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, a Senior Fellow at the Pioneer Institute.   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: podcast@patientsrising.org 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.

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 time. We got news this week that it finally has some life!    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: podcast@patientsrising.org 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.

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 this really means, and how this framework could derail the entire drug development industry if this comes to pass.  You won’t want to miss what he has to say. We also discuss the increasing prevalence of Prescription Drug Affordability Boards and what that might mean as we progress into the second month of 2024.   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: podcast@patientsrising.org 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.

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 campaigns here.   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: podcast@patientsrising.org 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.

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 including a report from HealthcareDive that HHS has named its first – “Chief Competition Officer” and a report from CNBC that Eli Lilly has a new website offering telehealth prescriptions and direct home delivery of certain drugs.    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: podcast@patientsrising.org 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.

This week, we discuss the idea of “dual eligibles” 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 announcement by the Biden administration 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 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: podcast@patientsrising.org 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.

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 short. He breaks down what these barriers are, and what will need to change if we want people to actually be able to grow older where they choose.  Also, we talk about a decision from the Colorado Prescription Drug Affordability Board to not place a price cap on a best-selling cystic fibrosis medication.   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: podcast@patientsrising.org  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.

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.   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: podcast@patientsrising.org 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.

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 the American Telemedicine Association. Kyle shares a policy update and what to expect for the future of telehealth.  Also, we discuss a potential merger between two major insurance players.    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: podcast@patientsrising.org 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.

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, shares his story. 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 Department of Health and Human Services.  Resources and previous episodes on open enrollment: Patients Rising Podcast: Open Enrollment Explained Patients Rising Podcast: Get Covered   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: podcast@patientsrising.org 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.

It can be difficult to navigate the procedures and interactions that come with a hospital visit. However, knowing what to expect going in can help improve your experience. This week, we talk with hospitalist and author, Dr. Monique S. Nugent about how to physically and mentally prepare for hospital visits. Her new book, “Prescription for Admission: A Doctor’s Guide for Navigating the Hospital, Advocating for Yourself, and Having a Better Hospitalization,” serves as a guide for patients who need help navigating the hospital. Also, we touch on a bill introduced in Congress that would help terminally ill patients get immediate access to benefits of the SSDI program. Hear from Congresswoman Diana Harshbarger from Tennessee who helped introduce the bill in an episode of the Healthcare Policy Pop.    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: podcast@patientsrising.org 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.

Taking care of and connecting with a loved one who is living with dementia is difficult, but it's also something that many people have to do. This week, we talk with Mary Anne Roberto and Debbie Axel, co-founders of Always Home Connected, a company that helps provide caregivers and families with more resources that encourage bonding. They walk us through why they started their company, the types of products they sell, and share the impact that they have made in the lives of caregivers and aging patients.  You can learn more about Always Home Connected here.   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: podcast@patientsrising.org 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.

Everyone seems to be talking about Artificial Intelligence, and there have been questions about how it could benefit the healthcare industry--but what you might not know is that it’s already being used in a number of ways. Luckily, this week we’re joined by Naomi Lopez, the Founder of Nexus Policy Consulting, who has been working to help legislators understand AI. Naomi walks us through the ways that healthcare could continue to use AI to help patients and the industry as a whole.  Also, we touch on a potential bill that would help protect patients by reducing prescription drug costs and extending certain expiring provisions under Medicare and Medicaid.   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: podcast@patientsrising.org 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.

There’s a new bill that could help many rare disease patients gaining traction, but it still has a long way to go. This week, we’re joined by Peter Pitts, a Former FDA Associate Commissioner, who gives us the lowdown on the Promising Pathways Act. He tells us what types of diseases are likely to be affected by this bill, and why it will make a significant difference in the lives of patients.  We also speak with Senator Mike Braun of Indiana, who introduced the bill alongside other legislators of both parties.    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: podcast@patientsrising.org 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.

This week we talk about a major victory for patients regarding Copay Assistance Programs. We’re joined by one of the major players in the lawsuit that made it happen, George Huntley, the CEO of the Diabetes Leadership Council and the Diabetes Patient Advocacy Coalition. He helps us break down why this was such a significant win for patients.  We also discuss the new Patients Rising working paper all about current formulary practices and how they’re hurting patients..    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: podcast@patientsrising.org 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.

As the popularity of weight-loss drugs continues to rise, the Congressional Budget Office is looking for new research on anti-obesity medications to see what the impacts could be. Ike Brannon, a Senior Fellow at the Jack Kemp Foundation, joins us to chat about the potential drugs, what they mean for Americans, and how it would impact the congressional budget. We also talk about a major Cigna settlement due to violations of the False Claims Act.    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 Patient 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: podcast@patientsrising.org 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.

Open enrollment is officially here, so this week we do a deeper dive on everything that you need to know to help you choose the right plan. Samantha Sauer, the Director of the The Patient Helpline here at Patients Rising, helps us navigate the different types of Medicare, the options that come with employer or private insurance, and why patients with chronic illness should ask a few more questions. Also, we have an update on the Medicare price negotiation as part of the IRA.     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: podcast@patientsrising.org 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.

Maternal mental health issues impact at least one in five of those pregnant or postpartum. This week, Adrienne Griffin, Executive Director of the Maternal Mental Health Leadership Alliance, discusses misconceptions about maternal mental health and resources available to pregnant and postpartum people. She also tells us what the Alliance is doing to transform the maternal mental health landscape.  Plus, Dr. Bob breaks down a significant win for patients with copay accumulator policies.   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: podcast@patientsrising.org 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.

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: podcast@patientsrising.org 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.

It’s clear that we need to fix the way we measure the value of new medicines. Current methods fail to account for the benefits to caregivers, the long-term savings from keeping a job or avoiding the hospital, and the countless scientific discoveries that a new drug can lead to. But there is a solution according to this week’s guest, biotech investor Peter Kolchinsky. He talks about his new study that looks at innovative ways to assess the real value of medicine. Peter explains how insurers use cost-effective math to determine what drugs they will and won’t cover, and alternative methods that take into account patient and caregiver needs. Plus, Terry and Bob discuss some must-pass healthcare bills for the chronic disease community. New Report: Getting the math right when measuring the value of new medicines Protect Medicare patients’ right to get care at home | The Hill  Patients Rising Now Issues Must Pass for Patients List for Congress   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: podcast@patientsrising.org 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.