Managed Care Cast

This week, the top managed care news included Biden reopening Affordable Care Act insurance marketplaces; medical claim denial rates highest in initial COVID-19 hotspots; obesity linked with mortality in acute lymphoblastic leukemia.

On this episode, we speak with Andrew Smith, PhD, Huntsman Mental Health Institute at the University of Utah School of Medicine, coauthor of a paper looking at the mental health stressors facing first responders and health care workers during the coronavirus disease 2019 (COVID-19) pandemic. The paper found that a sizable number of these frontline workers are at risk for psychiatric illnesses at s...

This week, the top managed care news included President Joe Biden's executive orders to reform public health; incoming CDC Director to prioritize communication, coronavirus disease 2019 vaccine rollout; CMS finalizes rule on electronic prior authorization.

The authors of a Clinical research article in the January 2021 Health IT issue of The American Journal of Managed Care® discuss their findings and suggestions for making telehealth access more equitable for all.

This week, the top managed care news included new CDC guidance to base state COVID-19 vaccine supply on administration rates; a report finds record drop in cancer mortality but persistent disparities; Jardiance moves 1 step closer to FDA approval for use in heart failure.

On this episode of Managed Care Cast, we speak with the new chief financial officer of Strive Health, a value-based kidney care company that works with payers and providers to create an integrated care delivery system for chronic kidney disease (CKD) and end stage renal disease (ESRD). We discuss the changes coming to nephrology practices as well as new ways of looking at the whole patient to try...

This week, the top managed care news included FDA advising against changes to vaccine dose schedules; drop in mammography screenings during the first months of the pandemic; first anti-TIGIT therapy granted Breakthrough Therapy designation by the FDA.

This week, the top managed care news included the first coronavirus disease 2019 vaccine shipments arriving nationwide; FDA panel votes to expand use of heart failure drug; efforts to address social determinants of health amid the pandemic.

On this episode of Managed Care Cast, we speak with Bechara Choucair, MD, the chief health officer of Kaiser Permanente, about their social health playbook, which guides clinicians about how to help patients with their social health needs during the pandemic.

As 2020 ends, the last interview in a year-long series running during the 25th anniversary of The American Journal of Managed Care® (AJMC®) is with the journal’s co-editors-in-chief: Michael E. Chernew, PhD, and A. Mark Fendrick, MD. This episode of Managed Care Cast is a preview of that conversation, which appears in the December issue. Chernew and Fendrick discuss which issues they think Preside...

Diabetes is an established risk factor for more severe cases of coronavirus disease 2019 (COVID-19). But recently reported cases of COVID-19-related diabetes among those with no preexisting risk factors suggest the 2 conditions may have a bidirectional relationship. Interested in these rare cases, which don’t appear to fit the typical 2 types of diabetes, Francesco Rubino, MD, a professor of metab...

Recently released vaccine data from both Pfizer and Moderna indicate encouraging steps forward in the global fight against coronavirus disease 2019 (COVID-19). But both vaccines are still a long way from becoming readily available to the wider public, prompting the question, who should be prioritized once doses become available? To provide guidance on this front, The National Institutes of Health...

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 reports of 2 vaccines’ efficacy against coronavirus disease 2019 (COVID-19); a study finds no risk reduction in cardiac events with fish oil; calls for long-term follow-up to understand effects of lingering COVID-19. Read more about the stories in this podca...

The coronavirus disease 2019 (COVID-19) pandemic has required health care systems to overhaul their ways of delivering care to patients in order to keep patients, families, and clinicians safe. For medical home visit programs accustomed to visiting patients in person, this task has required creative use of new technologies and relied on regulatory flexibility to facilitate their work. On this epis...

As the health care industry continues to combat health and cost-related issues exacerbated by the COVID-19 pandemic, employers remain a key figure in the pursuit for higher value care. Recently, the Leapfrog Group partnered with the Health Transformation Alliance, or HTA, to help delineate high-value health care services with a particular focus on transparency and payment reform. On this episode o...

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 the Supreme Court signaling willingness to uphold the Affordable Care Act; Pfizer’s coronavirus disease 2019 vaccine shows 90% efficacy; racial disparities in lung cancer screenings and prescribing biologics. Read more about the stories in this podcast: Supr...

As the costs of cancer care continue to rise in the United States, eyes are increasingly turning to payment reform. Research by the Northeast Business Group on Health found that in 2015, employers spent $125 million on cancer care, and since then, cancer therapy costs have increased substantially with greater use of immunotherapy and the introduction of chimeric antigen receptor T-cell therapies t...

EDIT: This podcast has been updated as of 11:45 am EST. Every week, The American Journal of Managed Care® recaps the top managed care news of the week. This week, the top news in managed care included top health care takeaways from the 2020 general election; a Q&A with William Shrank, MD, MSHS, on connecting Medicare Advantage providers and patients; Managed Care Cast discusses balancing evidence...

With the coronavirus disease 2019 pandemic, new research is quickly being released as more and more is learned. However, the flood of new research needs to be balanced with appropriate review before action is taken. In the latest Managed Care Cast, Denise Basow, MD, president and CEO of clinical effectiveness at Wolters Kluwer, speaks with Patricia Salber, MD, MBA, of The Doctor Weighs In, about t...

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 updates on coronavirus disease 2019 therapies and vaccine candidates; a discussion on keeping physicians independent through value-based care; an overview of the 2020 Community Oncology Alliance Virtual Payer Exchange Summit. Read more about the stories in t...

The company Aledade was created 6 years ago to help physicians stay independent by implementing a value-based care business model. In this episode of Managed Care Cast, Patricia Salber, MD, MBA, of The Doctor Weighs in, speaks with Aledade co-founder, Farzad Mostashari, MD, about what his company has accomplished and why these efforts are important for all stakeholders. Read more about Aledade, ac...

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 coronavirus disease 2019 (COVID-19) delays in breast cancer surgery; targeted therapies associated with decreased mortality risk for non–small cell lung cancer; an inside look at a patient’s perspective of early-onset Parkinson disease. Read more about the s...

2020 is the 25th anniversary of The American Journal of Managed Care® and October’s edition of the journal features an interview with Kavita Patel, MD, MS, a nonresident fellow at the Brookings Institution and a primary care physician.

Ten months into the coronavirus disease 2019 (COVID-19) pandemic, some states continue to struggle to keep up with new cases and protect their most vulnerable populations from bearing the brunt of the disease. However, one state was able to get ahead of the pandemic early on, and, through public private-partnerships, secured immediate care for hundreds of the highest risk individuals within weeks....

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 the first case of coronavirus disease 2019 (COVID-19) reinfection in the United States; a positive side to halting trials to evaluate vaccine safety; a rise in employer-sponsored health insurance premiums for 2020. Read more about the stories in this podcast...