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Open Enrollment Explained

Patients Rising Podcast

Release Date: 10/02/2023

QALY Ban Bill Takes Leap Forward show art QALY Ban Bill Takes Leap Forward

Patients Rising Podcast

This week’s podcast is all about the QALY and the bill going to the Senate that would ban its use.  The QALY is a metric used to determine how cost-effective a treatment is based on its ability to return a sick person to perfect health. Even if a treatment helps a chronically ill person to live longer, it will not be categorized as valuable as treatments are aimed at diseases that affect younger and healthier populations.  To help us understand how the QALY negatively impacts those with chronic illness, we’re joined by Michael Riotto, a member of Patients Rising, and Bill Smith,...

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Nation's First Obesity Bill of Rights show art Nation's First Obesity Bill of Rights

Patients Rising Podcast

Treating obesity would cause chronic disease rates to go down, healthcare costs would be reduced, and the lifespan of Americans would increase. But until now, the stigmas relating to obesity have prevented any significant legislation that addresses the issue. To help break it down, we’re joined by Nancy Glick, the Director of Food and Nutrition Policy at the National Consumers League. Nancy helps us understand what an Obesity Bill of Rights actually is, who it covers, and why it's a necessary step.  We also discuss a bill that Patients Rising has been trying to move forward for a long...

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March-In Madness show art March-In Madness

Patients Rising Podcast

In an effort to curb drug prices, President Joe Biden announced late last year a proposed framework to guide government agencies on how to use march-in authorities if a drug’s price is considered too high. But what exactly constitutes “too high?” Your guess is as good as ours, and that’s just the beginning of the issues we expect to come from this framework if it moves forward. We spoke with Joe Allen, Executive Director of The Bayh-Dole Coalition.  The Bayh-Dole Act is where march-in rights stem from and we figured he would be the perfect person to explain march-in rights, what...

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Presidential Candidates' Views on Healthcare show art Presidential Candidates' Views on Healthcare

Patients Rising Podcast

As the 2024 election season starts to ramp up, we think that it’s important that you know exactly where the presidential candidates stand on healthcare.  This week, we unpack what the major players in the presidential race have to say about their healthcare plans. We get into the nitty-gritty for the front runners of each party, covering Trump, Desantis, Haley, Stein, West, and Biden.  If we didn’t talk about a candidate you’re interested in, you can find their .   Need help? The successful patient is one who can get what they need when they need it. We all know insurance...

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4 Things Patients Can Do for 2024 show art 4 Things Patients Can Do for 2024

Patients Rising Podcast

This week, a Resource Coordinator and Patient Navigator with our Patient Helpline goes over the top four steps that patients and caregivers can take to make 2024 their smoothest and most organized healthcare year yet. From what to do in the months leading up to a visit to how to take control of your health on your own time, Levi Peterson shares everything patients and caregivers need to be prepared.  Also, applications for Patients Rising’s Fly-In Scholarships for this year’s event open this Wednesday, January 17th. Lastly, we discuss two major news stories from this past week...

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Dual Eligible = Double Trouble? show art Dual Eligible = Double Trouble?

Patients Rising Podcast

This week, we discuss the idea of with Steve Peskin, the CEO of SRP Advisors. Steve explains the difficulty for dual eligible patients in knowing what part of their healthcare is covered by Medicaid and what part is covered by Medicare. He mentions the need for coordination between state and federal government and shares a few ideas for how the current system can be improved. Also, we talk about an  that the Administration for Strategic Preparedness and Response will incorporate fair-pricing provisions into contracts.   Need help? The successful patient is one who can get what they...

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Staying At Home As You Age show art Staying At Home As You Age

Patients Rising Podcast

One survey shows 77% of adults over 50 would prefer to grow older where they already live instead of moving to a home or an assisted living facility–but there are obstacles in place for those who want to stay in their homes.  This week, we talk about the current challenges of aging in place with Dan Weinrieb, the Head of Strategic Partnerships at Jukebox Health, a company dedicated to making aging at home a common-sense and cost-effective option for older adults. Dan says the issues relating to aging in place are known, but taking action to fix the problems is where our system falls...

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March-In Mayhem 🥾 show art March-In Mayhem 🥾

Patients Rising Podcast

Last week, the White House announced it has plans to use the government’s “March-in” rights on drugs developed with public funding.  This week, we’re joined by our very own Executive Director here at Patients Rising, MacKay Jimeson. He explains why he and other experts believe this will not lower what patients pay at the counter for prescriptions, and actually could do much more damage by discouraging new treatment development, particularly for the rare disease patient community.  We also talk about the FDA approval of a powerful new tool that will treat sickle cell disease....

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Telehealth Extension show art Telehealth Extension

Patients Rising Podcast

Is telehealth here to stay? That’s the big question! Both providers and patients have benefited from the increase in telehealth practices born out of the COVID-19 pandemic. It has allowed high-risk patients to have access to their healthcare provider without having to risk going into a doctor's office, and providers say that telehealth has given them the opportunity to see the patient’s environment and family, which allows them to take those factors into consideration when formulating a treatment plan. This week, were joined by Kyle Zebley, the Senior Vice President of Public Policy for...

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A Patient Takes His Insurance Co to Court show art A Patient Takes His Insurance Co to Court

Patients Rising Podcast

After being diagnosed with throat cancer, a top trial lawyer was told by his insurance that it wouldn’t cover the treatment his doctor ordered because it wasn't “medically necessary.” Fortunately, he did what he does best, and fought back. This week, attorney and patient advocate Robert Salim, . He explains exactly how he took on his insurance provider, how he won, and what it means for other patients dealing with the same issue.  Plus, an update on open enrollment with new uptake numbers released by the .  Resources and previous episodes on open enrollment:   Need help?...

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More Episodes

With the Open Enrollment Period fast approaching, Levi Peterson, a Resource Coordinator for our Patient Helpline walks us through what everyone needs to know about Medicaid and Medicare eligibility, PPOs and HMOs, and how to pick a health plan that best fits your needs.

We also discuss a so-called ICER update that doesn’t do much updating and still doesn’t help patients.

Patients Rising Now Statement | ICER ‘Updates’ are Thinly Veiled Strategy to Continue Discriminatory Tactics 

ICER’s Updated Treatment Assessment Still Ignores Patient Concerns 

 

Need help?

The successful patient is one who can get what they need when they need it. We all know insurance slows us down, so why not take matters into your own hands? Our Navigator is an online tool that allows you to search a massive network of health-related resources using your zip code so you get local results. Get proactive and become a more successful patient right now at the Patients Rising Helpline.

Have a question or comment about the show, or want to suggest a show topic or share your story as a patient correspondent?

Drop us a line: [email protected]

The views and opinions expressed herein are those of the guest(s)/ author(s) and do not reflect the official policy or position of Patients Rising, nor do the views and opinions stated on this show reflect the opinions of a guest’s current or previous employers.