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tv   Discussion on Health Care Access  CSPAN  July 6, 2021 11:39am-12:15pm EDT

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c-span giving you a front row seat to democracy. >> jen psaki is holding a news conference today at 12:30 eastern time. watch live as she takes reporters questions here on c-span. >> today, a conversation about how the budget reconciliation process works in congress. watch the event live on c-span. online at, or listen on the free c-span radio app. >> the administrator for the centers of medicare and medicaid services discuss health care access, medicaid expansion, telehealth services and the impact of covid-19 on the health industry. this also includes interviews with unitedhealth group executive vice president dr. margaret mary wilson and democratic congressman berra, a doctor. from an event hosted by
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axios, this is just over half an hour. hosted by axios, this is just over half an hour. >> welcome to another vitals check-up virtual event, our monthly series spotlighting the most pressing health care issues and trends. i'm tina reid, axios health care editor, and i'm joining you from the washington d.c. thank you to united health group for making this conversation on strengthening health care accessibility and the future of providing care possible. welcome the our audiences on facebook, youtube, twitter the, linked in and on you can join the conversation with hashtag axios events. i will be joined by my colleague and senior editor sam baker. we will unpack how the pandemic has shifted the conversation around is access to care from telehealth to evolving hospital operations and take a closer look at care accessibility and the future of providing care.
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up first is the administrator of the centers for medicare and medicaid services joining us from washington d.c. if welcome, administrator. >> thank you. it's a pleasure to be here with you. >> you have been on the job for about a month now. what have you been spending the most time on so far? >> it's been such a pleasure to be the cms administrator, and what an honor and a privilege. most of my time, i would say, so far has been spent getting to reconnect with the cms staff who are among some of the finest federal employees in this country and just getting up the speed on all the work that is going on and jumping into supporting the affordable care act. >> now, you are coming to this role with quite a bit of public service under your belt, but
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you're also joining when we're still in the midst of a pandemic. how does that change how you are to think about the role and what you're prioritizing? >> i think that coming from a pandemic -- and we are still in the midst of it, a although so many wonderful signs of people getting vaccinated -- has really helped really focus on making sure we are prepared for the next public if health crisis -- public health crisis, really a making sure that our country is, we strengthen our coverage. and so we at cms and i have been very focused on making sure the coverage is accessible. we are really seeing incredible gains in health insurance coverage, and i think it's because people are realizing how important it is, and people will sign up when you make it affordable. we're also very focused on advancing health equity.
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so the disparities in our health care system are longstanding, there are not new, there are generational. but we have a moment, because the country has seen what happens and what these disparities look like up close and in stark reality, in painful realities. and so we are really focused on making sure that all of our policy initiatives are really focused on advancing health equity in really a particular moment in time that we need to take quite seriously. .. it comes, i would say in multifaceted ways. the first way we are focused on
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advancing health equity is making it the first question and not the last question so every single policy coming to me, the team knows i'm going to ask about health equity so they automatically start talking about how whatever the policy initiative is, how we are going to build in health equity whether it's making sure we are collecting data so we can take better decisions, whether it making sure we are looking at the policies through lines and as we start doing it, the policies improve and i would give one example, maternal health which has been a focus of mine the last couple of years, it is incredible when you take a look at the data where the deaths occur. they don't just occur at the time of delivery, thicker all couple of months later because it's a vulnerable time for women when they are getting more
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comfortable with new baby and they are going back to work, dealing with so many things and many times pregnant women, after they have their child, they switch coverage and when we look at the data, we find ways to experience health equity with the american rescue plan making postpartum care and extending coverage through the medicaid program so that us one example of how when we look at data to see what's happening, we can make other policies and improve healthcare systems for the people who it's meant to serve. >> during the pandemic we saw major delays in routine care and screening. i've heard private payers saying this is an area they are watching closely because there's concern over future cost. how are you thinking about the
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downstream cost and what to do about it? >> it's incredible, we have seen that in the 2020 data, people may have put off care for probably obvious reasons. again i think that comes from a combination making sure people have coverage so when people know they can go to the doctor have access to care, they are going to be more likely to do that. we are seeing advances and making more care accessible and fattest another important piece, making sure we are supporting the community, making sure trusted partners are educating people about their options and that will continue to be an emphasis that we are working with stakeholders that are trusted partners to the people
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being served as a way to make sure people are getting the care that they need. >> telehealth was one of the big solutions that we saw take off during the pandemic and i know a lot of the questions in the industry, how will be take these? how do you characterize what you seek moving forward for telehealth and what the reimbursement should be? >> that's a critical question from a telehealth had been a discussion before covert and we all have a perfect laboratory of seeing what a difference telehealth can make. i've heard so much certainly in my own life and many members of congress how important telehealth has been to communities, particularly in the mental health space and making sure that people were able to
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seek access to care, get it during the pandemic and what a difference it made in terms of, even in terms of hospitals and people showing up for their appointment. telehealth remains critical. we have to think about how we make sure that people get access to the care they are receiving so that's going to be an important piece so we will be looking at that as we make these policies more permanent. >> is there something in that purview or is it going to require congress to act? >> there are some pieces of telehealth that cms will have some authority but congress will need to act on some critical pieces, to, to make telehealth permanent. >> i wanted to move on to
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medicaid, i know that you have experienced working with medicaid, what can you tell us how you are working from a republican but states to move different decayed expansion and what is your thought process working with the states? >> it is critical in my mind for cms to be very responsible to all of its partners and states are key in that. states are the ones administer the medicaid program and its critical that cms that we make sure we keep in mind state perspective, i have had such an education in my prior life how difficult sometimes it is for states to offer luxury smoothies what's going on. we are developing a team that is
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going to have state perspective. we are going to work and having open door policy on medicaid expansion, want to work with state in their financial advantage. the american rescue plan is incredible and looking to expand medicaid programs. >> i guess for states looking to accept what is the best way to move forward or gain cooperation i guess to get it to move forward, hands off approach? hands on? >> it's important, in my mind that state will have different ideas what they want to do and we want to make sure in the medicaid program at the end of the day we are focused on the
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people so i want to continue to work with state on developing care for their population and if they choose not to expand, it's important there be an option for people so clearly focused on as the president outlined the campaign, making sure we are doing something in the coverage gap and starting to see interest there from congress. >> if you had to think one thing the trump administration to write on healthcare, what would it be? >> i think the trump administration has wanted to focus on prescription drugs and really tried to do that, that is certainly going to be a focus on this administration to work with congress to pass important comprehensive prescription drugs cross in this upcoming session.
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>> i know aji home has gotten a lot of attention recently, is cms going to take a national coverage on that? >> cms is looking at what the fda has approved and we will review all that evidence and look forward to hearing from stakeholders on those pieces. >> but obviously we are looking at costing medicare a lot of money depending on how many seniors end up taking it. cms administrator, how do you plan on making for authority to address prescription drug cross. >> as we know, there are exciting and innovative products coming out the pharmaceutical industry alzheimer's in
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particular, a devastating disease, expect critically important as you raise from brusque to address prescription drug costs we hope to work with congress, we have bipartisan interest in addressing prescription drug costs as a former health -- i'm very excited working congress to address scripting costs and help that we can do that this year. >> thank you very much for joining us here today. >> thank you for having me. have a good rest of your day. >> you too. next, if you from top segment with my colleague at xes axioms. >> thank you. joining us from houston texas, executive vice president and chief medical officer at united healthcare, doctor margaret wilson.
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>> thank you very much. it's a pleasure to be here today. >> can you tell our viewers about united health group as well as the work you're doing shape healthcare delivery and improve access to care? >> certainly brief united health group is an enterprise that comprises 350,000 team members, almost a third of a million across the world. each and every day, each of those team members breaks up dedicating themselves to help people live healthier lives and make the health system better for everyone. simply put, provide healthcare benefits to the united oscar brief we serve individuals, employers from medicare and medicaid beneficiaries and also health services. often warcry healthcare
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marketplace and care providers, government, lifecycle companies and in my formal role as senior vice judge chief medical officer, i was critical peter brent integrated benefits services. we have 200 clinics and 52 hospitals across the world primarily south america serving more than 7 million people. at the core of our mission at united healthcare is sustainability, we consider that foundational to our business, culture admission if you may be aware, we recently released annual sustainability reports. basically that rests on four pillars, helping modernize the healthcare system people and culture, responsible business practices and environmental health but most important for
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the first time this year we made a firm commitment that we think are truly critical in entering 85% of our members will receive preventive care services annually by 2030. second, more than half, 55% exactly of outpatient services and radiology process will be delivered in high quality effective settling's by 2030 the third is by 2025, we will close 609 gaps. >> that is tremendous, what a great potential impact now and in the future. moving to the present day, we know that corbett has had major impact on the healthcare industry. how has corbett impacted how you
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look at access to care and how you dress the challenges that surface because of covered? >> the covered pandemic drove a significant pivot in the way we all you healthcare. it really gave momentum to the urgent need for healthcare transformation, real gaps in our healthcare system but it's also fresh thinking how we interact with patients and urgency around innovation and what happened with the vaccine and advances made in vaccine development platforms. we have experienced globally the challenges around access so we have a strong focus driven by the pandemic expanding access. that is critical to marginalize the healthcare system because every single person, regardless
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of their status should be short of optimal quality affordable care under their needs and deeply committed to advancing this not just u.s. but across the world. an example, expanding access to care, but is critical. it's about connecting people to primary care and specialty care arising from fact. an example, we believe if you are able to flip people to appropriate care one example is we've seen to helping critical and we see challenges with that emerging postcard so with our platform, we are able to connect members for care providers and
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showing good outcomes, the program fees increased and hospitalizations by about half and reduced pressure by half. we are leaning into supporting the workforce. we know there will be impending shortage of commission in 21st century so we are supporting that. $3 million to the university of nevada to help support primary care curriculum so bring this together, we believe the capabilities and improving access to private care will definitely make a difference. it's really around building stronger and healthier communities, not just expanding access but as i pointed out by helping build a workforce at the other level but also, you may be
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familiar with our diverse initiative since 2007, we have had it in that space. those are a few of the examples of some of the things we are doing. >> that is fantastic, very holistic approach. interesting to hear how covered has helped healthcare accelerate transformation, we have seen this in other organizations as well. as we develop this, what is the united healthcare drink while also advancing health in equities. >> we have had a strong focus on health equity for more than a decade and we have strengthened and continue to strengthen our focus you may have noted recently a couple of days ago the disparity report and still speak tooth disparities amongst vulnerable populations, african-american fathers, like mortality, we still have those challenges so one area of focus
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working strategic partners to address these issues. a couple of examples of some of the work we've done, we worked with community healthcare workers in hawaii, michigan and ohio this was within united healthcare community healthcare plan and we have shown working and designing quarterly appropriate focus interventions, we see great results for our collaborative work has shown 83% reduction after disparities amongst women in ohio related to postpartum care. in the same population michigan, we were able to 42% reduction at 40% reduction amongst women living in hawaii. three of us together, we continue to have a strong focus on health equity and really leaning into decreasing healthcare disparities in the
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population. >> that is incredible, great results but still a lot of work to be done. grateful you are here with leadership during this work. thank you for the wonderful conversation thank you for everything that you do. >> thank you so much for having me and thank you for what you do as well. >> nafta my colleague, sam baker. >> thank you. i am a senior editor here at actio's in our final cast today is the representative for california congressional district. joining us from washington d.c. thank you for taking the time today. >> thanks for having me on. >> we are talking about care delivery and the future of care delivery, we know we get new data almost every day that
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people put off during the pandemic so some that was actual treatment from a routine vaccinations are way down so as a start, how do we get back to normal on what we've already missed out on it at the same time, we have worked the country to begin with so getting back to normal, is it good enough? >> it probably isn't so i think that is a great question. so much in the last year end a half has been focused on the pandemic and protecting public health and the last few months on the vaccination efforts, obviously we still have a ways to go getting vaccines to the harder to reach populations but there's a lot of reaching healthcare that did not get taken care of, cancer screening, vaccination, journal physical.
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there is going to be this demand that potentially overwhelms the system as we come out of the pandemic. on top of that, you got a healthcare workforce that was stretched thin dropped the pandemic, the effects of burnout and these things, we do worry about the potential of time in the workforce so we got to pick up how work through necessary care and fan we did see in the pandemic charting happen, the things we don't want to go away like telemedicine, it did provide access to care through the pandemic, they are all good things, democrats and republicans just continue to see this and make it more readily available, we got to figure out how to pay for and what it looks like. >> telehealth, as you mentioned, a silver lining, things we did
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write we'd like to continue, are there any other interventions in that category, in your mind that you would like to keep going? >> i can think of a few other things, we have to take the opportunity to build up public health infrastructure, we certainly saw how public health and the health department free pandemic which left us in a challenging place to address the pandemic when it hit. now throwing billions of dollars cap public health department and vaccination efforts and etc. from let's build public health from department and infrastructure that we deserve and community based issued by other diseases, vaccinations, clean water and etc., those are
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measures usually important that can have real impact so as we expend this, let's also be strategic coming up telehealth for structure in america. >> specifically on the delivery side and outside public health emergencies when we back to normal healthcare needs, telehealth is one thing everybody wants, there's obviously a lot of gaps that can be filled out your countries will just have more people being providers. some of the obstacles some are local as we've seen up close, some are usually structural so i wonder, is that a shift that
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congress can generate or are you more on the edges? >> i think we can still take some of that shift and how we do that is we are appropriating funds of funds through this american rescue plan. also the pandemic exposed what was already there in terms of real healthcare in equities, particularly communities of color and less resource communities and telehealth, telemedicine was great for a lot of folks the a lot of communities don't actually have broadband access to those tools so congress has a role working with the abiding administration as we put together plan, can we address that? again, i don't think that is going away, i think those are
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going to continue and then, can we really address the healthcare equities, communities that really do have lack of access and regular access to healthcare? the biden ministration talks about healthcare equity, they obviously have a position, cms and hhs and equity issues, if you think there is the opportunity to get to these product to reach communities? [sirens] >> anytime we want more of something in the healthcare system, the way to get it is throw some money on it. we've got mark telehealth and reimbursement rules around telehealth. a lot more primary care providers, there's a lot of members i think with bipartisan support, change reimbursement for primary care, a more lucrative specialty.
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usually that seems to work and at the same time we have $3 billion a year how do we change incentives without ending up with a healthcare system like this? >> we do have to address the cost of healthcare, i think you will see congress trying to address pharmaceutical costs, i think there's probably sweet spot in the generic space we could put together democrats and repugnance to address at least jaron eric cost of medications to bring back down, that could be tens of billions of dollars savings. i do think some of the price negotiations pieces, the things that trump administration did in terms of this, some may stay in the biden administration, that will be a little bit harder. you seek market consolidation in the hospital and that hospital
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space so that will be interesting to see how that gets addressed what is the balance between primary care and specialty care and what does that model look like? my sense is will move in a direction value -based contracting where we shift more on to the providers saying here is what that payment looks like, you figure out the best way draft and deliver that cost of care and free pandemic, they were moving in that direction, i think you will continue to see in this direction. >> on drug prices, it's a little more complicated sometimes when you look get into weeds, there's obviously cancer treatment for example, the expert could try to put a real value on drugs
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sometimes expensive and you have drugs that don't seem to work at an incredibly high price state increases, how do you go about think about what's the right tool to get all the right outcomes? >> that is an issue we've been working on for a while. you see remarkable therapies, the oncology space that are not only lifesaving but they are coming with a big price take so in the commercial sector, they say we will pay the price on the front end but it work it paid over five, ten years and there is going to be shared. if that comes back and the therapy doesn't do what it was supposed to thing some of that payment back to the payer. i think with got to think about that model in the medicare, medicaid space particularly for high cost therapies, i would
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love to see that congressional budget office so maybe we are spending $300,000 on the front tier sickle cell anemia but how many hospitalizations are going to save? what is the true cost of curing the disease? that's how we would look at in the commercial sector and how we have to look at it and the government sector for medicare and medicaid patients. >> there enough. that is our time, houston generous with yours but thank you for joining us, great to be with you. >> thank you for having me on. >> thank you for joining our final checkup series this afternoon which has made everyone smarter, faster. thanks again to united health group and for making this conversation possible.
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for more information and stay on top of all of today's healthcare news, subscribe to our healthcare newsletter and you can do that at ask we'll see you there and next month for another vital checkup. >> white house press secretary jen psaki is holding a press conference at 12:30. watch as she takes reporters questions here on c-span. today, a conversation about how the budget reconciliation process works in congress. watch the brookings institution event live at 2:30 p.m. eastern on c-span, online at, or listen on the free c-span radio app. ♪
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>> our first guest of the morning is three to group debt, with the -- the program director of the futures for workers program. thank you for joining us this morning. you, pedro, it's great to be here. host: talk about the ford foundation and the futures of worker program, tell us what that is. guest: the ford foundation is a large social justice philanthropy. its mission is to tackle inequality in all of its forms. the future of workers


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