Managed Care Cast

On today’s episode of Managed Care Cast, we feature a short excerpt of an upcoming interview in the August issue of The American Journal of Managed Care® with Mandy K. Cohen, MD, MPH, North Carolina's secretary of the Department of Health and Human Services, as part of our yearlong Q&A series. We discussed the state's upcoming transition to Medicaid managed care, the pandemic, her advice to public...

Every week, The American Journal of Managed Care® recaps the top managed care news of the week. This week, the top managed care news included states facing COVID-19 spikes reporting health coverage losses; new COVID-19 data protocol raises concerns; and experts discuss key steps to reduce racial inequities in cancer care. Learn more about the stories in this podcast: States Facing COVID-19 Spikes...

Routine preventive screenings and vaccination rates have decreased due to the coronavirus disease 2019 (COVID-19) pandemic, while the Director of the National Cancer Institute recently warned delays in cancer screenings are likely to result in thousands of excess deaths. At the same time, a recent study found the pandemic could create losses of up to $15 billion for primary care practices. To find...

Every week, The American Journal of Managed Care® recaps the top managed care news of the week. This week, the top managed care news included CMS planning to pay more for at-home dialysis equipment; ACR supports continued use of telemedicine after the COVID-19 pandemic passes; coverage of AIDS 2020, the 23rd International AIDS Conference. Read more about the stories in this podcast: CMS Seeks Ince...

Medication access barriers and nonadherence significantly impact medication underuse in the United States. This issue is estimated to cost the country’s healthcare system between $100 billion to $290 billion annually, as patients who underuse medication are more likely to have complications, which can result in costly health care utilization. Recently, The Pharmacy Quality Alliance (PQA) and Natio...

The last decade has brought great strides in diabetes care. Better insulins and better technology can allow people with diabetes—both type 1 and type 2—to keep their blood sugar from rising and falling in ways that cause long-term damage to their eyesight and vascular systems. New classes of drugs for patients with type 2 diabetes have been shown to cut the risk of heart and renal failure, and mor...

The significant effect of the COVID-19 pandemic on mental health was spotlighted in a recent collaborative study conducted by the National Alliance of Healthcare Purchaser Coalitions, Total Brain, and One Mind. Compared with before the pandemic began, study findings indicate stark increases in rates of depression, anxiety, and stress, with women shown to be at a greater risk. On this episode of Ma...

Every week, The American Journal of Managed Care® recaps the top managed care news of the week. This week, the top managed care news included CMS proposing rules for value-based contracting in Medicaid; claims data highlighting racial disparities in COVID-19 effects; an interview with Anthony Fauci, MD, on the progress made against HIV. Read more about the stories in this podcast: CMS Issues Rules...

Older and poorer Americans are disproportionately affected by the coronavirus disease 2019 (COVID-19) pandemic. In this episode of Managed Care Cast, we speak with Richard Shinto, MD, MBA, president and CEO of InnovaCare Health, about the company’s care of their Medicare Advantage and Medicaid beneficiaries in Puerto Rico during the COVID-19 pandemic. He last spoke with us in 2018 about the effect...

Every week, The American Journal of Managed Care® recaps the top managed care news of the week. This week, the top managed care news included more details about the COVID-19 vaccine process; attempts to reinforce social distancing amid reopening; a recap of the American Diabetes Association 2020 Virtual Scientific Sessions. Read more about the stories in this podcast: US Releases More Details Abou...

The ramifications of the COVID-19 pandemic has caused uncertainty among employers nationwide adjusting to this new normal. Notably, viable health care coverage has emerged as an essential necessity, with employees seeking favorable benefits. A recent analysis by Willis Towers Watson indicates that individual markets, once characterized as volatile, have emerged as an option now associated with sta...

In this episode of Managed Care Cast, we speak with the lead author of a study in the June issue of The American Journal of Managed Care® about the nationwide dearth of suppliers of the Medicare Diabetes Prevention Program, which aims to reach older adults with prediabetes. Natalie D. Ritchie, associate research scientist in the Denver Health and Hospital Authority Office of Research and an assist...

Every week, The American Journal of Managed Care® recaps the top managed care news of the week. This week, the top managed care news included HHS distributing COVID-19 funds to Medicaid and CHIP providers; the National Kidney Foundation issues a statement on health disparities and racial violence; a preview of our coverage of the American Diabetes Association 2020 Virtual Scientific Sessions. Read...

Chronic musculoskeletal pain costs the United States hundreds of billions of dollars each year. Now, with the coronavirus disease 2019 (COVID-19) pandemic, healthcare providers are tasked with providing optimal care to patients while minimizing human contact as much as possible. On this episode of Managed Care Cast, we speak with Jeffrey Krauss, MD, chief medical officer of Hinge Health and Stanfo...

Every week, The American Journal of Managed Care® recaps the top managed care news of the week. This week, top managed care stories included an additional setback for Medicaid work rules; another study finding more benefits from SGLT2 inhibitors; researchers finding unwanted end-of-life care causes stress. Read more about the stories in this podcast: OCM, Other APM Timelines Extended Due to COVID-...

In this episode of Managed Care Cast, we speak with the lead author of a study in the May issue of The American Journal of Managed Care® about the shift in new accountable care organizations (ACOs) from being led by hospital systems to being led by physician groups, and the accompanying policy shifts that are needed. David Muhlestein, the chief strategy and chief research officer at Leavitt Partne...

Amid COVID-19, patients with Parkinson disease have had to adjust to the physical and mental challenges precipitated by the pandemic. Notably, those with Parkinson disease, who are already linked with heightened feelings of stress and anxiety, may be further at risk. On this episode of Managed Care Cast, we speak with Rachel Dolhun, MD, vice president of Medical Communications at The Michael J. Fo...

In a prior study, nearly 7 in 10 employees indicated in a survey that the COVID-19 pandemic is the most stressful time of their entire professional career. Researchers from Lyra Health, an employee behavioral health provider, recently conducted a study examining the efficacy, in real-world circumstances, of a structured, cognitive behavioral coaching program delivered through video or telephone. O...

Against a backdrop of the health care and cost concerns stemming from the COVID-19 pandemic, the April issue of The American Journal of Managed Care® features an interview with Dr. Sherry Glied,  health economist and dean of New York University’s Robert F. Wagner Graduate School of Public Service, about the Affordable Care Act and Medicaid, as well as the vital role that public service leadership...

The 2020 Community Oncology Conference, hosted by the Community Oncology Alliance (COA), will take place virtually on April 23 and April 24. The American Journal of Managed Care® (AJMC®) is bringing you a series of previews so you can learn more about what to expect when you attend this virtual meeting. In this interview we speak with Debra Patt, MD, MPH, MBA, executive vice president of policy an...

The 2020 Community Oncology Conference, hosted by the Community Oncology Alliance (COA), takes place virtually on April 23 and April 24. The American Journal of Managed Care® (AJMC®) is bringing you a series of previews so you can learn more about what you'll hear when you attend this virtual meeting. In this interview we're speaking with Lee Schwartzberg, MD, FACP, the chief medical director of W...

Complex care management programs aim to improve health outcomes of high-cost, high-need patients through coordinating medical and social services. In general, Medicaid patients have high rates of chronic conditions and often utilize preventable acute care, leading to avoidable spending. To determine the impact complex care management programs can have on Medicaid beneficiaries, researchers conduct...

Efforts to ensure that veterans have timely access to healthcare include community partnerships and the Veterans Choice Program, but new research suggests that women veterans may be receiving less care, particularly those who report unstable housing or mental/behavioral health issues, On this episode of Managed Care Cast, we speak with Laurel A. Copeland, PhD, about the paper “Gender Differences i...

Prior authorizations play a key role in checking on the safety and appropriateness of medical treatments among patients, but when they take too long, efficiency of care suffers. On this episode of Managed Care Cast, we speak with April Todd, senior vice president, CORE and Explorations for CAQH, on CAQH CORE’s recent approval of a 2-day rule for health plans in requesting additional supporting inf...

This week, top managed care stories included an additional setback for Medicaid work rules; another study finding more benefits from SGLT2 inhibitors; researchers finding unwanted end-of-life care causes stress.