Cybersecurity is a central part of every nation’s infrastructure – especially when it comes to health care. The availability and free flow of health information is critical to providing care. Unfortunately, patient information isn’t just valuable to caregivers, it’s also becoming a primary target for criminals across the globe.In this special episode, Chip Kahn moderates a panel of cybersecurity experts, with significant experience in the health care sector, from around the world. The discussion, entitled 'Navigating Today's Cyber Threats for Tomorrow's Healthcare,' was organized by Future of Health, a group made up of thought leaders from hospital systems, academia, policymaking, payers and patient advocacy.Topics discussed include:Current state of cyber defenses today – vulnerabilities, variabilities across the worldGoals of cybercriminals targeting health care entities – money, data, or mayhem Paying ransom – views from different countriesPolitical implications – how to react when cyber breaches become geopolitical events Proper role of governments in cyber defense and attack mitigation – the role of mandates and the threat of penaltiesLasting advice – the one thing health care entities must do to protect themselves.The virtual panel:US: Meredith Griffanti, Senior Managing Director, Global Head of Cybersecurity & Data Privacy Communications, FTI ConsultingUK: Dr. Saif Abed, Director of Cybersecurity Advisory Services, The AbedGraham Group and Cybersecurity Consultant, World Health Organization Singapore: Kim Chuan, Group Chief Information Security Officer, SingHealthIsrael: Alon Rozen, CEO of Elements Group, and former Chief of Staff at the Israeli Ministry of Defense and Director General of the Israeli Homefront Defense MinistryMore: Established in 2018, Future of Health's diverse membership represents the foremost health organizations and thought leaders from hospital systems, academia, policymaking, payers, industry, and patient advocacy. Each year, FOH members address, through discussion and research process, pivotal issues facing health care across the world. From this process FOH develops insights and recommendations disseminating findings through published papers which serve as a blueprint for a common vision for the future of health.

With zero-dollar premiums, caps on out-of-pocket costs, and perks that range from meal delivery to gym memberships – even loaded debit cards – membership in Medicare Advantage (MA) plans is surging in enrollment and popularity among seniors.  In fact, earlier this year, enrollment in Medicare Advantage plans surpassed enrollment in traditional Medicare, with more than 50 percent of eligible seniors now choosing this privatized version of coverage.  However, aggressive marketing campaigns and a lack of transparency in coverage often hide the downsides of Medicare Advantage, which include limited networks and strict prior authorization policies that make it harder for millions of seniors to quickly get the care they need. As we explore in this episode, these downsides also impact care providers, like hospitals, as well as the taxpayers who are footing the bill.Our guest, Tricia Neuman, is the executive director of KFF’s Program on Medicare Policy and has been with the organization for almost 30 years. She looks back on the creation of MA, discusses the program’s unexpected rapid growth, examines its impact on the health care system, and shares what she thinks comes next for seniors’ coverage.Topics discussed include:Evolution of Medicare Advantage – popularity and benefitsFlooding the airwaves – impact of overzealous marketingWhat’s in it for insurers? – how insurers game the system Impact on patients– from narrow networks to excessive prior authorizations Problems for providers – limitations on care from denials and delays Taxpayers pay the price – MA now spends more per beneficiary than Traditional MedicareWhat’s next – the future of Medicare Advantage More:KFF is an independent source for health policy research, polling, and journalism. Its stated mission is to serve as a nonpartisan source of information for policymakers, the media, the health policy community, and the public.KFF has four major program areas: KFF Policy; KFF Polling; KFF Health News (formerly known as Kaiser Health News, or KHN); and KFF Social Impact Media, which conducts specialized public health information campaigns.

The recent cyberattack on Change Healthcare exposed fissures in the American health care system that are still reverberating - impacting patients and providers alike months after it was exposed.As hospitals, physicians, and other providers get back on their feet, they're also improving their cyber defenses to stay one step ahead of increasingly persistent hackers.This crisis also sparked conversations among policymakers weighing the implementation of new regulations on health care entities, including potential penalties for those who have been victimized.In this episode, Lynn Sessions looks at the cyber-security issues facing hospitals and health care organizations, from evolving threats to how we need to think about mitigation and resiliency. Lynn is a partner at the law firm BakerHostetler and leads the Healthcare Privacy and Compliance practice, where she has handled more than 1,000 health care data breaches and ransomware attacks.Topics discussed include:Evolving efforts of hospitals to increase cybersecurity protectionsThe anatomy of a health care cyberattack – effects of ransomware vs. malwareVulnerability of 3rd party entities in health care – like Change HealthcareRole of the federal government – protecting hospitals, penalizing bad actorsMoving forward – fighting the next generation of cybercriminals More:BakerHostetler has a diverse team with wide experience in counseling health systems, physician groups, insurers and employers across the country regarding risk assessments, developing comprehensive incident response plans, and responding in a timely and accurate manner to privacy and security incidents, from lost paper files and laptops to the largest cyber incident ever reported involving medical information.More here - https://www.bakerlaw.com/services/digital-assets-and-data-management/healthcare-privacy-and-compliance/ 

Good health care depends on good health coverage, particularly for the most vulnerable. The Affordable Care Act expanded Medicaid eligibility and created exchanges where many Americans could access health insurance, often at a subsidized price. These new pathways to affordable coverage led to the uninsured rate dropping to record lows.Unfortunately, those recent gains in coverage and access now face new hurdles. After the end of the Covid public health emergency, states began a process of redetermining Medicaid eligibility which caused tens of millions to lose coverage. Many were forced to find a new source of insurance coverage, or lost it completely. The passage of the Inflation Reduction Act created enhanced subsidies for individuals seeking insurance on the ACA marketplace exchanges, leading to a record high enrollment this year. Those subsidies are set to expire in 2025.  Unless Congress steps in, this could increase premiums, making coverage too expensive for many, threatening access to health care. In this episode, Stan Dorn, who has worked on coverage issues for almost 40 years and currently serves as the Director of the Health Policy Project at UnidosUS, explains what these dual threats to coverage mean for individuals and their families.Topics discussed include:Current state of the Medicaid redetermination process and its impact on coverage for recipientsCongressional action needed to avoid looming marketplace coverage cliff  Long-term policy changes that will improve the ACA by protecting Medicaid expansion and continuing affordability in the exchange marketplaceMORE: UnidosUS, previously known as NCLR (National Council of La Raza), is the nation’s largest Hispanic civil rights and advocacy organization. Through a unique combination of expert research, advocacy programs, and an Affiliate Network of nearly 300 community-based organizations across the United States and Puerto Rico, UnidosUS simultaneously challenges the social, economic, and political barriers that affect Latinos at the national and local levels. When it comes to health care, the group is focused on ensuring access to affordable coverage with an emphasis on helping people through the Medicaid unwinding process and enrolling them in exchange plans.

The Change Healthcare cyberattack on February 21st upended a huge slice of the U.S. health care system, virtually crippling all aspects of the patient care continuum when the clearinghouse’s services were hacked. That is because Change Healthcare processes 15 billion claims totaling more than $1.5 trillion a year and may handle 50 percent of all medical claims in the country. The impact has been devastating for many patients, hospitals, and providers, particularly those already operating under financial constraints. Having an understanding of the size and scale of this cyberattack has been critically important to ensuring lawmakers and regulators understand the outsized impact on providers. Enter Matt Szaflarski, a revenue cycle intelligence leader at Kodiak Solutions. In the aftermath of the attack, Matt has become a leading voice in clarifying the role, scale, and impact within the care continuum and quantifying its impact. In this episode, Szaflarski discusses:The role of a clearinghouse in patient care from start to finish;A breakdown of the Change Healthcare cyberattack and subsequent fallout, including the effect on patients and loss of provider safety nets; andFuture of health care and recovering from the hack.More: Kodiak Solutions is a leading technology and tech-enabled services company that simplifies complex business problems.Kodiak has built a high-performing business for healthcare provider organizations revolving around a proprietary net revenue reporting solution, Revenue Cycle Analytics, and expanded to a broad suite of software and services in support of CFOs. Kodiak’s 400 employees engage with more than 1,850 hospitals and 250,000 practice-based physicians across all 50 states.Learn more here: https://www.kodiaksolutions.io/

There are two Americas - rural and urban – particularly when you look at access to health care.  With roughly 60 million people, or one in five Americans, living in small communities from coast to coast, how do we ensure patients have access to the care they need when they need it? And what policies can help bridge the gap? Former Senator Heidi Heitkamp has dedicated her life to representing the interests of rural America and fighting to save this way of life. She currently serves as founder and board chair of the One Country Project, an organization dedicated to advancing rural America through and ensuring its priorities and values are represented and reflected in Washington, D.C.  In this episode, Sen. Heitkamp discusses the issues facing small communities and how lawmakers can help solve health inequities between rural and urban areas.  Topics include: Unique health care challenges faced by rural Americans Hospital closure crisis Impact of public programs like Medicare, Medicaid, and the Affordable Care Act Threat of funding cuts to rural health care programs, like site-neutral, low-volume and Medicare-dependent hospitals  Unintended consequences of Medicare Advantage Mission of the One Country Project MORE:   The One Country Project is dedicated to reopening the dialogue with rural communities, rebuilding trust and respect, and advancing an opportunity agenda for rural Americans. Its mission is to ensure rural America’s priorities and values are heard, understood, well-represented and reflected in policy in Washington.  Learn more here: https://onecountryproject.com 

GUEST: Dr. Jonathan Perlin, President and CEO, The Joint Commission IN THIS EPISODE:  The Joint Commission is possibly the most impactful health care quality and performance organization in the world. With the rise of AI and concerns growing over issues like environmental sustainability, its mission has never been more critical.Dr. Jonathan Perlin, in his second year at the helm of The Joint Commission, is on a quest to reshape safety and performance measurement and its impact on care delivery for hospitals and other settings.In this episode, Dr. Perlin outlines his H.E.L.P agenda and explains how the acronym is a guide for the organization as it aims to better ensure patients’ safety and effective hospital care.H.E.L.P Agenda includes: Health EquityEnvironmental Sustainability  Learning Health Care/AIPerformance Improvement and Integration MORE: The mission of The Joint Commission is to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value.It aims to accomplish this goal by setting quality standards, evaluating an organization’s performance, and providing an interactive educative experience that provides innovative solutions and resources to support continuous improvement.Learn more here: https://www.jointcommission.org/

IN THIS EPISODE:For the past 15 years, drug shortages have been a persistent problem for hospitals and thepatients they serve – and extreme cases can even lead to rationing, delaying, or cancelingtreatments or procedures.Tackling the drug shortage crisis is a complicated issue requiring creative solutions. That’s whereCivica comes in – a non-profit pharmaceutical company created by hospitals and health systemsto address these critical shortages.In this episode, Chip speaks with Civica’s Senior Vice President for Public Policy Allan Coukellabout why the company was formed, the challenges they are tackling, and how it plans to helppatients into the future. Topics include:The state of hospital drug shortages in the US todayTaking the bull by the horns: how a non-profit company created by hospitals is helpingpatients.The success of Civica's model:Long-term purchase and supply contracts directly with hospitals that add stabilityto the market.Maintaining an approximately 6-month buffer inventory of every drug.US sourcing whenever possible.Intensive quality oversight of suppliers.A single cost-plus price, available to every purchaser.How the company got into drug production.Policy solutions to ease drug shortages.GUEST:Allan Coukell, Senior Vice President. Public Policy, Civica Inc.MORE:Civica currently delivers 80+ drugs, all chosen by US hospitals for being at risk of shortage, withmore than 140 million containers delivered to hospitals over five years, serving 60 millionpatients.It currently works with 1,500+ hospitals from 55-member health systems, like HCA Healthcare,Mayo Clinic, Common Spirit & US Department of Veterans Affairs.Learn more here: https://civicarx.org/

Guest:Phillip Morris, Partner & Leads Strategic Insights Practice, LSGIn this episode:It is only January, but the campaign season is already in full swing. From the White House tocontrol of Congress - power in Washington is up for grabs. In this episode, Chip Kahn talks withPhillip about what issues matter most to voters and where health care fits into that list ofpriorities.Topics they examine include:Most important issues to likely voters in this year's election - inflation, the economy, and immigration.Views on health care – voters point to big insurance and pharmaceutical companies as the main reasons for rising costs and lack of pricing transparency.Growing concern over Medicare Advantage plans delaying and denying doctor-ordered care for seniors.Voter’s view hospitals favorably and consider them among the most essential providers of health care in their communities.Overwhelming support for lawmakers ensuring hospitals have the necessary funding to provide 24/7 care.Political trends for 2024 and into 2025.MORE:Phillip Morris and his firm, LSG. recently conducted a poll on behalf of FAH and found wide support for hospitals and hospital funding among likely voters. The survey also discovered the vast majority are concerned about cuts to Medicare and abuses by Medicare Advantage plans, including denials and delays of care through prior authorization, denied payments for necessary treatments, and network restrictions limiting provider choice.Key findings include:Voters view hospitals favorably and consider them among the most essential providers of health care in their communities.Nearly three-quarters (72%) of likely voters view hospitals favorably.The vast majority (82%) believe the federal government should provide adequate funding to ensure hospitals serving rural and underserved communities remain open.Lawmakers’ positions on hospital funding will affect voters’ actions at the ballot box.Seventy percent of voters would be less likely to vote for a Member of Congress who supported cuts to hospitals that threatened their ability to stay open.An overwhelming majority (89%) would be willing to take action to support policies that would ensure access to hospital care.Voters are concerned about the impact of Medicare Advantage practices on consumers’ access to health care.The vast majority (78%) of voters are concerned about the trend of Medicare Advantage plans delaying or denying access to care for seniors.A majority (56%) of voters believe there should be more regulation and oversight of Medicare Advantage plans.Likely voters blame health insurers most for the lack of transparency in health care costs.You can learn more here.

Chip and Dr. Liz Fowler, Deputy Administrator of CMS and Director of the agency’s Center forMedicare and Medicaid Innovation (CMMI), discuss CMMI’s mission to improve healthoutcomes, overcome the obstacles to health equity, and reduce care costs. They look back onwhat CMMS has accomplished in its first 10 years, what we have learned from thisexperimentation, and the future of care and payment innovation.Topics they examine include:CMMI’s successes over the last decade and what programs have resonated most.Controversial CBO report that says CMMI’s programs have increased federal spending –not lowered it.Performance of CMMI bundled payments and rationale behind a new mandatory bundledpayment program.Goals of the newly announced state-based AHEAD model and how it will interact withother ACO and value-based care programs.Dealing with the challenges created by massive growth in Medicare Advantage.How CMMI is addressing the broad issue of health equity.MORE:Dr. Fowler has the unique role of leading an agency she helped create. From 2008-2010, she wasChief Health Counsel to Senate Finance Committee Chair, Senator Max Baucus (D-MT), whereshe played a critical role in developing the Senate version of the Affordable Care Act. Theframework for the CMMI was embedded in the law – so now, after several roles in the private