87. 2024 Medicare Advantage and Part D Program Audit Enforcement Report Out: What Does It Tell Us?
The Healthcare Labyrinth
CMS’ Medicare Advantage (MA) program audits are getting tougher and more detailed every year. About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change. Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible, incisive deep dives on the most pressing issues and events in American...
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86. Will The New 100% RADV Audits Be Fair To Medicare Advantage Plans?
The Healthcare Labyrinth
While justified, there is some question about whether the new RADV audits will be fair to MA plans. About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change. Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible, incisive deep dives on the most pressing issues and events in American...
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85. Healthcare Developments Beyond The One Big Beautiful Bill
The Healthcare Labyrinth
The Big Beautiful Bill buried some other important healthcare developments. About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change. Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible, incisive deep dives on the most pressing issues and events in American healthcare. Marc seeks to help...
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84. The One Big Beautiful Bill Passes
The Healthcare Labyrinth
The one big beautiful bill has passed. Listen in to learn about how it happened and the impact of healthcare reductions. About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change. Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible, incisive deep dives on the most pressing issues and...
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83. Are There Smarter Healthcare Cuts?
The Healthcare Labyrinth
There are smarter healthcare cuts and sensible reforms that could be made and spare major impacts to coverage. About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change. Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible, incisive deep dives on the most pressing issues and events in...
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82. Will Health Plan Pain Continue?
The Healthcare Labyrinth
As bad as health plans have had it the past few years, trends seem to show the pain continuing. About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change. Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible, incisive deep dives on the most pressing issues and events in American...
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81. How Mighty Big Healthcare Has Fallen
The Healthcare Labyrinth
The mighty big healthcare companies have fallen, in this case a victim of their own financial mismanagement and shenanigans. About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change. Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible, incisive deep dives on the most pressing issues...
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80. Republicans Are In Stealth Mode On Healthcare Coverage Cuts, But The Impact Is Real
The Healthcare Labyrinth
The GOP is not following the same overt repeal of healthcare coverage as it did in 2017, but the stealth approach still has real impact. About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change. Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible, incisive deep dives on the most...
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79. Managed Care Enters New Cycle; Medicare Advantage Needs To Pivot To Thrive
The Healthcare Labyrinth
Managed care is entering a new conversion cycle just as Medicare Advantage plans have to pivot to thrive. About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change. Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible, incisive deep dives on the most pressing issues and events in American...
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78. The Budget Reconciliation Saga
The Healthcare Labyrinth
The House has passed the budget reconciliation bill, but the Senate intends to put its mark on the bill and there are competing forces as in the House. Final passage is some time off still. About The Podcast: Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change. Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast...
info_outlineThere are smarter healthcare cuts and sensible reforms that could be made and spare major impacts to coverage.
About The Podcast:
Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.
Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change.
Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible, incisive deep dives on the most pressing issues and events in American healthcare.
Marc seeks to help Americans become wiser consumers and navigate the healthcare maze with more confidence and certainty through The Healthcare Labyrinth website and his book of the same name.
Marc is an unconventional Republican who believes that affordable universal access is a wise and prudent investment. He recommends common-sense solutions to reform American healthcare.
Tune in every week as Marc examines the latest developments in the space, offering analysis, insights, and predictions on the changing state of healthcare in America.
About The Episode:
On this episode, Marc discusses the budget reconciliation bill. There are smarter healthcare cuts and sensible reforms that could be made and spare major impacts to coverage.
Key Takeaways:
The problem with the Republican healthcare budget reduction proposals is that these are clear and deliberate reductions to Medicaid and Exchange coverage.
The GOP is being quite stealthy, but nonetheless Republican lawmakers get to the same place as more explicit coverage termination initiatives.
About 16 million could lose coverage and the bill would decrease spending by $321 billion to hospitals, $81 billion to physicians and $191 billion for drugs.
If the Exchange premium tax credits expire, spending would decline by an additional $262 billion.
There are smarter cuts that can be made. A case can be made that provider cuts are needed to attack the high-cost and inflation problem we have in healthcare.
High costs are driving premiums and creating a situation where we are priced out of healthcare.
Done right, price reform brings inflation down and bends the cost curve. Over time, it could mean a real reduction in prices and costs.
Done over a reasonable period of time, it would force provider reform, especially at hospitals.
We need site-neutral policies. There is no reason that hospital-owned settings (outside of inpatient) should be paid more for the same services provided at independent free-standing facilities or a physician’s office.
Reforming the 340B drug discount program may not save major government spending, but reforms would reduce costs to employers and beneficiaries.
President Trump has proposed most-favored-nation (MHN) pricing across the entire healthcare system.
Several possible changes could be made to Medicare Advantage risk adjustment over time.
The healthcare system could be transformed to the benefit of plans, providers, employers, and consumers.
It is far superior to how each party thinks about it – the GOP’s chopping at coverage and the Democrats’ fixation with driving more and more coverage and benefits without a thought to efficiency.