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
Wednesday Jan 03, 2024
Best of 2023 - Number 1
Wednesday Jan 03, 2024
Wednesday Jan 03, 2024
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. A medical director at his insurance company denied PET scan for being “not medically necessary” as Dr. Hurley and his physician were fighting to figure out how to best treat his cancer. Tragically, that decision may have cost him his life. Appropriately, as we continue to work to better our healthcare system in his memory, our most listened to episode of 2023 was Matthew's interview with Dr. Dan Hurley.
New episode next week!
Wednesday Dec 27, 2023
Best of 2023 - Number 2
Wednesday Dec 27, 2023
Wednesday Dec 27, 2023
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.
Next week: the most popular episode of 2023.
Wednesday Dec 20, 2023
Best of 2023 - Number 3
Wednesday Dec 20, 2023
Wednesday Dec 20, 2023
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 died during the COVID-19 pandemic and what that means for our healthcare system going forward.
Next week, Matthew shares the second most popular episode of the year.
Wednesday Dec 06, 2023
Ep. 72 - Possible Cigna / Humana Merger
Wednesday Dec 06, 2023
Wednesday Dec 06, 2023
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 alternatives” to the Affordable Care Act.
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Articles mentioned in this program:
Reports of Cigna and Humana merger - Matthew Handley at FLATLINING.net
The 543-word editorial that may have just upended the presidential campaign - POLITICO
Wednesday Nov 29, 2023
Pulse Check on the Candidates: Nikki Haley
Wednesday Nov 29, 2023
Wednesday Nov 29, 2023
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 Strategies President and CEO Ron Howirgon and Matthew Handley discuss Haley's proposals, their viability, and how they might affect American healthcare.
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Pulse Check on Robert F. Kennedy, Jr.
Pulse Check on Perry Johnson
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Articles mentioned in this program:
Nikki Haley is coming for your retirement - Paul Krugman in the New York Times
Nikki Haley's Medicare Advantage - The Editorial Board of the Wall Street Journal
Nikki Haley Calls For Eliminating 'Certificate of Need' Bills [sic] to Lower Medical Costs - Timcast
Wednesday Nov 15, 2023
Ep. 71 - AMA debates ban on corporate medicine
Wednesday Nov 15, 2023
Wednesday Nov 15, 2023
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 AMA Debates a Federal Ban on Corporate Medicine - The American Prospect
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Wednesday Nov 08, 2023
Ep. 70 - BREAKING: Cigna may sell its Medicare Advantage business
Wednesday Nov 08, 2023
Wednesday Nov 08, 2023
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? Matthew Handley and Fulcrum Strategies CEO Ron Howrigon (also a former Cigna executive) discuss.
Reuters - Cigna explores shedding Medicare Advantage
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Wednesday Nov 01, 2023
Ep. 69 - UnitedHealthcare’s new variable co-pay product
Wednesday Nov 01, 2023
Wednesday Nov 01, 2023
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 to be on the lookout for new plans?
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Wednesday Oct 25, 2023
Ep. 68 - Let doctors be doctors
Wednesday Oct 25, 2023
Wednesday Oct 25, 2023
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 for Medicaid patients. What does risk mean in the healthcare world and should providers take on risk?
BCBS North Carolina to purchase more than 50 FastMed urgent care clinics - Becker's Payer Issues
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Wednesday Oct 18, 2023
Ep. 67 - What the new CMS guidance on NSA means for your group
Wednesday Oct 18, 2023
Wednesday Oct 18, 2023
The Centers for Medicare and Medicaid Services issued new guidance for the No Surprises Act after the previous guidance was struck down in federal court. In short: the Department of Health and Human Services handed a win to the insurance companies that will surely end up back in court. Fulcrum Strategies president and CEO Ron Howrigon discusses with Matthew Handley what it means for emergency medicine doctors, radiologists, and anesthesiologists.
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About Fulcrum Strategies
Fulcrum Strategies is a health care consulting firm specializing in payer contract negotiation and strategic planning for physician practices founded in 2004 by Ron Howrigon, a former managed care executive. After 18 years working for various national payers, Ron became disillusioned with what he saw happening to physicians, particularly their declining reimbursement. In founding Fulcrum, Ron’s goal was to provide medical practices with professional negotiation resources in order to produce better managed care contracts for medical professionals. Almost two decades later, our organization has helped over 5,000 physicians in groups of all sizes and specialties across the country to significantly improve their contract language and reimbursement rates, strategically plan for the future, and achieve business success.