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 treat…

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 Pol…

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 …

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, Desa…

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 eve…

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 idea…

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 Ju…

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, a…

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 th…

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 hi…

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:…

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 t…

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 legislator…

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 sign…

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 als…

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 congressio…

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 wi…

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…

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…

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 investo…

With flu season fast approaching, Dr. Paul Offit joins us to discuss all of his vaccine recommendations, including COVID-19, RSV, and flu vaccines, population immunity, and targeting high-risk groups. Plus, Terry and Bob talk about why insurers are marking up the prices of generic drugs – which should be a cheaper option for patients. Generic Drugs…

Hope can be powerful when receiving a diagnosis… but are we able to quantify just how powerful it really is? Carol Graham joins us to discuss how she believes the U.S. should be using “hope” as a measurement of both social and economic well-being. Plus, how hope and optimism can change outcomes for patients. And Terry and Bob tell us about the lack…

Mark King’s advocacy journey began in the 1980s after he was diagnosed with HIV. Now, he’s written a book that discusses his advocacy journey, the struggles of living with the disease, and the stigma that comes with it. Hear how he has coped over the years, and what he hopes for the next generation of advocates. And Terry and Bob discuss a few stor…

For Neal Shah, life was going according to plan. Then suddenly, he became a caregiver overnight. Hear how his experience pushed him to create CareYaya, which he calls the “Uber of caregiving.” It’s a matchmaking system that pairs pre-med college students with families in need of a caregiver to provide companionship and day-to-day support for a love…

Investing in healthcare like we invest in curbing carbon emissions. It’s a novel idea, but something that Dr. Andrea Feigl, the Founder and CEO of Health Finance Institute, says could change the future of health, specifically chronic disease management. And Terry and Bob discuss a brand new survey from Patients Rising that’s all about patients and …

Mel Mann was diagnosed with a cancer known as CML and given three years to live. That was in 1995. Today, in 2023, Mel Mann is still living and still advocating – all thanks to accelerated approval and a clinical trial. Hear the story of how this Army vet, and longest-living Gleevec patient, beat the odds and stands here today. And Terry and Bob di…

What do patients really think about clinical trials? Do they trust them? Are they wary? Today’s episode features Jim Sliney Jr., who breaks down a survey project from Patients Rising that determined some surprising results. We also speak with Myisha Malone-King, a patient advocate who was diagnosed with Crohn’s disease over 14 years ago and who rec…

One mom’s journey into patient advocacy started after two of her daughters were diagnosed with galactosemia, a rare disease. There’s finally a potential new treatment for this condition, which families say has helped their children who have participated in the clinical trial. But they’re worried their voices are being ignored. Jodie Solari, Communi…

This week’s episode dives into the concept of running a clinical trial before ever running a clinical trial. How is that possible? It’s an idea called digital twins & we have an expert interview to break it down. Colin Hill, CEO and Co-Founder of Aitia shares how this AI-powered approach can make drug testing and discovery more efficient for diseas…

The first episode featuring our Health Plan Heroes was so good – we decided to do a second one. Listen now to see how these businesses have reinvented their health plans to provide top-tier coverage at a fraction of the cost. Plus, did you miss this year’s Fly-In or just want to get a jump on next year’s? Registration is already open for the 2024 e…

It’s here! The 2023 We the Patients Fly-In is THIS WEEK and we have several Health Plan Hero Winners on the podcast to discuss their health insurance success stories as they get ready to accept their awards in person in Washington D.C. Plus, Terry and Bob lay out all the policy priorities patients will be advocating for on Capitol Hill during the F…

RSV immunizations for infants are on the way, but still have a large hurdle to clear. Ronda Miller-Ernest, a pediatric nurse practitioner with more than 30 years of experience, joins us to discuss the dangers of RSV, her personal experience, and why it’s important that future immunizations are available through the Vaccine for Children Program. Plu…

UnitedHealthcare makes a confounding decision that could affect countless patients starting June 1st. Gastroenterologist Dr. Bruce Hennessy joins us to discuss how new prior authorizations for colonoscopies and other screenings could delay cancer diagnosis and subsequent care. Plus, Terry and Bob dive into the healthcare news of the week, including…

C. diff, an infectious disease can be deadly for many – but especially those with compromised immune systems. We speak with a member of the Patients Rising team about their run-ins with the disease and learn how you can best protect yourself. And Terry and Bob dive into the healthcare news of the week, including an article written by Bob himself wi…

May marks National Stroke Awareness Month and this week we’re speaking with a stroke survivor who wants to make sure if a stroke ever happens to you – you’ll know all the signs. Hear Stacy Quinn’s personal story and how delaying care almost cost her everything. And Terry and Bob dive into the healthcare news of the week, including FDA approval of t…

Another week, another middleman making it harder for patients to get the care that they need. This week, we learn more about Group Purchasing Organizations – also known as GPOs – and how they cause drug and supply shortages across the spectrum of care. And Terry and Bob dive into the healthcare news of the week, including an opinion piece in The Wa…

So often on the Patients Rising Podcast, we discuss the affordability of healthcare. This week, guest Peter Kolchinsky outlines how thinking of paying for medicines like paying for a house mortgage leads to lower costs for patients, and encourages investment in the cures of tomorrow. Plus, Terry and Bob look at the latest healthcare headlines, incl…

For many patients living with chronic illness the idea of “fundraising” isn’t just a child’s bakesale to pay for a field trip, it’s a necessity to pay for life-saving treatment. On this week’s podcast we speak with Sonny Mullen, Director of Outreach at Help Hope Live, an organization that has been raising money to cover medical expenses since 1983.…

AI is having its moment in all industries, including healthcare. In this episode, hear how AI-driven tools can help oncologists treat patients. Navid Alipour, CEO of CureMatch, talks about the role of AI in care and how it helps doctors do their jobs. And Terry and Bob dive into the latest healthcare headlines, including Mark Cuban’s Cost Plus Drug…

The ability to catch cancer early on can greatly improve a patient’s outcome. But most cancers don’t have a traditional, routine screening. That means many patients may have cancer but not show symptoms until the disease progresses. By then, treatment options may be limited. To spot cancer earlier, GRAIL has developed a blood test that screens for …

Mystery healthcare prices leave patients in the dark. But thanks to hospital and insurer price transparency rules, those costs are being made public. The catch? The files that contain those prices aren’t easy for consumers to read. Health tech companies have stepped up to decipher these files and make it easier for patients to shop for care. Mark G…

Get a look at the behind-the-scenes math that often determines whether or not insurance will cover the costs of treatments. Health technology assessments attempt to determine the value of a new treatment. But not all of these equations take into account patient voices, experiences, and needs. That includes the QALY - a discriminatory health care me…

Lack of transportation is one of the biggest barriers to patient care. But when employers cover transportation for patients, it can lead to better health outcomes and lower overall costs. Casey Billington of Concierge Nurse Navigators explains why employers need to incorporate transportation into their health plan benefits so that patients can trav…

Vertical integration in the vision insurance market has led to higher costs and fewer options for patients. Two optometrists, Dr. Ron Benner and Dr. Bill Reynolds, explain how this impacts the price of your glasses, and how the DOC Access Act could fix this problem. And Terry and Bob break down a new poll that shows consumers support FDA regulation…

The Patients Rising Podcast has moved to Monday mornings! In this episode, hear how Florida is poised to take on PBMs, the pharmaceutical middlemen, and how potential reforms would help patients access affordable medications. Jared Willis gives his updates from the Sunshine State. And a shortage of kidneys available for transplants has patient advo…

Ahead of Rare Disease Day, Congresswoman Cathy McMorris Rodgers (WA-05) joins the podcast to discuss new legislation that would ban the use of a discriminatory health care metric, quality adjusted life year, or QALY. Learn how the QALY hurts treatment access for patients with rare diseases and disabilities, and how a government ban on QALYs would c…

Current barriers to clinical trial access make it difficult for patients from underserved communities to access cutting edge care. Those barriers include restrictive eligibility criteria, which can lead to an underrepresentation of racial and ethnic minorities in clinical trials. Lucile Adams-Campbell, Ph.D., breaks down those barriers and outlines…

Stephen Kay took a job 10 hours away from his wife. Why? Because he needed insurance that would cover the costs of her multiple sclerosis care. While she had Medicare before turning 65, she was unable to purchase a supplemental plan, or Medigap plan, to cover her major costs. This is a reality facing numerous patients who live with disabilities, in…

Over the past 30 years, cancer death rates have declined by 33%. Ahead of World Cancer Day, hematologist Dr. Rafael Fonseca joins the podcast to talk about the latest innovations and improvements in cancer care delivery that have contributed to this decline. Plus, many patients with chronic diseases depend on employer-sponsored health plans. But lo…

This year, six biosimilars for the top-selling medicine, Humira, will enter the market, with the first launching on January 31, 2023. Increased competition from biosimilars can drive down costs. But experts argue that insurers and pharmacy benefit managers will receive those savings – not patients. On this episode, hear from pharmacists, health eco…