Managed Care Cast

Dr Elizabeth Warner, chief medical officer at CDPHP, discusses how Wellness Way's focus on patient experience, community partnerships, and integration of physical and mental health care services sets it apart from traditional hospital-based care.

Prompt care supports mental well-being, as hidradenitis suppurativa is often associated with depression and anxiety due to its physical and social challenges.

On this episode of Managed Care Cast, we're talking with Benjamin Ukert, PhD, of Elevance Health's Public Policy Institute. His study, "Racial and Ethnic Disparities in Prior Authorizations for Patients With Cancer," evaluated prior authorization decisions in cancer care by race and ethnicity for commercially insured patients.

In our conversation with Jeff Giullian, MD, MBA, chief medical officer with DaVita Kidney Care, we dive into 4 important aspects of kidney care: prevention, social support, integrated care, and patient support

On this episode of Managed Care Cast, we're talking with Rick Chapman, PhD, chief science officer of the Center for Innovation & Value Research, formerly known as the Innovation and Value Initiative (IVI). We discussed the Center's Rare Disease project, including the primary goals, key discoveries from Phase 1, and what to expect moving forward.

To help celebrate and recognize National Recovery Month, we have brought you another limited-edition month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. In this final episode, we speak with Lyndra Bills, MD, senior medical director, and Shari Hutchison, MS, director of program evaluation and outcomes, both with Community Care Behavioral Health Organization.

Delia Orosco, MS, director of Community Wellness Centers at Inland Empire Health Plan (IEHP), shares insight into innovative initiatives like the mobile mammogram clinics.

To recognize National Recovery Month, we are bringing you another limited-edition month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. In episode 4, Amy Herschell, PhD, associate vice president, Program Implementation and Evaluation, Community Care Behavioral Health Organization, and Jessica Meyers, MSEd, senior advisor for implementation, UPMC Center for High-Value Hea...

On this episode of Managed Care Cast, we're talking with Simon F. Haeder, PhD, MPA, associate professor of public health at Texas A&M University. His study, "When is a Network Adequate? Consumer Perspectives on Network Adequacy Definitions," explored the factors that consumers consider essential for an adequate provider network, including travel times, inclusive care, and language access.

Chris Barton, senior director of Integrated Systems of Care & Network Innovation at Horizon Blue Cross Blue Shield of New Jersey, discusses how the Youth Behavioral Health Strategy program focuses on addressing the specific needs of youth with mental health and substance use issues through a comprehensive approach

To recognize National Recovery Month, we are bringing you another limited-edition month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. In episode 3, we speak with Kim MacDonald-Wilson, ScD, CPRP, senior director, Recovery and Wellness Transformation, and Tracy Carney, CPS, CPRP, senior recovery specialist, both at Community Care Behavioral Health Organization, part of t...

To recognize National Recovery Month, we are bringing you another limited-edition month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. In episode 2, we speak with Rebekah Sedlock, DSW, LCSW, Community Care Behavioral Health Organization, part of the UPMC Insurance Services Division, and Mandy Fauble, PhD, LCSW, UPMC Western Behavioral Health at Safe Harbor.

To recognize National Recovery Month, we are bringing you another limited-edition month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. In episode 1, we speak with Michael Lynch, MD, associate professor of emergency medicine at the University of Pittsburgh and an attending emergency physician and medical toxicologist at the University of Pittsburgh Medical Center.

On this episode of Managed Care Cast, we're talking with Eden Miller, DO, founder of the Diabetes and Obesity Care clinic in Bend, Oregon, which provides high-level obesity intervention and diabetes treatment and prevention. Her study, "Inadequate Insurance Coverage for Overweight/Obesity Management," reviews the US obesity epidemic and discusses insufficient insurance coverage for obesity managem...

On this episode of Managed Care Cast, we're talking with Marge Ciancetta, the product manager of Cotiviti's Star Intelligence solution, which helps health plans and providers improve their Medicare Advantage Star Ratings. We discussed all things Star Ratings, including their importance, how they are calculated, and their impact on plans in 2024. Looking ahead, we also discussed strategies to impro...

On this episode of Managed Care Cast, we're talking with Sreekanth Chaguturu, MD, chief medical officer of CVS Health; Cathy Moffitt, MD, FAAP, CHIE, chief medical officer of Aetna; and Joneigh Khaldun, MD, MPH, FACEP, chief health equity officer of CVS Health. We discuss various topics, including the current challenges in primary and preventive care engagement, the role of trust in patient-provid...

On this episode of Managed Care Cast we speak with Jeffery A. Goad, PharmD, MPH, 2024-2025 president of the National Foundation for Infectious Diseases, on the recent report from the World Health Organization and UNICEF on public immunization rates, with national and global health implications.

On this episode of Managed Care Cast, we're talking with Jason Spangler, MD, MPH, the CEO of the Center for Innovation and Value Research, formerly known as the Innovation and Value Initiative (IVI). We discuss the strengths and limitations of health technology assessment (HTA), one major limitation being its lack of equity. We also touch on IVI's recent rebrand to the Center for Innovation and Va...

Melissa Clarke, MD, CMQ, the chief health equity officer at Elevance Health, explains "Health Equity by Design" and how Elevance Health is committed to ensuring a personalized and intentional approach for all its members, regardless of race or ethnicity, sexual orientation, gender identity, disability, and geographic or financial access.

On this episode of Managed Care Cast, we're talking with Jason Shafrin, PhD, the senior managing director of FTI Consulting's Center for Healthcare Economics and Policy and an adjunct professor in the University of Southern California's Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences. His study, "Quantifying the Insurance Value for Rare Diseases: Duchenne Muscular Dystrophy," estimat...

Today we are bringing you a conversation between 3 experts on paroxysmal nocturnal hemoglobinuria (PNH). Ryan Haumschild, PharmD, MS, MBA, vice president of Pharmacy at Emory Healthcare and Winship Cancer Institute, spoke with Jamie Koprivnikar, MD, of John Theurer Cancer Center; David Dingli, MD, PhD, of Mayo Clinic; and Brian P. Mulherin, MD, of American Oncology Network. The topics of conversat...

On this episode of Managed Care Cast, we're talking with Sreekanth Chaguturu, MD, the chief medical officer of CVS Health. We discuss the impact of recent pharmaceutical innovations, namely glucagon-like peptide-1 (GLP-1) receptor agonists and biosimilars, on patient health outcomes. Also, we explore the role of trust between patients and providers in adopting new medications, along with initiativ...

Kim Zynn, vice president of UPMC Health Plan's provider network and development relations team, shares how physicians can become LGBTQIA+ affirming providers, which is designated within the health plan.

Douglas Weber, MD, explains how zuranolone has changed the landscape for postpartum depression treatment, addressing a gap in care within the specialty.

Charlie Borowicz, manager of trans and gender diverse health at Allegheny Health Network, shares how the program offers comprehensive patient-first care to those in the LGBTQ and gender diverse community.