated next year several plans are floating around Washington, D.C., all promising, among other things, to "bend the cost curve" or improve health care affordability.  In this 33 minute podcast Mr. Rother briefly defines National Coalition on Health Care's goals and how and why its health care affordability reform proposal, "Curbing Costs, Improving Care: The Path to an Affordable Health Care Future" was created.  He moreover discusses options in the plan beginning with several "game changers" identified in the report, i.e., reforms that pay for value or outcomes instead of services or volume, reforming how Medicare pays doctors, options for limiting the tax exclusion employers receive in providing employee health benefits, and taxing sugar-sweetened beverages.  He outlines reforming chronic disease care, improving medication adherence and lowering drug costs and reforming the private insurance markets via value based insurance designs.  More thematically he discusses market competition, active purchasing and transparency.  Finally, John describes what has been Congressional leadership's reception to the plan and chances next year for legislating any number of these affordability reforms.John Rother is President and CEO of the NCHC, America's oldest and most diverse group working to achieve comprehensive health system change.  Prior to NCHC, Mr. Rother was for over 25 years the Executive Vice President for Policy, Strategy, and International Affairs at the AARP (formerly the American Association for Retired Persons).   From 1981 to 1984, Mr. Rother was Staff Director and Chief Counsel for the U.S. Senate Special Committee on Aging.  From 1977 to 1981 he served as Special Counsel for Labor and Health to Senator Jacob Javits.  Mr. Rother was graduated from Oberlin College and the University of Pennsylvania Law School. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

Listen NowIn this 35 minute podcast Ms. E. Diane Champé discusses the prevalence of child abuse and her personal experience as a victim and a survivor.  She explains how and why the issue receives little attention, for example, responses she has received on Capitol Hill and elsewhere in attempting to draw attention to the subject and the inadequacies in abuse reporting and data collection, in federal research in the dissociative disorders and in ADA (the Americans with Disabilities Act) accomodation for employees with mental health diagnoses.  Also too she discusses time limits, due to statutes of limitations, survivors face in suing their abusers in civil court. Ms. Champé's work on behalf of adult survivors includes hosting a survivors' website at www.edcinstitute.org and speaking publicly about the long-term effects of child abuse and neglect.  Ms. Champé is also a member of Maryland’s Victim Services Professional Network.  Her more recent work includes participation in a national trauma campaign for SAMHSA (a division of the U.S. Department of Health and Human Services) and in the State Public Systems Coalition on Trauma.  She's presented before the US Congress, state and local officials and institutions of higher learning.  Ms. Champé recently established a 501(c)(3) social service agency, the E. Diane Champé Institute, which will provide safe havens for adult survivors of child abuse and neglect.  Her autobiography Conquering Incest: My Life as a Trauma Survivor was published in 2011.  This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com

Listen NowIn this 38 minute interview Dr. Reischauer defines what's meant by the "fiscal cliff" and what's problematic about it near and long term.   He discusses what the Congress can possibly achieve during the lame duck session concerning unemployment insurance, the AMT (Alternative Minimum Tax), the so called "doc fix" and how sequestration might likely be addressed by the Congress and/or the administration. The sunsetting Bush-era tax cuts, Medicare and Medicaid reforms, the "absurdity" of the debt ceiling and social security are also all examined.Dr. Reischauer is one of the two Social Security and Medicare trustees.  Up until recently he was President of the Urban Institute, a nonpartisan social and economic policy research institute.  Presently he serves as Urban's Distinguished Institute Fellow and President Emeritus and as well Senior Fellow of the Harvard Corporation.  Among other positions, Dr. Reischauer was Director of the Congressional Budget Office (1989-1995) and a member and vice-chair of the Medicare Payment Advisory Commission (MedPAC) (2000-2009).  He was graduated from Harvard and Columbia universities. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.thehealthcarepolicypodcast.com