Managed Care Cast

On this episode of Managed Care Cast, we speak with Tham Le, PhD, MPH, and Linda Wastila, PhD, MSPH, lead and senior authors, respectively, of “Patterns of Opioid Use in Commercially Insured Patients With Cancer,” which was published in the May issue of The American Journal of Managed Care®. They took up their investigation after finding that most previous similar studies of opioid use focused on...

Drug overdose deaths are skyrocketing, with more than 100,000 people dying in 2021, according to the CDC. Obtaining treatment for substance use disorders (SUDs) has never been easy, and this month in Health Affairs, a recent paper examined trends in the use of treatment services to see what, if anything, changed from 2010 to 2019. Despite an increase in insurance coverage over much of that time pe...

On this episode of Managed Care Cast, we speak with Dr Joanne Armstrong, vice president and chief medical officer for Women’s Health and Genomics at CVS Health, on the distinct pathophysiology of cardiovascular disease in women, applicability of current screening and care delivery guidelines for heart health in regards to minority populations, and how her own health experiences have influenced her...

April is Parkinson’s Disease Awareness month, and on this episode of Managed Care Cast, we take a look at the Parkinson's Progression Markers Initiative (PPMI), a study from the Michael J. Fox Foundation for Parkinson's Research (MJFF). The multicenter, international study aims to end Parkinson disease, which is expected to double worldwide by 2040, to more than 14 million people. The study is inv...

In 2018, the FDA approved a record 66 novel drugs. Among them were cancer treatments, orphan drugs for rare diseases, drugs under expedited review, and biosimilars. However, access to each of these drugs for patients covered by different health plans was not uniform. On this episode of Managed Care Cast, we speak with Ari D. Panzer, BS, a master of public policy candidate at Duke University, and l...

Entering its 51st year, the American Kidney Fund has made it its mission to help all patients affected by chronic kidney disease (CKD), which is the fastest-growing noncontagious disease in the United States: from those at risk for chronic kidney disease through patients requiring dialysis and/or transplant. First and foremost is uncovering the primary cause of their kidney failure. Unfortunately,...

It’s well known the state of maternal morbidity and mortality in the United States is subpar. From stark racial disparities in maternal deaths to a severe shortage of midwives and doulas, birthing people in the United States face unique challenges not seen in other high-income countries. Plus, the recent increase in legislation aimed at curbing abortion access throughout the nation may serve to ex...

National Public Health Week, the annual initiative from the American Public Health Association, falls within the first full week of April. On this episode of Managed Care Cast, to mark the conclusion of National Public Health Week this year, which ran from April 4-10, we speak with Perry N. Halkitis, PhD, MS, MPH, dean of the Rutgers School of Public Health, who is also a public health psychologis...

In January 2022, Vanderbilt University Medical Center, Meharry Medical College, and the University of Miami Miller School of Medicine announced the receipt of a $12.4 million grant from the National Institutes of Health to develop the Southeast Collaborative for Innovative and Equitable Solutions to Chronic Disease Disparities. The center’s work aims to reduce disparities seen in the southeast Uni...

An unprecedented level of detail and robustness around interoperability standards is on its way, and on this episode of Managed Care Cast, we speak with Donald Rucker, MD, the former National Coordinator for Health Information Technology in HHS, about what the opportunities and responsibilities for payers are. The change is precipitated by 2020 rulemaking regarding the 21st Century Cures Act requi...

Within Virginia, one of 13 states that fall within the Appalachian region of the United States, the current overall poverty rate is 10.6%, giving the state a 10th place ranking on a list of the top 10 states with the lowest poverty rates. However, the average poverty rate of the southwest corner of the state, which includes the 6 counties of Buchanan, Dickenson, Russell, Lee, Scott, and Wise, is d...

CMS first implemented the Comprehensive Primary Care Plus, or CPC+, Initiative in January 2017. The medical home model is a large-scale redesign effort meant to improve primary care through payer reform and care delivery transformation. However, an interim data analysis of the initiative’s first 3 years among Medicare fee-for-service beneficiaries did not demonstrate improvements in either care co...

Sexual orientation and gender identity change efforts (SOGICE), more commonly known as conversion therapy, is a discredited practice opposed by a number of medical, mental health, and human rights organizations, including the American Academy of Pediatrics and the American Academy of Child and Adolescent Psychiatry. Yet annually, the practice’s harms lead to estimated direct and indirect costs of...

On this episode of Managed Care Cast, we speak with Tim Gronniger, the CEO of Caravan Health, about what to look for as accountable care organizations (ACOs) and policy makers try to encourage more providers to join value-based care arrangements.

Since 1999, nearly 841,000 Americans have died of drug overdoses, according to data from the CDC, while opioids serve as the main driver of these deaths. Synthetic opioids account for 73% of opioid-involved overdose deaths. The COVID-19 pandemic exacerbated the opioid epidemic as individuals encountered disruptions in routine treatment, alongside steep increases in depression and anxiety rates. On...

Human papillomavirus, or HPV, is the most common sexually transmitted infection in the United States and causes the majority of cervical cancer cases in the country. But screening for HPV can catch the virus early and potentially prevent it from developing into cervical cancer. In addition, safe and effective vaccines against HPV exist, essentially making cervical cancer a preventable disease. How...

Providers who treat high-need, high-cost patients can face challenges to deliver efficient and effective care. Health centers funded by the Health Resources and Services administration (HRSA)—otherwise known as federally qualified health canters or FQHCs— provide care to nearly 30 million Americans, many of whom are uninsured or underinsured. Because data on these patients’ complexity and utilizat...

There is already an enormous amount of concern and worry about the effect of the pandemic on cancer screening; for instance, a recent report from the American Association for Cancer Research found an 87% drop in breast cancer screening, an 84% decline in cervical cancer screening, and an 80% reduction in colon cancer screening. On this episode of Managed Care Cast, we discuss how health care inequ...

According to the CDC, 37.3 million individuals in the United States currently have diabetes, while of these, 8.5 million are undiagnosed. In addition, more than 1 in 3 Americans currently have prediabetes—or higher than normal blood sugar levels—but 80% of this population is unaware they even have the condition. The American Diabetes Association estimates diagnosed diabetes costs the country $327...

On January 1, 2022, California law SB-306 went into effect with the aim of reducing soaring sexually transmitted infection (STI) rates in the state. As part of SB- 306, California now requires health insurance to cover at-home STI testing kits and requires syphilis screening during both the first and third trimester of pregnancy, in addition to other mitigation strategies. Even before the COVID-19...

This week’s Managed Care Cast conversation took place on the same day President Joe Biden announced the return of the Cancer Moonshot, a program he initiated when he was vice president in the Obama administration. The reinvigorated program aims to cut cancer deaths by 50% over the next 25 years and to increase cancer screening, which has dropped sharply during the pandemic. This Friday, February 4...

Although racism and bias have been long documented issues affecting health equity, findings of a recent study published in Health Affairs indicates these issues may be more embedded in the US health care system than originally thought. Examining electronic health records (EHRs) from an urban academic medical center, researchers found that negative descriptors were significantly more likely to appe...

In recent years, predictive models in medicine have become increasingly popular what with the continued integration of artificial intelligence and data technology into health care. However, these models can carry the risk of bias depending on which individuals make up the data sets. The close relationship between health care and technology also raises a myriad of questions when it comes to regulat...

On December 30th, 2021 the No Surprises Act went into effect. Broadly speaking, the act aims to curb surprise bills Americans may incur when they receive care from an out-out-network provider. In response to the act’s implementation, the American Hospital Association, American Medical Association, and others sued, claiming the law jeopardizes patients’ access to care on the basis that providers an...

On this episode of Managed Care Cast, we interview the lead author of a paper in the January issue of Health Affairs about what physicians know and don't know regarding their responsibilities to accommodate patients with disabilities when they come in for an office visit.