Health Affairs Pathways

This week, we begin the second season of Health Affairs Pathways. Sania Ali and Avni Kulkarni present "While We Wait," a look at mental health boarding in the emergency department.

In the final episode of Piecemeal, Dr. Lalita Abhyankar discusses the delicate balance between physician burnout, autonomy, employment, quality of care, negotiating power, and the continuity of the physician-patient relationship.

Guests include Dr. Jonathan Zhang from McMaster University; Dr. Farzad Mostashari, CEO of Aledade; Dr. Umar Bowers from Dawson Med; and Dr. Kyle Leggot from the University of Colorado School of Medicine.

Piecemeal was produced by Dr. Lalita Abhyankar for Health Affairs.

Works Cited:

• Consolidation of Primary Care Physicians and Its Impact on Health Care Utilization (Health Economics)
• Making Health Care Markets Work: Competition Policy for Health Care (JAMA)
• Information Blocking (HealthIT.gov)
• Potential Contracting Issues of “All-Or-Nothing” Clauses: New HHS Secretary, Policy Priorities (Norton Rose Fulbright)
• Payer Trend: 'Tiering' Physicians and 'Steering' Patients (American Academy of Family Physicians)
• Medicare Shared Savings Program (Centers for Medicare & Medicaid Services)

Music produced by So Brown and Jack Mason.

In the penultimate episode of Piecemeal, Dr. Lalita Abhyankar interviews Dr. Cory Capps from Bates White Economic Consulting to dive into vertical integration, antitrust policy, the challenges of antitrust enforcement in the health care space, and what might be next.

Piecemeal was produced by Dr. Lalita Abhyankar for Health Affairs.

Works Cited:

• Your Doctor/Pharmacist/Insurer Will See You Now: Competitive Implications of Vertical Consolidation in the Healthcare Industry (Senate Committee on the Judiciary, Subcommittee on Antitrust, Policy and Consumer Rights)
• Physician Practice Consolidation Driven By Small Acquisitions, So Antitrust Agencies Have Few Tools To Intervene (Health Affairs)

Music produced by So Brown and Jack Mason.

Who do you want your physician to be employed by? That's the question Lawrence Casalino from the Weill Cornell School of Medicine asks at the top of the latest Piecemeal episode.

In this episode, Dr. Lalita Abhyankar explores the relationship between negotiating power among large provider groups and insurers, capitation, the role of private equity in the health care system and independent primary care, and consolidation in the primary care market.

Guests include Lawrence Casalino from Weill Cornell School of Medicine; Shawn Martin, CEO of the American Academy of Family Physicians; Gail Guerrero and Cathy Romero from Gila Valley Clinic; and Dr. Kyle Leggot from the University of Colorado School of Medicine.

Piecemeal was produced by Dr. Lalita Abhyankar for Health Affairs.

Music produced by So Brown and Jack Mason.

In this episode of Piecemeal, Dr. Lalita Abhyankar discusses the ongoing organizational pressures that independent primary care practices face in the wake of the COVID-19 pandemic and how some pivoted their business models.

Guests include Wayne Strouse, Tina Philip, Gail Guerrero and Cathy Romero from Gila Valley Clinic, and Arun Villivalam from Los Gatos Doc.

Piecemeal was produced by Dr. Lalita Abhyankar for Health Affairs.

Music produced by So Brown and Jack Mason.

On the second episode of Piecemeal, Dr. Lalita Abhyankar explores the policy issues that promote health care consolidation. She explores the fee-for-service payment model, various value-based payment models, the challenges of telehealth, payment reimbursement negotiations, and the complex balance of managing patient visits.

Guests include Dr. Farzad Mostashari, CEO of Aledade; Dr. Gary Price, President of The Physicians Foundation; and Dr. Kyle Leggot from the University of Colorado School of Medicine.

Piecemeal was produced by Dr. Lalita Abhyankar for Health Affairs.

Works Cited:

• 2019 Merritt Hawkins Physician Inpatient/Outpatient Revenue Survey (Merritt Hawkins)

Music produced by So Brown and Jack Mason.

Welcome to Health Affairs Pathways.

Health Affairs Pathways explores the avenues and alleyways of the health care system through a variety of storytelling – from investigative journalism and health policy explainers to long-form interviews.

Unique series are created by fellows at the Health Affairs Podcast Fellowship Program, designed to support early to mid-stage professionals pursue an audio project, tell a unique health care story, and highlight voices that may not be heard otherwise.

Our first series, Piecemeal, is from Lalita Abhyankar, a physician and storyteller based in San Francisco, CA. Her series examines how consolidation in health care is affecting independent primary care. Guests on this episode include Dr. Wayne Strouse and Shawn Martin, CEO of the American Academy of Family Physicians.

Piecemeal was produced by Dr. Lalita Abhyankar for Health Affairs.

Works Cited:

• Consolidation Of Providers Into Health Systems Increased Substantially, 2016-18 (Health Affairs)
• What We Know About Provider Consolidation (Kaiser Family Foundation)
• Can Small Physician Practices Survive? Sharing Services as a Path to Viability (JAMA)
• 2021 Survey of Final Year Medical Resident (Merritt Hawkins)

Music produced by So Brown and Jack Mason.

Welcome to Health Affairs Pathways, which explores the avenues and alleyways of the health care system through a variety of storytelling – from investigative journalism and health policy explainers to long-form interviews.

Our first season is a six-part series from Lalita Abhyankar, a physician and storyteller based in San Francisco, CA. Her series, titled Piecemeal, examines how consolidation in health care is affecting independent primary care.

The first episode will be published on January 26, 2022.