Medicare Meet-Up

In the final episode of the Re-examining Value series, Meg and Melissa speak with Jennifer Clawson, partner and director of Value-Based Health Systems at Boston Consulting Group and Stefan Larsson, Chairman and Founder of the International Consortium for Health Outcomes Measurement (ICHOM) about the future of value in healthcare.

You can learn more about Jennifer Clawson and Stefan Larsson’s latest work in their New England Journal of Medicine article “Value-Based Health Care at an Inflection Point: A Global Agenda for the Next Decade” or through their book The Patient Priority: Solve Health Care’s Value Crisis by Measuring and Delivering Outcomes that Matter to Patients.

 For more information about the International Consortium for Health Outcomes Measurement (ICHOM), visit https://www.ichom.org/

In the second episode of the Re-examining Value series, the Medicare Team speaks with Ann Greiner, president and CEO of the Primary Care Collaborative and Brock Slabach, COO of the National Rural Health Association about ongoing opportunities to improve patients’ care in the value movement.

Show notes:

1. “Wakely Risk Insight for the Medicare Shared Savings Program: Performance Year 2023 Results.” (Wakely)
2. “Relationships Matter: How Usual is Usual Source of (Primary) Care?” (Primary Care Collaborative)
3. “Primary Care Practice Finances in the United States Amid the COVID-19 Pandemic.” (Harvard Center for Primary Care)
4. “The Health of US Primary Care: A Baseline Scorecard Tracking Support for High-Quality Primary Care.” (Milbank Memorial Fund)
5. For more information about the Primary Care Collaborative, visit https://www.pcpcc.org/
6. For more information about the National Rural Health Association, visit https://www.ruralhealth.us/

In this first episode of the Re-examining Value series, the Medicare Team speaks with Mai Pham, founder and president of the Institute for Exceptional Care, and Rob Nelb, principal analyst from the Medicaid and CHIP Payment and Access Commission (MACPAC) about what the value movement got right and where it falls short.

The Medicare Team is joined by national experts and colleagues Lauren Block, Leah Montgomery, and Maddy Bjorklund from Aurrera Health Group to talk about life after the public health emergency for Medicare and Medicaid beneficiaries.  

Show Notes

Here are links to the podcasts Meg, Melissa, and Maddy recommended in the intro:

• Good Inside
• Films to be Buried With
• Relentless Health Value
• KHN’s What the Health
• Trade-offs

For more information on the PHE topics addressed during the episode, check out:

• Medicaid Health Plans Try to Protect Members – And Profits During Unwinding (KHN)
• Unwinding the Medicaid Continuous Enrollment Provision: Projected Enrollment Effects and Policy Approaches (HHS)
• FCC Provides Guidance to Enable Critical Health (FCC)
• What the End of the Medicaid Continuous Coverage Requirement Means for Health Care Coverage and Access (Harvard Health Policy Review)
• New Coalition Features Resources and Best Practices to Support Medicaid Redetermination (AHIP)
• States Must Act to Preserve Medicaid Coverage as End of Continuous Coverage Requirement Nears (CBPP)
• States Can Reduce Medicaid’s Administrative Burdens to Advance Health and Racial Equity (CBPP)

The Medicare Team talks with special guests Kristal Vardaman and Mary Russell, Senior Directors at Aurrera Health Group, to answer listener questions about emerging policies and considerations for serving dual-eligible individuals.

In the first episode of 2023, special guest Jeff Micklos, executive director of the Health Care Transformation Task Force, joins the Medicare Team to answer listener questions about the current state of value-based care and the top health policy priorities in the new year. 

Show notes

For more information about the Health Care Transformation Task Force, visit www.hcttf.org or reach out to Jeff at [email protected]. 

To learn more about the Accountable Care Action Collaborative, visit www.hcp-lan.org/accountable-care-action-collaborative/.

In the last episode of 2022, the Medicare Team learns whether their healthcare predictions from January’s podcast came true – and if anyone fulfilled their New Year’s resolutions. Special guest Jen Ryan – executive vice president of Aurrera Health Group with more than 20 years of experience in Medicaid policy – joins Meg and Melissa as they share new predictions for the upcoming year.

Show Notes:

Comparison chart from Medicare.gov for original Medicare and Medicare Advantage (starts on page 5).

Pathways to Resilience website with more information about the program’s efforts to promote trauma-informed policies.

Article published in the New York Times comparing Medicare Advantage to “one-stop shopping.”

The Medicare Team catches up with special guests Ashley Fitch, Director of Community Partnerships and Innovation from Mount Sinai and Kathy Vesley, President and CEO of Bay Aging to learn more about how they are addressing social determinants of health through building networks of community-based organizations. Meg and Melissa also discuss Medicare Open Enrollment, the Bundled Payments for Care Improvement Advanced (BPCI-A) extension, and all things flu season.

Here are some tips from AARP to avoid Medicare fraud during open enrollment season: https://www.aarp.org/money/scams-fraud/info-2019/medicare.html

In the first episode of Season 3, Meg, Melissa, and Brede catch up on all the Medicare news that happened over summer break including the passage of the Inflation Reduction Act, the Physician Fee Schedule proposed changes for MSSP, and the many new Requests for Information. Meg also checks in with Jason Rose, Chief Executive Officer of AdhereHealth, a healthcare technology solutions company centered on improving medication adherence, to get his take on the changes to Part D in the Inflation Reduction Act.

In this second installment of the Medicare Meet-up Health Equity Mini-Series – and the last episode of Season 2 – Meg, Melissa and Brede chat about the latest Medicare news and the recent Aurrera Health Group webinar – Making Sense of Payment Mechanisms in ACO REACH. They continue the discussion of health equity and interview Leon Caldwell, Ph.D., American Hospital Association’s senior director for health equity strategies and innovation at the Institute for Diversity and Health Equity about how hospitals can be community leaders in advancing equity.