DC EKG

Stay On Course Studios

Join former White House policy expert Joe Grogan as he cuts through the complexities of healthcare legislation and its real-world implications. Each episode of DC EKG aims to demystify the policies shaping our healthcare system, uncovering how these changes impact patients, providers, and payers across the country. New episodes drop every Monday.

  1. 1D AGO

    Ryan Long on the ACA Subsidy Fight, Phantom Enrollees, and Reforming 340B

    Podcast TitleDC EKG with Joe Grogan: A Healthcare Policy Podcast Episode124 Episode TitleRyan Long on the ACA Subsidy Fight, Phantom Enrollees, and Reforming 340B Episode DescriptionJoe Grogan is joined by Ryan Long of Paragon Health Institute and the University of Southern California to break down two fights shaping health policy right now: a California wealth tax pitch framed as a health care fix, and the battle over extending enhanced Affordable Care Act subsidies. They unpack how enhanced subsidies changed who qualifies, why zero-premium plans opened the door to broker-driven enrollment and fraud, and why the medical loss ratio creates perverse incentives that can push premiums higher. They also explain how silver loading and cost-sharing reduction policy distort the exchange market, and what reforms could lower costs without writing a blank check. The episode closes with Ryan's latest work on the 340B program, including why drug arbitrage rewards hospitals with a stronger commercial mix and can fuel consolidation, and why direct, targeted assistance could better support hospitals that truly serve low-income and rural patients. Chapters and Timestamps00:01 Intro00:23 Welcome, and what is on the agenda01:25 California wealth tax and structural deficits11:20 Enhanced ACA subsidies and the shutdown fight16:54 Income caps, zero premium plans, and phantom enrollees21:50 Fraud, Medicaid exposure, and public trust30:39 Medical loss ratio incentives and ACA market fixes38:41 340B: how arbitrage works and why it drives consolidation44:51 What reform could look like47:20 Closing SEO KeywordsAffordable Care Act, ACA subsidies, enhanced subsidies, premium tax credits, exchange plans, zero premium plans, phantom enrollees, medical loss ratio, cost sharing reduction, silver loading, Medicaid fraud, Minnesota fraud, California wealth tax, 340B program, drug arbitrage, hospital consolidation, site neutral payments, commercial mix, Medicare Trust Fund About Our GuestRyan Long is a health policy expert with experience on Capitol Hill, including years in the Speaker's office and on the House Energy and Commerce Committee. He is affiliated with Paragon Health Institute and the University of Southern California. CreditsSponsor: Survivors for SolutionsExecutive Producer: John “CZ” Czwartacki, DC EKG PodcastProducer: Julie Riga, Stay on Course Studios, https://www.stayoncourse.studio

    49 min
  2. 1D AGO

    Healthcare AI Gets Real

    DC EKG with Joe Grogan: A Healthcare Policy Podcast Ep. 122 In this episode of DC EKG with Joe Grogan: A Healthcare Policy Podcast, Joe recaps the first Healthcare AI Policy Summit, held on December 10th in Washington, DC, with his co-host for the event, Naomi Lopez, founder of Nexus Policy Consulting. They walk through the big themes shaping healthcare AI right now: how HHS is approaching AI adoption, what real regulatory clarity could look like, and how new federal initiatives like ACCESS and TEMPO may reshape chronic disease management for Medicare patients. Joe and Naomi unpack HHS Deputy Secretary Jim O’Neill’s view of AI in government, from using large models to improve physician productivity, payment integrity, and care coordination to managing privacy and re-identification risk when working with federal health data. They dig into the ACCESS Medicare payment model and the FDA TEMPO initiative, explaining how these pilots test AI and machine learning tools in real-world chronic disease management (hypertension, diabetes, musculoskeletal pain, and depression), and what that means for Medicare payment models, FDA oversight, and healthcare innovation. The conversation then widens to physician burnout, interoperability, rural care, and the role of states and federal preemption in setting the rules for healthcare AI. If you care about the real-world impact of healthcare AI on policy, payment, and patients, this episode offers a clear, practical summary of what the summit revealed and what to watch next. Today Joe and Naomi cover: Jim O’Neill’s vision for AI at HHS, including internal AI adoption and keeping a direct line open for small innovators. ACCESS and TEMPO as new federal test beds for AI in chronic disease management and Medicare payment. How wearables, remote monitoring, and “virtual ICU” models can support aging in place and reduce pressure on state budgets. Ways AI can reduce documentation burden, support care coordination, and act as a first-line triage tool without replacing clinicians. The emerging idea of personal AI agents that help patients navigate the system and share the right data with clinicians. How AI-enabled diagnostics and tools can expand access in rural and underserved communities. Why interoperability, ONC’s API rules, and the balance between state AI regulation and federal preemption will shape how quickly these tools scale. The potential for tech companies to become Medicare Part B providers under ACCESS, and what that means for reimbursement and competition. Key Takeaways: Healthcare AI is being built into policy through programs like ACCESS and TEMPO, tying AI tools to Medicare payment and FDA pathways in chronic disease management. Regulatory clarity and predictable routes from FDA clearance to Medicare reimbursement are essential for sustained AI adoption. AI is currently most valuable as a force multiplier for physician productivity, taking on administrative and analytic work so clinicians can focus on patients. Personal AI agents may become a primary interface between patients and the health system, coordinating data, benefits, and care. Rural and underserved communities could benefit significantly if payment and regulatory rules support AI-enabled diagnostics and remote care. Interoperability, state AI laws, and federal preemption will determine whether healthcare AI stays in pilots or reaches patients nationwide. Joe's guest, Naomi Lopez, is the founder of Nexus Policy Consulting and a leading voice in healthcare policy, healthcare AI, and state health reform. She co-founded a healthcare AI working group with Joe Grogan and co-hosted the inaugural Healthcare AI Policy Summit on December 10th in Washington, DC.

    48 min
5
out of 5
12 Ratings

About

Join former White House policy expert Joe Grogan as he cuts through the complexities of healthcare legislation and its real-world implications. Each episode of DC EKG aims to demystify the policies shaping our healthcare system, uncovering how these changes impact patients, providers, and payers across the country. New episodes drop every Monday.

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