Subscribe to UnitedHealthcare's Community & State newsletter . Listen to this bonus episode from Health Affairs' Narrative Matters podcast, which highlights personal stories from the front lines of care. In this episode, host Jessica Bylander interviews Wanda Irving, chair of the board of Dr. Shalon’s Maternal Action Project, before Irving reads an essay from the February 2022 issue of Health Affairs, dedicated to the theme of racism and health. This essay remembers the life and legacy of Sh...
Feb 17, 2022•34 min•Ep. 71
Subscribe to UnitedHealthcare's Community & State newsletter . "Members of racial and ethnic minority groups have long suffered from health inequities in the United States. These inequities result, in large part, from racial and ethnic minority populations' inequitable access to health care, which persists because of structural racism in health care policy. Racism includes a complex array of social structures, interpersonal interactions, and beliefs by which the group in power categorizes pe...
Feb 15, 2022•31 min•Ep. 70
Subscribe to UnitedHealthcare's Community & State newsletter . The February 2022 issue of Health Affairs focuses entirely on racism and health . It includes papers that trace the long history of racism to present day policies and practices that are the reasons for large and sustained health disparities. Racism and bias come in many forms and given the social stigma associated with them, they can be difficult to study. When a study comes along that provides new empirical data on bias, it make...
Feb 08, 2022•27 min•Ep. 69
Subscribe to UnitedHealthcare's Community & State newsletter . The COVID-19 pandemic has made the relationship among research, policy, and public health strikingly clear. People who may have given little thought to health policy and research began following the latest study results to guide their own behavior and push governments and businesses to make decisions that reflect a combination of science and their own values and risk tolerance. Health journals like Health Affairs responded by acc...
Feb 01, 2022•29 min•Ep. 68
Subscribe to UnitedHealthcare's Community & State newsletter . Precision medicine is built on a platform of big data, or large data bases that permit analysis of correlations among environmental and personal factors, treatments, and health outcomes. Data bases that once included only paper records now include tissue samples, air and water samples, and more. There's vast potential for significant advances in health care from precision medicine. But existing large data bases tend to be drawn a...
Jan 25, 2022•26 min•Ep. 67
Subscribe to UnitedHealthcare's Community & State newsletter . Advance care planning is a term used to describe when a person prepares for future management of serious or terminal illness, including developing an advance care directive or what is sometimes is called a living will. Beginning in January of 2016, Medicare made it possible for certain clinicians to bill for their work for patients to develop advance care plans. Despite the new billing option, uptake has been quite slow. In healt...
Jan 18, 2022•27 min•Ep. 66
Subscribe to UnitedHealthcare's Community & State newsletter . "Let us hope that this is a one in a hundred years pandemic. We don't want to build our health care system to operate at all times as if tomorrow will be COVID." - Sherry Glied On December 15, Health Affairs published ahead-of-print, “ National Health Care Spending In 2020: Growth Driven By Federal Spending In Response To The COVID-19 Pandemic , ” the annual national health expenditures article prepared by the Centers for Medicar...
Jan 11, 2022•50 min•Ep. 65
Subscribe to UnitedHealthcare's Community & State newsletter . When you think of the health care workforce, nurses and physicians are probably the first professions which come to mind. But there are actually more personal care aides in the US than physicians. Together with home health aides and nursing assistants, personal care aides comprise one-fifth of the US health care workforce. These workers provide essential supports to people who face limitations in basic activities such as eating, ...
Dec 14, 2021•26 min•Ep. 63
Subscribe to UnitedHealthcare's Community & State newsletter . The availability of pharmacist-administered vaccination has grown in recent decades. Proximity to a pharmacy has found to be predictive of vaccine use. In Florida, Publix grocery stores were the first retail pharmacies to provide COVID-19 vaccinations to eligible members of the public. For more than a month after the initial rollout, Publix remained the sole retail pharmacy authorized to administer COVID-19 vaccines. Grocery stor...
Dec 07, 2021•25 min•Ep. 62
Subscribe to UnitedHealthcare's Community & State newsletter . This episode originally aired on November 10, 2020. The U.S. health policy community recognizes that fee-for-service models incentivize physicians and health systems to perform more tasks than may be needed. And, these models can contribute to industry fragmentation as organizations chase revenue. But is fee-for-service really the smoking gun when it comes to the high levels of U.S. health care spending? The answer is, unsurprisi...
Nov 30, 2021•28 min•Ep. 6
Subscribe to UnitedHealthcare's Community & State newsletter . Medical advances have enabled many people to be cared for appropriately in an outpatient setting rather than being admitted to a hospital. Yet, since Medicare payment rates are generally lower for outpatient visits than inpatient hospital stays, hospitals have a financial incentive to admit patients. Observing what were believed to be inappropriate admissions, in 2013 Medicare adopted the "two-midnight rule" stating that hospital...
Nov 16, 2021•26 min•Ep. 61
Subscribe to UnitedHealthcare's Community & State newsletter . When we launched A Health Podyssey in 2020, our goal was to take listeners beyond the research published in Health Affairs . For A Health Podyssey 's one-year anniversary, we wanted to take listeners on an Excursion and speak with someone who epitomizes so much of what brings professionals into the fields of health policy and health services. Ashish Jha from the Brown University School of Public Health is a widely published resea...
Nov 09, 2021•34 min•Ep. 60
Subscribe to UnitedHealthcare's Community & State newsletter . With about 700 pregnancy-related deaths every year, the United States has the worst maternal mortality rates among developed countries. One response to this crisis has been the creation of state and local maternal mortality review committees (MMRCs), which are multidisciplinary committees that examine the context in which maternal deaths occur. The October 2021 issue of Health Affairs is focused on the topic of perinatal mental h...
Nov 02, 2021•22 min•Ep. 59
Subscribe to UnitedHealthcare's Community & State newsletter . Postpartum depression is a common condition among people who give birth. Within four weeks of childbirth, 13% of women experience postpartum depression with as many as 19% of women affected three months postpartum. Mothers who experienced postpartum depression are more likely to experience impaired mother-infant bonding, which has been linked to increased risk for infant maltreatment and socio-emotional behavior and cognitive pro...
Oct 26, 2021•24 min•Ep. 58
Subscribe to UnitedHealthcare's Community & State newsletter . Systems of oppression like racism, sexism, and classism lead to poor health outcomes. These factors are a source of poor mental health and have particular implications for pregnant and birthing people. Black women who face multiple axes of oppression experience higher rates of maternal mental health conditions than the population as a whole. Yet maternal mental health issues among black women are under reported and often under ad...
Oct 19, 2021•29 min•Ep. 57
Subscribe to UnitedHealthcare's Community & State newsletter . Mental health conditions, such as mood and anxiety disorders are diagnosed in one of every five pregnant or postpartum people. Despite this high burden of morbidity and mortality and economic costs, perinatal mental illness is poorly addressed by the current US healthcare system. Jennifer Moore, founding executive director of the Institute for Medicaid Innovation , joins A Health Podyssey to discuss perinatal mental health and wh...
Oct 12, 2021•31 min•Ep. 56
Subscribe to UnitedHealthcare's Community & State newsletter . Most office workers think of paid sick leave as a benefit for them and their family members, but there are societal benefits to paid sick leave as well. Since 1993, the United States has guaranteed access to unpaid sick leave through the Family and Medical Leave Act (FMLA) but that guarantee leaves out a large number of workers. A growing number of US states and localities have sought to fill-in some gaps of the FMLA, but many re...
Oct 05, 2021•27 min•Ep. 55
Subscribe to UnitedHealthcare's Community & State newsletter . Roughly 6 million adults ages 65 and older in the United States have dementia. That number is projected to more than double by 2050. Family caregivers play an essential role in caring for people with dementia, including help with dressing to eating assistance and more. In 2020, it's estimated that more than 11 million family members and other unpaid caregivers provided care to people with dementia. But what about those who don't ...
Sep 28, 2021•30 min•Ep. 54
Subscribe to UnitedHealthcare's Community & State newsletter . Recent reports suggest about six-tenths of a percent of the United States population, or 1.4 million people, identify as transgender. Transgender individuals are people whose personal and gender identity are different from the gender they were thought to be at birth. Good information about the health status of this group has been hard to come by although research is growing. Some data come from Medicare, which is useful but not r...
Sep 21, 2021•23 min•Ep. 53
Subscribe to UnitedHealthcare's Community & State newsletter . The US government reports that the total spending on hospital care in 2019 was almost $1.2 trillion. High and highly variable hospital prices have been in the news recently in part due to new information made available under the price transparency rules implemented by the Trump administration. Competitive markets are supposed to constrain prices, but in much of the US, there's little competition among hospitals and consolidation ...
Sep 14, 2021•33 min•Ep. 52
Subscribe to UnitedHealthcare's Community & State newsletter . The quality-adjusted life-year (QALY) combines the expected effects on longevity and the expected effects on quality-of-life into a single standard measure. QALYs are often used as part of cost effectiveness analysis, particularly when analyzing the effectiveness of drugs. QALY as a measurement has received a lot of criticism. It's been criticized in concept or in the specifics of how it's defined or used. This criticism often fo...
Sep 07, 2021•31 min•Ep. 51
Subscribe to UnitedHealthcare's Community & State newsletter . If you're a regular listener of A Health Podyssey , you know that most episodes revolve around a particular study published in Health Affairs. Every once in awhile, a person's experience as it relates to health care warrants an excursion from the constraints of discussing a single study. For those, we want to offer listeners a broader conversation. Welcome to A Health Podyssey Excursion . Dr. Julian Harris is the CEO of ConcertoC...
Aug 31, 2021•44 min•Ep. 50
Subscribe to UnitedHealthcare's Community & State newsletter . While estimates vary, spending on prescription drugs in the United States exceeds $500 billion per year. This makes drug prices a perennial health policy topic. In this context, payers and manufacturers are in a constant battle. Manufacturers seek to expand their market while payers attempt to use their leverage to negotiate lower drug prices. Often, patients and clinicians are caught in the middle and left to navigate increasing...
Aug 24, 2021•33 min•Ep. 49
Subscribe to UnitedHealthcare's Community & State newsletter . As part of Policy Spotlight, a new virtual event series from Health Affairs , Editor-in-Chief Alan Weil welcomed Chiquita Brooks-LaSure, the new Administrator of the Centers for Medicare and Medicaid Services (CMS) at the US Department of Health and Human Services for a one-on-one discussion about her priorities at CMS, where she oversees programs including Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and t...
Aug 17, 2021•58 min•Ep. 48
Subscribe to UnitedHealthcare's Community & State newsletter . In our multi-payer health care system, the pharmaceutical market involves the complex interplay of manufacturers, insurers, prescribers, and patients. Each seeks to protect its own interest, which can be counterproductive for overall system efficiency. The United States also has a high rate of generic drug use, which is considered a success story as the introduction of generics can rapidly and dramatically reduce drug prices. But...
Aug 10, 2021•32 min•Ep. 47
Subscribe to UnitedHealthcare's Community & State newsletter . Migrants on their way to another country and people seeking asylum are often overlooked in health policy. During the COVID-19 pandemic as immigration and asylum processes stalled, thousands of people were stranded at Mexico's northern border. With limited health care and sometimes crowded and unsanitary living conditions, COVID posed a significant risk. How Mexico's response to COVID-19 took into account the particular needs of i...
Aug 03, 2021•29 min•Ep. 46
Subscribe to UnitedHealthcare's Community & State newsletter . Children born in the United States are born US citizens. Some of these children are born to immigrant parents who returned to their country of origin, either voluntarily or because they were deported. In 2015, more than half a million US citizen children lived in Mexico having returned with their parents. These children may face language and school adjustments, stressful living arrangements and economic and heath challenges. Fewe...
Jul 27, 2021•24 min•Ep. 45
Subscribe to UnitedHealthcare's Community & State newsletter . BONUS EPISODE As part of Policy Spotlight, a new virtual event series from Health Affairs , The Commonwealth Fund President David Blumenthal welcomed Micky Tripathi , the national coordinator for health information technology (IT), to an in-depth discussion of Biden administration's plans and priorities for health care data. The interview was conducted on July 1, 2021. At the Department of Health and Human Services, Micky Tripath...
Jul 22, 2021•52 min•Ep. 44
Subscribe to UnitedHealthcare's Community & State newsletter . Sixty-eight percent of undocumented immigrants in the United States come from Mexico or Central America. As a result, deportation policies have a disproportionate effect on people of Hispanic origin. Immigration enforcement activity may influence behaviors like obtaining health care services; the effects of which can be felt throughout the community. On today's episode of A Health Podyssey , Abigail Friedman from the Yale School ...
Jul 20, 2021•23 min•Ep. 43
Subscribe to UnitedHealthcare's Community & State newsletter . Roughly 45 million immigrants live in the United States today, a fourfold increase since the 1960s. Immigrants face unique challenges obtaining health care services. Some of the challenges are caused by explicit policies designed to limit or exclude immigrants from programs and benefits available to people born in the US. Other barriers relate to household income or the greater likelihood of having limited English proficiency. Th...
Jul 13, 2021•23 min•Ep. 42
