Jim Scott,

President and CEO

This is, no doubt, a time of upheaval for those of us who are committed to improving lives by improving our healthcare system. But even during this time of extraordinary change, there are enduring constants that ground our work. The health system in the United States continues to be shaped by three dominant forces: the administration and agencies of the federal government; Congress, which creates the legal framework and funding for existing and new programs, such as Medicare and Medicaid and the more recently created ACA; and the private sector, composed of a variety of entities, including pharmaceutical companies, hospitals, patient advocacy groups, insurance companies, and professional associations, to name a few. 

The company that I founded 16 years ago is, of course, part of the private sector. Before launching Applied Policy, I had experience at a major pharmaceutical company, at the Centers for Medicare & Medicaid Services implementing the Medicare Modernization Act, and on Capitol Hill, where I helped to shape the legislation that created Medicare Part D drug coverage, the Medicare Advantage Program, and added several preventive services to the Medicare program. 

Given that I had worked in a variety of settings, colleagues often have asked what inspired me to land in the private sector, creating a consulting firm focused on healthcare reimbursement. 

There was, of course, the motivation to shape my own business, test myself as a manager, and reap the results of my efforts. More than that, I wanted to have the latitude to offer a variety of creative approaches to solve new and recurring problems that prevented or slowed the delivery of superior healthcare to patients who deserved and needed it. This latitude, housed in the private sector, has become even more important as we navigate this new environment, which demands new approaches. 

I invite you to join me and my staff here at Applied Policy as a client or colleague. As daunting as it may seem, I’m confident that we can manage this time of change to ensure that we discover and seize on the opportunities it presents to improve the lives of patients served by CMS programs. 

ACIP: The Committee Shaping National Vaccine Policy

Shortly after casting a pivotal vote to advance Robert F. Kennedy Jr.’s nomination for Secretary of Health and Human Services (HHS) this week, Senator Bill Cassidy (R-La.) took to the Senate floor to explain his decision.

Cassidy, a physician and member of both the Finance and Health, Education, Labor, and Pensions (HELP) committees—before which Kennedy had testified—had previously expressed hesitation about the nomination, citing Kennedy’s past statements questioning vaccine safety. When it came time for the Finance Committee to vote, Cassidy was seen as critical to moving the nomination forward.

In his remarks, Cassidy stated that after multiple conversations with Kennedy, he was confident the nominee would “maintain the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices’ recommendations without changes.”

While those who have followed Kennedy’s nomination are familiar with the controversy surrounding his past statements on vaccines, many are not aware of the work of the Advisory Committee on Immunization Practices (ACIP)—the committee that shapes national vaccine policy and to which Kennedy could have the option of making multiple appointments as HHS Secretary. Understanding ACIP’s structure and function is key to appreciating the significance of Cassidy's statement.

Providers Await Clarity on Telehealth Flexibilities

By Simay Okyay McNutt

Community Health Centers: The Basics

Introducing our Executive Order Tracker

Applied Policy Welcomes Hugh O'Connor

Hugh O'Connor

Health Policy Associate

Hugh O’Connor, MPA, has joined Applied Policy as a Health Policy Associate.

O’Connor comes to Applied Policy from Acumen, LLC, where he was a Data and Policy Analyst and served as the lead author for two proposals included in the Inpatient Rehabilitation Facilities and Long-Term Care Hospitals final rules and for one quality measure.

In welcoming O’Connor, Applied Policy COO John Voorhees highlighted his data and policy analysis skills, as well as his writing ability.

“Not only can Hugh interpret complex datasets, but he can also convey his understanding as clear and actionable policy insights,” Voorhees said. “That combination is a value-add when representing our clients’ interests.”

O’Connor earned his Bachelor of Arts in History with honors and his Master of Public Affairs from Brown University. While at Brown, he served as a research assistant to Professor Seth Rockman, focusing on “small bill” laws in the early 19th-century United States. He also previously served as a consultant to the U.S. Coast Guard and completed an internship at Partnership for a Secure America.

Outside work, O’Connor enjoys reading, travel, and photography. He holds a second-degree Black Belt in Tae Kwon Do and Hapkido.

Read O'Connor's full bio here.

NVHPF Hosts Its First Reporters' Panel of 2025

Friday, Feb. 7, at noon ET

The Northern Virginia Health Policy Forum is honored to host Phil Galewitz of KFF, Maya Goldman of Axios, and John Wilkerson of STAT in conversation with Applied Policy President and CEO Jim Scott.

On January 23 and 24, the Medicaid and CHIP Payment and Access Commission held a virtual public meeting, which included the following sessions:

• Timely Access to Home-and Community-Based Services
• Home- and Community-Based Services Payment Policy Option
• Vote on Recommendations for the March Report to Congress

The Medicare Payment Advisory Commission held a virtual public meeting on January 16 and 17. The meeting’s sessions focused on chapters that will appear in MedPAC’s March 2025 Report to Congress, which will be released by March 15, 2025.

Topics covered included:

• Assessing payment adequacy and updating payments: Physician and other health professional services
• Assessing payment adequacy and updating payments: Hospital inpatient and outpatient services
• Assessing payment adequacy and updating payments: Skilled nursing facility services, home health agency services, inpatient rehabilitation facility services, outpatient dialysis services, and hospice services
• Eliminating Medicare’s coverage limits on stays in freestanding inpatient psychiatric facilities
• Medicare prescription drug program (Part D): Status report
• Ambulatory surgical center services: Status report
• The Medicare Advantage program: Status report
• Reducing beneficiary cost-sharing for outpatient services at critical access hospitals

February 18-20

Medtrade 2025

February 26-27

Meeting of the Advisory Committee on Immunization Practices (ACIP)

February 27-28

MACPAC Public Meeting

March 6-7

MedPAC Public Meeting

On Our Bookshelf

Doctored: Fraud, Arrogance, and Tragedy

in the Quest to Cure Alzheimer's

It isn’t often that the term “muckraking journalist” is used as a compliment. Yet, Aaron Rothstein, M.D., employs it with appreciation in his review of Charles Piller’s book, Doctored: Fraud, Arrogance, and Tragedy in the Quest to Cure Alzheimer’s.

Writing in the Wall Street Journal, Rothstein—a neurologist and bioethicist—notes that his work with stroke patients was among the several research projects halted in 2023 after Science published an article in which Piller alleged extensive fraud in Alzheimer’s research. Rothstein acknowledges that, without Piller’s investigative reporting, he might have been placed in a position to put “patients at risk while offering groundless hope.”

Doctored expands on the revelations in Piller's original article, offering a meticulously researched investigation into scientific misconduct in Alzheimer’s research. It examines image and data manipulation, the influence of ego and group dynamics, and the weaknesses in the peer review and government oversight processes meant to uphold scientific integrity.

Piller’s book arrives at a critical moment. Escalating rates of dementia have made the work of ethical Alzheimer’s researchers more important than ever. At the same time, public trust in both scientific research and government health agencies continues to erode. Yet Piller doesn’t intend to fuel conspiracy theories. When asked about the intersection of Doctored and the growing public pushback against science, Piller emphasized, “We are very fortunate in the United States to have important and very effective institutions of science that have well guarded the drug supply and the food safety of our nation.” He said that his book is meant to offer a critical examination of how scientific institutions can be improved. When institutions and research are under assault, the best defense may very well be to acknowledge and address their weaknesses.

Why was the dermatologist fired?

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