The FLATLINING Podcast from Fulcrum Strategies

The FLATLINING Podcast from Fulcrum Strategies

The FLATLINING Podcast from Fulcrum Strategies brings you great healthcare news analysis and discussion each week from industry experts who know their way around politics, economics, and a doctor’s office. Questions about payor issues, Medicaid expansion, or the No Surprises Act? We’ve got you covered. New episodes drop every Wednesday morning.

Episodes

April 17, 2024 21 mins
This week on the FLATLINING Podcast from Fulcrum Strategies, Matthew and Ron discuss the news that UnitedHealth Group posted a $1.4 billion loss in quarter 1 of 2024 following the Change Healthcare cyber attack.  They talk about whether or not providers should care about news such as this.
Then, they discuss a new law going into effect in California that ups the minimum wage for healthcare workers to $25 an hour.  There could be som...
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Today on the FLATLINING Podcast from Fulcrum Strategies, Ron Howrigon and Matthew Handley take a look at some of the latest healthcare news.  First, they discuss changes to the Medicare Advantage rates published by the Centers for Medicare and Medicaid Services; they explain why insurers are saying out of pocket expenses will go up for seniors.  Ron and Matthew also discuss Home Depot’s decision to appeal a settlement with BlueCros...
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Today on the FLATLINING Podcast from Fulcrum Strategies, Matthew Handley and Ron Howrigon have a conversation with Matthew Stephens, MD, a board certified radiologists at Radiology of Indiana. Dr. Stevens, Matthew, and Ron discuss the exciting topic of artificial intelligence in healthcare, particularly AI's influence in radiology.  They discuss what some of the pitfalls are of using the new technology and what might be coming next...
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In this episode of the FLATLINING Podcast from Fulcrum Strategies, Ron Howrigon and Matthew Handley discuss Congress’ late fix to eliminate part of the cut to Medicare physician fee schedule.  They also discuss a recent report about a whistleblower case that alleges major accountable care organization Aledade engaged in serious Medicare fraud. -- Follow Matthew on X and LinkedIn. Follow Ron on LinkedIn. -- Articles mentioned in thi...
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Medicare Advantage continues to be one of the most profitable sectors of the health insurance industry, yet a lobby group backed by the nation's largest payers has claimed the federal government isn't paying them enough.  Fulcrum Strategies President and CEO Ron Howirgon and Matthew Handley discuss this. Plus, Elevance-owned Anthem BlueCross BlueShield in New Hampshire has royally screwed up their mail-order pharmacy benefits for N...
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This week on the FLATLINING Podcast from Fulcrum Strategies, Ron Howrigon and Matthew Handley discuss a proposal in Washington to remove the site of service differential.  Removing that change would pay doctors the same regardless if a procedure is performed at a hospital or an office. Ron and Matthew also discuss if the Medicare fee schedule is going to change, a PhRMA's lawsuit against the Biden administration over drug price neg...
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On today's episode of the FLATLINING Podcast from Fulcrum Strategies, Ron Howrigon and Matthew Handley discuss a current US Supreme Court case that is looking at COVID-19 misinformation and free speech.  Namely, the justices are evaluating if misinformation is protected speech.  Matthew and Ron discuss what this could mean for physicians who think they are giving their medical opinion to patients or to the public on social media. P...
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In our continuing series on prior authorization, Ron Howirgon and Matthew Handley discuss a press release from Cigna detailing all the "good" reasons big insurers like it use prior authorizations.  They claim it is to save patients money but ultimately, it saves patients' lives.  But a new law in New Jersey seems to fly in the face of that saying in its introduction that prior authorizations can be detrimental to patient health in ...
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This week on the FLATLINING Podcast, Matthew and Ron talk about a new Centers for Medicare and Medicaid Services rule that requires insurance companies to respond to prior authorization requests for certain products within seventy-two hours.  Those products include Medicare, Medicaid, CHIP, and Obamacare plans.  Unfortunately, commercially insured patients are left out in the cold.  Ron shares his concerns with the rule but acknowl...
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This week on the FLATLINING Podcas from Fulcrum Strategies, Matthew and Ron discuss the current situation with the Medicare fee schedule.  Unfortunately, a cut was not removed by Congress and doctors are now being paid (on average) 3% less to see Medicare patients.  Ron shares his insights into what he thinks will change in the next few weeks. Then, Matthew and Ron discuss a story that was previously shared on Matthew's Friday Puls...
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This week on the FLATLINING Podcast from Fulcrum Strategies, Matthew Handley and Ron Howirgon discuss the failed Cigna / Humana merger and why Wall Street analysts thought it was a bad idea from the start.  They also talk about the potential buyer for Cigna's Medicare Advantage business and why it doesn't really matter in the grand scheme of Medicare Advantage plans. Matthew also asks Ron what he's looking at in 2024. The FLATLININ...
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January 3, 2024 50 mins
Our most listened to episode of 2023: In 2023, the nation’s largest health insurers saw several lawsuits brought against them for refusing to cover care under the guise that it was not medically necessary or that physicians did not comply with prior authorizations. This happened to otolayrngologist Dan Hurley and Matthew had the opportunity to interview him for the FLATLINING Podcast from Fulcrum Strategies before he died in August...
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December 27, 2023 31 mins
We are continuing the Best of 2023 series on FLATLINING Podcast from Fulcrum Strategies. Weight loss drugs got a lot of hype this year as more were approved by the FDA with very promising results. But, as has been noted by several lawmakers and activists, insurance companies are still refusing to cover the drugs. Ron and Matthew discussed the new drug from Novo Nordisk called Wegovy and how it could change America’s public health. ...
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December 20, 2023 29 mins
This week on the FLATLINING Podcast, we start our best of 2023 countdown with our third most popular program of the year.   Ron and Matthew discussed a bill that was proposed in the Indiana state legislature that attempted to regulate how hospitals can do business in the state.  That bill was later signed into law by Indiana Governor Jonathan Jennings.  Ron and Matthew also discussed statistics that showed just how many physicians ...
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December 6, 2023 21 mins
This week on the FLATLINING Podcast from Fulcrum Strategies, economist and CEO Ron Howrigon and Matthew Handley discuss the recent news that health insurance giants Cigna and Humana may merge.  They discuss why Cigna's stock price has failed to rebound since the news and why Ron thinks this deal will be approved by the FTC. They also discuss, briefly, former President Donald Trump's statements that he is “seriously looking at alter...
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November 29, 2023 21 mins
We are continuing our series on the FLATLINING Podcast which takes a look at the healthcare policies of the presidential candidates.  One of the Republicans who has some concrete ideas is former United Nations Ambassador and former South Carolina Governor Nikki Haley.   Haley has proposed:
  • Raising the Medicare and Social Security age
  • Expanding access to Medicare Advantage plans
  • Eliminating Certificate of Need laws
Fulcrum St...
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This week on the FLATLINING Podcast from Fulcrum Strategies, Ron Howrigon and Matthew Handley discuss recent reporting that the American Medical Association may lobby to ban corporate medicine.  Corporate medicine is the practice of entities owning physicians, such as an insurance company or a large hospital system.  They also discuss the potential cuts to the Medicare fee schedule in 2024. Articles mentioned in this episode: The A...
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Yesterday, Reuters reported that Cigna is in talks to sell its Medicare Advantage line of business.  Upon the release of the news, Cigna's stock price was down nearly 4% at points and ended the day down 3.85%.  As other insurers (namely Humana) aim to get out of their commercial business because Medicare Advantage was much more profitable, how is it that Cigna was unable to make their plans as profitable as they would have liked?  ...
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This week on the FLATLINING Podcast from Fulcrum Strategies, Ron Howrigon and Matthew Handley discuss UnitedHealthcare's new variable co-pay product called Surest.  They talk about these questions providers and patients may have about the product:
  • What is a variable co-pay plan and how does it work?
  • Why will some doctors cost more than other doctors?
  • Is this a cheaper plan for employers to buy for employees?
  • Why do providers need ...
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October 25, 2023 21 mins
This week on the FLATLINING Podcast from Fulcrum Strategies, Matthew and Ron discuss a recent move by BlueCross BlueShield of North Carolina to purchase the NC locations of retail healthcare chain FastMed.  What does that mean for patients and nieghboring providers?  Then, they dive into a recent LinkedIn post by Ron that discussed a call he had with a managed Medicaid payer who wanted one of his clients to take on a lot of risk fo...
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