The Healthcare Revolution with MHK

It was a busy year in 2022 for healthcare. In this edition of The Healthcare Revolution podcast, MHK President Marc S. Ryan reviews what happened in 2022 surrounding healthcare and what you can expect in 2023 given the split Congress.

With the Congress split in 2023 in terms of political control, the prospect for major healthcare legislation is in doubt. In this episode of the Healthcare Revolution, MHK president Marc S. Ryan covers what happened in the midterms and what we can expect over the next two years on the healthcare front.

Medicare Advantage Star ratings are in the news, with announcements that Star ratings dropped dramatically from 2022 to 2023. MHK’s president Marc S. Ryan tells you all you need to know about Medicare Advantage, including the background on the program, why it is important to health plan financing, and recent controversies about whether Star truly improves quality or not. His view is clear – Yes it does. And, it’s the most comprehensive and proven quality program in U.S. healthcare.

In this latest episode of The Healthcare Revolution with MHK, president Marc S. Ryan speaks with Dr. Marty Makary, MD MPH a leading healthcare reform expert and author of The New York Times bestseller The Price We Pay. It’s an intriguing conversation you don’t want to miss.

Two major healthcare provisions were included in the Democratic reconciliation bill known as the Inflation Reduction Act. They include extension of Exchange premium subsidies and Medicare drug price reforms. In this edition of the Healthcare Revolution with MHK, MHK President Marc Ryan discusses both important issues. Most importantly he asks: “Why all the fuss about drug price reform?”

In the latest edition of The Healthcare Revolution podcast, MHK president Marc S. Ryan reviews the recent Health and Human Services Office of Inspector General report regarding prior authorization in Medicare Advantage (MA) plans and the push for reforms and restrictions on utilization management in the MA private plan alternative to traditional fee-for-service (FFS). In addition, Marc provides an overview of the final 2023 MA and Part D rule. Major changes are in store for MA and Part D plans.

In this edition of The Healthcare Revolution podcast, MHK President Marc S. Ryan examines the recent controversy over the approval of Aduhelm and the backtracking the government did on coverage of the drug in Medicare. It is a microcosm about what is wrong with our drug approval and pricing process.

The Affordable Care Act turned 12. In this edition of The Healthcare Revolution podcast, MHK’s President, Marc S. Ryan tells you about the history of the ACA, the turmoil from Obama to Trump to Biden, and the accomplishments in terms of healthcare coverage expansion. He then reviews some looming risks to coverage.

The federal government says health plans and providers should be in store for a big interoperability rule in the Spring of 2022. The rule promises to clarify some existing rules and bring about medical electronic prior authorization and data-sharing between payers and providers. It will clearly define integration standards to use. While it will take time and cost to implement, it is a key initiative to reduce healthcare costs and improve quality.

Health plan profit margins are out and they show that health insurers continue to be responsible players in the healthcare system. This is driven by the adoption of the Minimum Medical Loss Ratio (MLR) across the lines of business. Learn about the minimum MLR, how it limits margins, and the results for 2021.