Policy Prescriptions

Dr. Clive Fields — co-founder of VillageMD and Chair of the MAHA workgroup on the HHS/CMS Healthcare Advisory Committee — joins the Zen Lobbyist, Gary Jacobs and Tom Koutsoumpas, Founder and President of Healthsperien, to go inside the commission shaping U.S. healthcare policy. They cover the structure of the 16-member advisory committee, why end-of-life conversations fail patients, the case for the collaborative care model in mental health, rural healthcare access, deprescribing, and what it will take to scale value-based primary care nationally. 

What You’ll Learn:
• How the HHS/CMS Healthcare Advisory Committee is structured — 16 members, 6 workgroups, and how it actually operates day to day
• What the "MAHA workgroup" is focused on and how it defines its mission
• Why so few patients get meaningful end-of-life conversations — and why data access (not conversation) is often the real failure point
• The difference between measuring "process" (did the box get checked) vs. "outcomes" in healthcare quality
• Why Dr. Fields thinks lifestyle factors (exercise, nutrition, loneliness) are the "real vital signs"
• The case for the collaborative care model as a fix for the mental health access gap in primary care
• Why deprescribing should be led by primary care physicians, not specialists
• How rural communities are solving access gaps through academic medical center partnerships
• Why the U.S. primary care shortage can't be solved by producing more doctors — and what team-based care means as an alternative
• Dr. Fields' take on the quality and motivations of career staff inside HHS and CMS

Timestamps:
00:00 Welcome 
02:25 From family doctor in Houston to national health reform figure
04:07 Founding VillageMD — scaling to 800 locations
05:41 Inside the HHS Healthcare Advisory Committee (structure & workgroups)
07:00 What Dr. Oz taught him about how CMS really works
09:12 The MAHA workgroup's mission
09:54 Why end-of-life conversations happen too late
12:46 The ER doctor's story: data access at the point of crisis
14:14 Annual wellness visits — process vs. outcomes
17:12 Pivot: lifestyle medicine as the "real vital signs"
10:03 The Mars analogy — rebuilding healthcare from primary care up
21:54 Addressing rural healthcare gaps
25:04 Case study: Boone, NC and academic medical center partnerships
28:33 Data interoperability as the key to efficiency
31:07 Mental health parity & the collaborative care model
34:00 Repurposing exam rooms for behavioral health integration
36:24 Deprescribing and the primary care doctor's role
37:44 The primary care physician shortage — team-based care as the fix
40:00 On the quality of people serving inside HHS/CMS
42:06 Closing thoughts

Former Congressman Patrick J. Kennedy has spent decades fighting for mental health parity, addiction treatment, and a healthcare system that treats brain health with the same urgency as physical health.

In this episode of Policy Prescriptions, host Gary Jacobs sits down with Patrick J. Kennedy and Healthsperien founder Tom Koutsoumpas to discuss why America’s future depends on protecting the health of our brains.Patrick shares the personal story behind his advocacy, including his own experience with addiction, the public disclosure that changed the direction of his political career, and the recovery journey that shaped his work after leaving Congress.

The conversation explores the growing pressures facing young people, including social media algorithms, sports betting, cannabis, vaping, alcohol, and other industries built around capturing attention and encouraging compulsive behavior. Patrick explains why brain health affects far more than personal wellbeing. It shapes workforce participation, economic productivity, public safety, education, and America’s ability to compete in a rapidly changing world.

Gary, Patrick, and Tom also discuss the need to move healthcare upstream by investing in prevention, early intervention, maternal mental health, long-term financing models, and stronger community-based care.

Topics covered include:

• Patrick J. Kennedy’s personal connection to mental health advocacy
• The fight for mental health parity
• Why brain health should be treated as a national priority
• The effects of social media algorithms on young people
• The rise of sports betting and cannabis use disorder
• Mental health, addiction, and homelessness
• The connection between brain health and economic productivity
• Preventive care and upstream healthcare interventions
• AI’s potential role in measuring long-term outcomes
• Recovery, connection, and the importance of speaking openly

Policy Prescriptions is powered by Healthsperien, a health policy consulting firm that helps organizations navigate Washington with data-driven insights and strategic guidance.

Learn more about Gary Jacobs and The Zen Lobbyist at garymjacobs.com.

Subscribe for more conversations about healthcare policy, leadership, and practical solutions that can improve the lives of patients and communities.

Chapters
00:00 Why America’s future depends on brain health
01:17 Patrick J. Kennedy’s personal journey with addiction
02:46 The disclosure that changed Patrick’s political career
03:38 Mental health parity and breaking the silence
04:47 Why the brain must be treated like every other organ
06:42 Tom Koutsoumpas on Healthsperien’s behavioral health work
09:43 Why mental and physical healthcare belong together
10:25 Social media algorithms and the dopamine economy
11:00 Sports betting and addiction-for-profit industries
12:39 Cannabis, psychosis, and rising treatment needs
14:00 Why brain health is a national security issue
16:02 Youth suicide, homelessness, and the growing crisis
18:03 Going upstream to reduce the risk of dementia
19:20 Why healthcare financing needs a long-term model
20:40 Nutrition, MAHA, and the food industry
23:10 Gary Jacobs on mindfulness and right speech
24:49 JFK, civic responsibility, and mental fitness
26:30 What the Green Berets understand about focus
28:21 Box breathing and the power of mental preparation
29:54 Preparing young people for the post-AI world
31:48 Why open conversations matter
33:19 Patrick’s recovery journey after leaving Congress
35:05 A Common Struggle and the power of connection
37:14 Final thoughts
38:10 Closing

What does “value-based care” actually mean, and why are healthcare leaders betting the future of medicine on it?

In this episode of Policy Prescriptions, Gary Jacobs sits down with Aisha Pittman, Senior Vice President of Government Affairs at National Association of ACOs, and Ray Quintero, Managing Partner at Healthsperien, for a deep conversation about the future of healthcare policy, Medicare reform, and accountable care organizations (ACOs).They break down how value-based care works, why fee-for-service medicine creates problems, and how new models like ACO LEAD are reshaping the healthcare system.

The conversation also explores:

• How ACOs improve patient outcomes while lowering costs
• Why healthcare providers are moving toward risk-based care
• The role CMS and CMMI play in healthcare innovation
• How policy changes move from pilot programs into law
• Why healthcare lobbying is more about relationships than money
• The future of Medicare and accountable care
• The human side of healthcare leadership and advocacy

Gary, Aisha, and Ray also discuss mindfulness, leadership, and why collaboration matters in healthcare transformation.If you work in healthcare policy, value-based care, Medicare strategy, hospital leadership, physician advocacy, or healthcare innovation, this episode gives a practical look at where the industry is headed next.

Chapters:
00:00 Introduction to Value-Based Care
01:35 What Value-Based Care Actually Means
03:47 How ACOs Change Healthcare Incentives
05:39 Helping Providers Navigate New Care Models
07:22 CMS, CMMI, and the Future of Healthcare Models
10:05 Why Healthcare Transformation Is Accelerating
12:00 ACO REACH vs ACO LEAD Explained
14:26 Bringing Specialists Into Accountable Care
15:18 Home-Based Care and High-Needs Patients
17:22 Why the LEAD Model Lasts 10 Years
18:33 The Mission Behind Healthcare Reform
20:20 Gary Jacobs on Yoga, Advocacy, and Leadership
23:38 Human Connection in Healthcare Policy
25:48 The Future of Value-Based Care
27:23 Will Fee-For-Service Ever Disappear?
29:43 What Healthcare Could Look Like in 10 Years
31:00 How Healthcare Models Become Law
33:18 Can Congress Actually Pass Reform?
36:29 Does Money Drive Healthcare Policy?
41:48 Why Relationships Matter More Than Lobbying Dollars
43:13 Final Thoughts

What role does music play in mental health and loneliness?

In this episode of Policy Prescriptions, Gary Jacobs sits down with legendary musician Neil Giraldo and policy leader Andrew MacPherson to explore how social isolation is shaping public health and what we can do about it.

Recorded at SXSW, this conversation connects music, policy, and human connection in a way that goes beyond headlines.

Neil shares his personal story of growing up with anxiety and isolation, and how music became his way out. Andrew breaks down how loneliness impacts the brain, why policymakers are finally paying attention, and what real solutions look like at the national level.

You’ll learn:

• Why loneliness is now a public health crisis
• How music creates real emotional and biological change
• The role of storytelling in influencing policy
• Why “social connection” belongs in healthcare
• What needs to change in Washington right now

If you care about mental health, leadership, or the future of public policy, this conversation will shift how you see connection.

⏱️ CHAPTERS / TIMESTAMPS
0:00 Intro: Policy, loneliness, and SXSW
1:20 The social connection crisis explained
3:30 Neil Giraldo’s story of isolation and anxiety
6:40 How music became his escape
9:30 Spirituality, identity, and mental health
13:00 Why storytelling drives policy change
16:00 Music as part of the healthcare system
18:30 The science: endorphins, serotonin, and healing
20:00 What it feels like to connect with 20,000 people
22:30 Music saving lives: real fan stories
24:00 Policy solutions and funding for connection
26:00 Final thoughts: empathy, suffering, and healing

What if lobbying isn’t the problem… but the solution?

In this episode of Policy Prescriptions, Gary Jacobs sits down with healthcare policy leaders Andrew MacPherson and Tom Koutsoumpas to break down what lobbying actually is, how it works, and why most people misunderstand it.

They explain how lobbying shapes healthcare, influences legislation, and impacts millions of lives. From the Medicare hospice benefit to modern health policy strategy, this conversation reveals how real change happens behind the scenes.

You’ll also learn:

• Why lobbying is a core part of democracy
• How policy decisions are influenced before meetings even happen
• The role of storytelling, data, and trust in shaping legislation
• Why access alone doesn’t drive results
• How everyday Americans influence policy more than they think

This episode challenges the narrative around lobbying and shows how education, advocacy, and engagement drive real outcomes.If you care about healthcare, policy, or how decisions get made in Washington, this is a must-watch.

Connect with Gary at garymjacobs.com and find our more about Tom and Andrew's work at healthsperien.com.

⏱️ CHAPTERS

00:00 What Is Lobbying Really?
01:45 Why Lobbying Gets a Bad Reputation
03:30 The Role of Advocacy in Democracy
06:00 Education vs Influence in Policy
08:00 What “Democratizing Lobbying” Means
11:00 Why Most People Don’t Understand Civics
13:00 The Real Cost of Lobbying Access
16:00 Access vs Expertise Debate
18:00 Why Storytelling Wins in Policy
21:00 The Power of Personal Stories
24:00 Do Former Politicians Have an Advantage?
26:00 What Makes an Effective Lobbyist
29:00 The Future of Lobbying and Technology
31:00 Final Lessons: Passion, Data, and Trust