Subscribe to UnitedHealthcare's Community & State newsletter . With the US becoming more focused on addressing mental health, one important topic is how society responds to people experiencing mental health crises. A typical crisis response involves a 911 dispatcher sending a police officer to respond and provide support. However, the vast majority of police officers have little or no training for how to best respond to those in mental health crises. In addition, people with serious mental h...
Jul 06, 2021•25 min•Ep. 41
Subscribe to UnitedHealthcare's Community & State newsletter . Gun violence harms the health of victims and witnesses, but it also disrupts community social cohesion and behavioral norms. The people in communities that have experienced violence can suffer adverse health consequences, including post-traumatic stress disorder. Exposure to gun violence and the disproportionate burden of that violence in certain communities is the topic of today's A Health Podyssey. Sarah James, a postdoctoral f...
Jun 29, 2021•23 min•Ep. 40
Subscribe to UnitedHealthcare's Community & State newsletter . Almost all commercial insurance plans have cost-sharing provisions where patients help pay for their health care services. Annual deductibles — which patients have to meet before insurance pays anything at all — and co-payments — where the patient pays either a fixed amount for or a share of the cost of each service received — are common examples. Cost-sharing generally reduces the health insurance premium by simply shifting a sh...
Jun 22, 2021•24 min•Ep. 39
Subscribe to UnitedHealthcare's Community & State newsletter . Lowering prescription drug prices continues to be a hot topic. Spending on biologic products, which includes most vaccines and gene therapies, was estimated at $125 billion in the United States in 2018, representing about a quarter of total pharmaceutical spending. Biosimilars, follow-on products to biologic drugs with essentially the same molecular composition to produce comparable clinical effects, are viewed by many as a way t...
Jun 15, 2021•27 min•Ep. 38
Subscribe to UnitedHealthcare's Community & State newsletter . BONUS EPISODE As part of Policy Spotlight, a new virtual event series from Health Affairs , Editor-in-Chief Alan Weil welcomed Elizabeth "Liz" Fowler , the new deputy administrator of the Centers for Medicare and Medicaid Services and director of its Center for Medicare and Medicaid Innovation to an in-depth discussion of Biden administration's plans and priorities for health care. The interview was conducted on June 3, 2021. As ...
Jun 09, 2021•57 min•Ep. 37
Subscribe to UnitedHealthcare's Community & State newsletter . Rates of burnout among primary care physicians is a growing concern in the health care workforce. Major shifts in the practice environment — from truncated office visits and growing documentation requirements to practice consolidation — have changed physicians' sense of efficacy and autonomy, both of which are important factors in work satisfaction. The COVID-19 pandemic has heightened these concerns as many physicians have been ...
Jun 08, 2021•26 min•Ep. 36
Subscribe to UnitedHealthcare's Community & State newsletter . Skilled nursing care is an important Medicare benefit but it also accounts for significant spending. In Medicare, cost sharing applies to patients' care in skilled nursing facilities after the twentieth day of residence. This prompts a spike in discharges from facilities at that time. But does cutting short these skilled nursing facility stays at day 20 negatively impact patient health? J. Michael McWilliams, a researcher from Ha...
Jun 01, 2021•32 min•Ep. 35
Subscribe to UnitedHealthcare's Community & State newsletter . The HITECH Act, part of the broad American Recovery and Reinvestment Act of 2009, ushered in major changes for health care's information and informatics landscape. The legislation may best be known for "meaningful use" requirements attached to hospital and/or physician funding to support the adoption of electronic health records (EHRs). The law also greatly boosted health information exchanges, or networks that share clinical inf...
May 25, 2021•28 min•Ep. 34
Subscribe to UnitedHealthcare's Community & State newsletter . "I think we need to step back first before we even ask the policy question and ask this simple question, is it okay in the United States to die of cancer simply because you don't have health insurance?" - Dr. Gerard Silvestri Cancer is a leading cause of death in the United States. Although there have been declines in cancer deaths in recent years, improvements have not been equally distributed across the population. The risk of ...
May 18, 2021•25 min•Ep. 33
Subscribe to UnitedHealthcare's Community & State newsletter . Many think of pharmacies primarily as places to get prescription medications, but pharmacists are highly trained clinicals who offer other important health care services. Pharmacies are a valuable health care resource, and access to pharmacies may be an overlooked contributor to health inequities. Individuals who live in pharmacy deserts aren't able to easily obtain prescription medications or essential health care services. Whil...
May 11, 2021•22 min•Ep. 32
Subscribe to UnitedHealthcare's Community & State newsletter . To say the role of private equity investment in the health care system is growing would be an understatement. In 2018, the valuation of private equity deals in the US health care sector surpassed $100 billion, a 20-fold increase from 2000 when it was less than $5 billion. Now, many are concerned that the incentive structures built into private equity financing have exacerbated trends such as surprise medical billing and contribut...
May 04, 2021•30 min•Ep. 31
Subscribe to UnitedHealthcare's Community & State newsletter . A central tenant of the move to value-based payment in health care is that quality can be measured and high quality providers should be rewarded for their excellence. But efforts to define and measure quality of care can run into challenges. It's considered benign to take certain types of risk factors, such as disease severity, into account when measuring quality of care. But accounting for social risk factors, like poverty or ho...
Apr 27, 2021•29 min•Ep. 30
Subscribe to UnitedHealthcare's Community & State newsletter . The Affordable Care Act (ACA) has been the law of the land in the U.S. for 11 years and helped more than 20 million Americans gain health coverage. Still, some are losing it, even at times when they arguably need it most. There are demonstrated health benefits for the mother and baby to having insurance before and during pregnancy and after giving birth. But a patchwork of programs leaves care gaps for this population. Typically,...
Apr 20, 2021•21 min•Ep. 28
Subscribe to UnitedHealthcare's Community & State newsletter . The number of urgent care centers grew significantly in the last decade, thanks in part by private equity investments. They seek to lower health costs and be cheaper than the ER by conveniently providing on-demand care for easily treatable conditions. But, when looking at the economics, urgent care clinics may increase net health care spending. In a new research article published in the April 2021 edition of Health Affairs , Dr. ...
Apr 13, 2021•22 min•Ep. 29
Subscribe to UnitedHealthcare's Community & State newsletter . The Affordable Care Act requires all private health insurance to fully cover birth control. According to new research published in the April 2021 edition of Health Affairs , this contraception mandate led to increased use of long-acting reversible contraceptives (LARCs) among women enrolled in high-deductible health plans. LARCs, such as IUDs, previously had high one-time, out-of-pocket expenses . This is a positive development f...
Apr 06, 2021•24 min•Ep. 27
Subscribe to UnitedHealthcare's Community & State newsletter . Nursing homes are challenging places to work. As David Grabowski, a professor of health care policy at Harvard Medical School , notes in today's episode of A Health Podyssey , "we knew the nursing home system was broken before the COVID-19 pandemic." Grabowski recently co-authored two papers in the March 2021 edition of Health Affairs on the topic of nursing home staffing using a new Medicare data set (Payroll Based Journal) that...
Mar 30, 2021•24 min•Ep. 26
Subscribe to UnitedHealthcare's Community & State newsletter . Medical training has historically focused almost exclusively on the skills and actions of individual physicians. Increasingly, clinical training is incorporating an understanding of how team-based care affects patient outcomes. For patients with chronic disease such as diabetes, hypertension and high cholesterol, can teams provide better care? Maximilian Pany and Lucy Chen, both MD-PhD candidates in health policy at Harvard Medic...
Mar 23, 2021•22 min•Ep. 25
Subscribe to UnitedHealthcare's Community & State newsletter . The COVID-19 pandemic has prompted an increase in telehealth utilization . Since that growth, researchers have made calls to ensure that telehealth's subsequent growth does not exacerbate disparities in care . Evidence of the “ digital divide ,” or differences in the technology or skills needed to access telehealth care, is widely documented . Race, age, geography, health coverage, and more can all impact how and if one adopts an...
Mar 16, 2021•24 min•Ep. 24
Subscribe to UnitedHealthcare's Community & State newsletter . Bundled payments have long been an experiment in the Medicare program to help reduce health care spending. The Affordable Care Act (ACA) gave the Centers for Medicare and Medicaid Services broad authority to test bundled payments, or paying providers for episodes of care instead of for each service provided. Research has found savings associated with participating in the Bundled Payment for Care Improvement (BPCI) initiative. Whi...
Mar 09, 2021•26 min•Ep. 23
Subscribe to UnitedHealthcare's Community & State newsletter . The COVID-19 pandemic caused an enormous wave of disruption to the U.S. economy, leading the unemployment rate to rise to a record high of 14.7% in April 2020 . While unemployment has since improved — the unemployment rate in January 2021 was 6.3% — America has yet to reach the employment levels it held before the pandemic. In response to so many out of work, the Coronavirus Aid, Relief, and Economic Security (CARES) Act in March...
Mar 02, 2021•26 min•Ep. 22
Subscribe to UnitedHealthcare's Community & State newsletter . There's no doubt that the COVID-19 pandemic spurred an increase in telemedicine use. As Americans were reluctant to venture out of their homes in the pandemic's early months, both public and private payers were quick to change telehealth reimbursement policies as admissions plummeted . According to new research published in the February edition of Health Affairs , 30.1% of all outpatient visits were provided via telemedicine from...
Feb 23, 2021•27 min•Ep. 21
Subscribe to UnitedHealthcare's Community & State newsletter . "Quite honestly, it is not easy to be a nerd on the reservation." - Dr. Donald Warne Pathways are not predetermined in life. But, without readily available role models to point to, it can be difficult for young people to know what options may be available as they advance toward adulthood. Currently, there's a shortage of health care providers for Indigenous populations , which have been linked to limited access to care and higher...
Feb 16, 2021•23 min•Ep. 20
Subscribe to UnitedHealthcare's Community & State newsletter . In the February 2021 edition, Health Affairs presented a collection of papers from the National Academy of Medicine (NAM) for their Vital Directions for Health and Health Care project . While originally established in 2016, NAM reassessed its priorities and found a vastly different health care landscape in 2020. Not only had the COVID-19 pandemic ripped through the health care ecosystem nationwide, but issues regarding maternal h...
Feb 09, 2021•28 min•Ep. 19
Subscribe to UnitedHealthcare's Community & State newsletter . The opioid epidemic has ravaged American life. It has claimed more than 750,000 lives as a result of a drug overdose since 1999. In 2018 alone, more than 2 million people had an opioid use disorder and more than 800,000 people used heroin. To alleviate these deaths of despair and get people the treatment they need, many individuals are looking to short-term residential facilities for substance use treatment programs, commonly ref...
Feb 02, 2021•22 min•Ep. 18
Subscribe to UnitedHealthcare's Community & State newsletter . Have health economists been underestimating supply-side constraints when making predictions regarding cost and utilization for universal health coverage programs, such as Medicare For All? That's certainly what Dr. Adam Gaffney, a pulmonary specialist from Cambridge Health Alliance and Harvard Medical School, and colleagues posit in a new policy paper published in the January 2021 issue of Health Affairs . As Gaffney and co-autho...
Jan 25, 2021•27 min•Ep. 17
Subscribe to UnitedHealthcare's Community & State newsletter . More than 500,000 individuals in the U.S. experience homeless at any given time, and many of those individuals qualify for Medicaid in states that expanded the program under the Affordable Care Act. Medicaid expansion can be helpful for individuals unable to afford private health insurance. Medicaid expansion has been found to slow rates of health decline for some low-income adults , for example. But to date, little is known abou...
Jan 19, 2021•22 min•Ep. 16
Subscribe to UnitedHealthcare's Community & State newsletter . For better or worse, online platforms and social media have enabled individuals to publicly post their opinions of businesses online. As a result, business are at the mercy of public feedback, which can have an impact on their success. Hospitals and physicians are not immune to this trend. The Centers for Medicare and Medicaid Services has pushed the idea of consumerization through price transparency policies and the Five-Star Qu...
Jan 12, 2021•21 min•Ep. 15
Subscribe to UnitedHealthcare's Community & State newsletter . Every year, Health Affairs publishes a retrospective look at national healthcare spending. In 2020, Anne Martin and colleagues from the CMS Office of the Actuary found that U.S. healthcare spending increased 4.6% to $3.8 trillion in 2019 . The rate of health spending declined slightly from 2018, which noted a growth rate of 4.7%. Hospital care, physician and clinical services, and retail purchase of prescription drugs, which acco...
Jan 05, 2021•27 min•Ep. 14
Subscribe to UnitedHealthcare's Community & State newsletter . As we close the books on the year 2020, we turn the tables on Health Affairs Editor-in-Chief Alan Weil wherein the interviewer becomes the interviewee. Alan shares a bit about his educational background, what it actually means to be the editor for the leading health policy journal, and how empirical research has changed since the COVID-19 pandemic. Looking back at the year's event, he elaborates on his blog post from June explain...
Dec 29, 2020•26 min•Ep. 13
Subscribe to UnitedHealthcare's Community & State newsletter . From severe weather such as the destructive wildfires in California to air pollution nationwide, there's a growing body of knowledge linking climate change to human health. On this episode of A Health Podyssey, host Alan Weil interviews Dr. Kristie Ebi, a professor in the Department of Global Health at the University of Washington, to discuss this complex relationship. Ebi served as the theme advisor for the December edition of H...
Dec 22, 2020•24 min•Ep. 12
