DC EKG with Joe Grogan: A Healthcare Policy Podcast

Ep. 122

In this episode of DC EKG with Joe Grogan: A Healthcare Policy Podcast, Joe recaps the first Healthcare AI Policy Summit, held on December 10th in Washington, DC, with his co-host for the event, Naomi Lopez, founder of Nexus Policy Consulting.

They walk through the big themes shaping healthcare AI right now: how HHS is approaching AI adoption, what real regulatory clarity could look like, and how new federal initiatives like ACCESS and TEMPO may reshape chronic disease management for Medicare patients.

Joe and Naomi unpack HHS Deputy Secretary Jim O’Neill’s view of AI in government, from using large models to improve physician productivity, payment integrity, and care coordination to managing privacy and re-identification risk when working with federal health data.

They dig into the ACCESS Medicare payment model and the FDA TEMPO initiative, explaining how these pilots test AI and machine learning tools in real-world chronic disease management (hypertension, diabetes, musculoskeletal pain, and depression), and what that means for Medicare payment models, FDA oversight, and healthcare innovation.

The conversation then widens to physician burnout, interoperability, rural care, and the role of states and federal preemption in setting the rules for healthcare AI. If you care about the real-world impact of healthcare AI on policy, payment, and patients, this episode offers a clear, practical summary of what the summit revealed and what to watch next.

Today Joe and Naomi cover:

Jim O’Neill’s vision for AI at HHS, including internal AI adoption and keeping a direct line open for small innovators.

ACCESS and TEMPO as new federal test beds for AI in chronic disease management and Medicare payment.

How wearables, remote monitoring, and “virtual ICU” models can support aging in place and reduce pressure on state budgets.

Ways AI can reduce documentation burden, support care coordination, and act as a first-line triage tool without replacing clinicians.

The emerging idea of personal AI agents that help patients navigate the system and share the right data with clinicians.

How AI-enabled diagnostics and tools can expand access in rural and underserved communities.

Why interoperability, ONC’s API rules, and the balance between state AI regulation and federal preemption will shape how quickly these tools scale.

The potential for tech companies to become Medicare Part B providers under ACCESS, and what that means for reimbursement and competition.

Key Takeaways:

Healthcare AI is being built into policy through programs like ACCESS and TEMPO, tying AI tools to Medicare payment and FDA pathways in chronic disease management.

Regulatory clarity and predictable routes from FDA clearance to Medicare reimbursement are essential for sustained AI adoption.

AI is currently most valuable as a force multiplier for physician productivity, taking on administrative and analytic work so clinicians can focus on patients.

Personal AI agents may become a primary interface between patients and the health system, coordinating data, benefits, and care.

Rural and underserved communities could benefit significantly if payment and regulatory rules support AI-enabled diagnostics and remote care.

Interoperability, state AI laws, and federal preemption will determine whether healthcare AI stays in pilots or reaches patients nationwide.

Joe's guest, Naomi Lopez, is the founder of Nexus Policy Consulting and a leading voice in healthcare policy, healthcare AI, and state health reform. She co-founded a healthcare AI working group with Joe Grogan and co-hosted the inaugural Healthcare AI Policy Summit on December 10th in Washington, DC.

In this episode of DC EKG with Joe Grogan: A Healthcare Policy Podcast, Joe sits down with health economist Tony LoSasso to dissect what serious, workable Obamacare reforms could look like without blowing up the Affordable Care Act entirely. They dig into the structure of healthcare subsidies, why current premium tax credits dull price sensitivity, and how that undermines insurance competition, drives up healthcare costs, and threatens the law's fiscal sustainability.

Tony lays out a path to modernize the ACA with defined-contribution-style subsidies, patient-directed “health freedom” accounts, and targeted support for people with preexisting conditions through high-risk pools, rather than hiding transfer programs inside community-rated premiums. Along the way, they tackle essential health benefits, community rating, Medicare pricing, certificate-of-need laws, and growing hospital market concentration, and ask what a real bipartisan healthcare reform deal might look like in today’s political climate.

Joe Grogan sits down with James Gelfand, president and CEO of The ERISA Industry Committee (ERIC), to break down the future of employer-sponsored insurance and the challenges shaping healthcare policy. They discuss how rising healthcare costs affect both employers and employees, the evolution of health savings accounts, and why direct primary care and telehealth represent major shifts in employer benefits.

The conversation highlights the growing crisis in mental health, the impact of hospital consolidation on costs and quality, and the political battles over healthcare reform. Gelfand explains why employer-sponsored insurance remains a critical safety net and what changes are needed to bring more transparency, value, and balance to the healthcare system.

In this episode of DC EKG, host Joe Grogan is joined by Ryan Long, Capitol Hill veteran and senior research fellow at the Paragon Institute, to unpack two big health policy debates: the 340B drug discount program and the enhanced ACA premium tax credits. Ryan explains how 340B drives higher drug spending, hospital consolidation, and rising premiums, while often benefiting wealthier hospitals over safety-net providers. He also breaks down why the temporary ACA subsidies are set to expire in 2025, the fraud and enrollment issues they’ve created, and what both parties are gearing up for as the fight continues.

In this episode of DC EKG, Joe Grogan sits down with healthcare entrepreneur and advocate Dutch Rojas to unpack some of the most pressing and misunderstood issues in American healthcare. From his unconventional path from accounting into healthcare to his outspoken advocacy for physician-owned hospitals, Rojas brings a fresh, unapologetic perspective to how we can break through the gridlock of consolidation and outdated policy. Rojas makes the case for why charity care is often used as a business strategy rather than genuine community support, and explains how site-neutral payments could dramatically lower costs for patients and employers alike. He also outlines how innovations like a healthcare commodities exchange could finally deliver the price transparency Americans deserve, and the competition the system desperately needs.

Join host Joe Grogan for an exclusive masterclass with Dr. Robert Burns, James Joo-Jin Kim Professor of Health Care Management at the Wharton School. A nationally recognized expert on the U.S. healthcare system, Dr. Burns unpacks the complex forces driving healthcare costs.

With a background in sociology, anthropology, and decades of research, Dr. Burns reveals why so many healthcare reforms fail, what policymakers and business leaders get wrong, and how the U.S. healthcare ecosystem really works behind the headlines. If you’ve ever wondered why American healthcare is so expensive, and what can actually be done about it, this episode is a must-listen.

Critics have been quick to attack the One Big Beautiful Bill (OBBB), but how much of what you’ve heard is true? In this episode, Joe Grogan sits down with Brian Blase to set the record straight on the bill’s health policy reforms and why they matter. From Medicaid funding changes to the role of provider taxes, Brian and Joe break down the bill’s impact, debunk common myths, and explore what’s next for U.S. healthcare policy. They cover how work requirements, eligibility reviews, and a focus on value could transform the system.

Paragon Institute Myth-Busting Series on OBBB: https://paragoninstitute.org/issue-library/obbb-myths-and-facts/

Brian Blase X: https://x.com/brian_blase?lang=en

In this episode of DC EKG, Joe Grogan sits down with Sean Spicer, former White House Press Secretary and host of The Sean Spicer Show. Spicer shares his experiences from working in various political roles, his thoughts on Republican strategies for the midterms, and the challenges of communicating healthcare policies. The discussion also delves into the differences between legacy media and new media, highlighting the need for self-reflection within traditional news outlets.

Stephen Parente, former White House Chief Economist for Health Policy and current Minnesota Insurance Industry Chair of Health Finance and Associate Dean at the Carlson School of Management, joins host Joe Grogan to discuss the state of healthcare transparency. They dive into the pros and cons of price transparency, the impact of the No Surprises Act, challenges for insurers and providers, and what transparency means for healthcare costs and future policy. Parente also hosts the On Background podcast, where he explores key issues in health finance and public policy.

In this episode of DC EKG, host Joe Grogan sits down with Dan Troy, former Chief Counsel of the FDA and a nationally recognized expert on healthcare law and the First Amendment. They explore Troy’s unique journey from free speech litigator to one of the FDA’s top legal voices, examining how the agency regulates what drugmakers, doctors, and companies are allowed to say—and what they’re not. The conversation dives into the legal boundaries of off-label promotion, the impact of direct-to-consumer advertising on patient care, and the growing tension between innovation and regulation in the pharmaceutical industry. Troy also offers his perspective on the Inflation Reduction Act and its potential chilling effect on drug development, underscoring the need for bipartisan support in shaping healthcare policy.