A major study shows that investing in primary care and managing disease states could reap huge savings and improve outcomes.

About The Podcast:

Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.

Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change.

Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible, incisive deep dives on the most pressing issues and events in American healthcare.

Marc seeks to help Americans become wiser consumers and navigate the healthcare maze with more confidence and certainty through The Healthcare Labyrinth website and his book of the same name.

Marc is an unconventional Republican who believes that affordable universal access is a wise and prudent investment. He recommends common-sense solutions to reform American healthcare.

Tune in every week as Marc examines the latest developments in the space, offering analysis, insights, and predictions on the changing state of healthcare in America.

About The Episode:

On this episode, Marc discusses a major study showing investments in primary care and managing disease states could reap huge savings and improve outcomes.

Key Takeaways:

America spends the most on healthcare but has the worst outcomes.

One reason is the lack of focus on primary care and management of disease states.

America has huge inpatient costs due to admissions for uncontrolled conditions.

Forty-three percent of patients with diabetes and heart disease are not treated at all with evidence-based treatments and only 20% are treated adequately based on evidence.

Wakey Consulting finds that annual wellness visits (AWVs) can demonstrably help control costs among Medicare beneficiaries.

Wakley found that AWVs are considerably underutilized. About 45% of beneficiaries had just one or no such visits during the study period.

But showing how such visits can reduce costs and improve outcomes, Medicare beneficiaries who had 4 to 6 visits during the study period had lower inpatient and emergency department spending.

Those who received AWVs had an average $885 reduction in total costs per beneficiary per year. The $885 is almost 6% of Parts A and B spending in 2024.

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THL Podcast

Resources:

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The Healthcare Labyrinth: A Guide to Navigating Health Plans and Fixing American Health Insurance

As always at the end of the year, I recap healthcare happenings and tell you my predictions for the new year – just don't hold me to them!

About The Podcast:

Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.

Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change.

Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible, incisive deep dives on the most pressing issues and events in American healthcare.

Marc seeks to help Americans become wiser consumers and navigate the healthcare maze with more confidence and certainty through The Healthcare Labyrinth website and his book of the same name.

Marc is an unconventional Republican who believes that affordable universal access is a wise and prudent investment. He recommends common-sense solutions to reform American healthcare.

Tune in every week as Marc examines the latest developments in the space, offering analysis, insights, and predictions on the changing state of healthcare in America.

About The Episode:

On this episode, Marc discusses the healthcare happenings in 2025 and makes some predictions for 2026.

Key Takeaways:

It was a busy year in healthcare with insurer woes, a new president, and a decidedly different healthcare policy approach.

The One Big Beautiful Bill dominated a lot of the news in the first half of 2025. It led to a massive tax cut package that cut healthcare in Medicaid and the Exchanges by $1 trillion over ten years.

The government shutdown for a record 43 days over whether Exchange subsidy enhancements would be extended. So far, they were not.

President Trump laid out an aggressive drug price reform agenda and so far has gained a lot of concessions and is pressing on with most-favored-nation price reform.

There was an insurer meltdown that led to executive changes and massive realignment and contraction in the industry, especially in Medicare Advantage (MA).

A PwC report said that there would be huge digital investments and a move to personalized care. $1 trillion would be spent annually on the tech transformation in healthcare by the mid-2030s.

My 2025 prediction report card was pretty good. I correctly forecast deep cuts in healthcare, a healthcare shakeup by Trump, drug price reform, and the expiration of subsidies at year's end.

My 2026 predictions include a striking of drug tariffs by courts, another GOP healthcare bill, Congress and CMS pushing many MA reforms, and Democrats taking back the House in midterms.

Connect With Marc:

Marc on LinkedIn

Marc on Twitter

THL Podcast

Resources:

THL's Newsfeed

THL's Blog

The Healthcare Labyrinth: A Guide to Navigating Health Plans and Fixing American Health Insurance

Each year I help people make their open enrollment decisions. These stories tell us just how unaffordable healthcare is in America.

About The Podcast:

Millions of Americans feel confused and frustrated in their search for quality healthcare coverage.

Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change.

Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible, incisive deep dives on the most pressing issues and events in American healthcare.

Marc seeks to help Americans become wiser consumers and navigate the healthcare maze with more confidence and certainty through The Healthcare Labyrinth website and his book of the same name.

Marc is an unconventional Republican who believes that affordable universal access is a wise and prudent investment. He recommends common-sense solutions to reform American healthcare.

Tune in every week as Marc examines the latest developments in the space, offering analysis, insights, and predictions on the changing state of healthcare in America.

About The Episode:

On this episode, Marc discusses the counseling he does to help people make their open enrollment decisions. These stories tell us just how unaffordable healthcare is in America.

Key Takeaways:

Each year I help many people make their open enrollment decisions.

One person just got a subsidy due to a quirk in the law in states that did not expand Medicaid under the Affordable Care Act. But the stats show that a reasonable Silver plan still costs over $800 per month for age 30.

One person's income will now mean he does not get any subsidy if the enhanced premium subsidies expire. He will pay about $20,000 in premiums for a family of two before and deductibles or cost-sharing.

I helped two elderly people find the right Part D coverage even with the major financial challenges in the program.

One person is 63 and desperately awaiting Medicare coverage. She relies on the Exchanges and given her income and age can only afford a Bronze plan with limited upfront coverage right now.

Statistics in the employer, Exchange, and Medicare worlds all show rising unaffordability of healthcare.

It is time to reexamine minimum essential benefits, provider pricing in healthcare, and how we think about comprehensive coverage.

Rich benefits ae useless if you cannot afford the policy or use the benefits.

Connect With Marc:

Marc on LinkedIn

Marc on Twitter

THL Podcast

Resources:

THL's Newsfeed

THL's Blog

The Healthcare Labyrinth: A Guide to Navigating Health Plans and Fixing American Health Insurance