Managed Care Cast

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast. This week, the top managed care news included Medicare cuts hospital payments over readmissions; a second-generation chimeric antigen receptor T-cell therapy shows promise; a diabetes drug is approved to prevent kidney failure for the first...

Digging Deeper Into the Increasing Use of Telehealth by Managed Care Cast

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast. This week, the top managed care news included state and federal crackdowns on vaping that forced out the president of Juul; FDA approved a groundbreaking diabetes treatment; Medicare Advantage premiums will decline for 2020. Read more about...

Now 3 years into the Oncology Care Model, practices participating in the episode-based model have recently received results from performance period 4, representing care delivered in the first half of 2018. Results from the previous 2 performance periods have some practices concerned because there was little improvement; During both performance period 2 and 3 approximately 30% of practices achieved...

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast. This week, the top managed care stories included Purdue Pharma filing for bankruptcy; new data showing the number of people who get screened for HIV at least once falls far short of what CDC recommends; findings that most US hospital market...

Exploring Reference-Based Pricing as a Method for Lowering Healthcare Costs by Managed Care Cast

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast. This week, the top managed care news included a report showing the US uninsured rate rose in 2018; the Trump administration indicating it will ban all flavors of e-cigarettes except for tobacco; new research showing the prevalence of hemoph...

To date, most alternative payment models (APMs) that have emerged in the shift toward value-based care have been initiated by payers and focused on primary care providers. However, there has recently been a new wave of payment reform in which providers, mostly specialists, are designing and implementing their own APMs in their practices. A study published in the September issue of The American Jou...

Relationships in healthcare are important and trust is crucial to those relationships. However, it has been on the decline in the United States. We speak with the executive vice president of the ABIM Foundation and representatives from the 8 winning organizations of the foundation's Trust Practice Challenge about the programs they implemented to rebuild trust. Read more: ABIM Foundation Trust Prac...

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast. This week, the top managed care news included a diabetes drug showing positive results in treating heart failure; new lipid guidelines promoting the use of proprotein convertase subtilisin/kexin type 9 inhibitors; and a study finding doctor...

On this episode of Managed Care Cast, we speak with the author of a new book that discusses the price and cost of American healthcare. Martin Makary, MD, MPH, a surgical oncologist and chief of the Johns Hopkins Islet Transplant Center, talked about what he found while writing The Price We Pay: What Broke American Health Care—and How to Fix It. Makary discusses spurious billing practices, overtrea...

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast. This week, the top managed care stories included a huge ruling against one opioid maker and a settlement offer from another; an expert panel calling for broader screening for hepatitis C; a review showing there are more fatal events linked...

As advocates for addressing social determinants of health (SDOH) look to get buy in from stakeholders, there's a need for building evidence base to show that initiatives addressing these determinants work. To discuss the importance of both quantifying and communicating the return on investment of these initiatives, we spoke with Susan Mani, MD, vice president of Clinical Transformation and Ambulat...

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast. This week in managed care, the top news included outcomes results in treating heart failure; US prevention experts said more women should get BRCA testing; the American Heart Association offered an advisory on treating high triglycerides wi...

Employers are the single largest provider and purchaser of healthcare insurance in the United States and they represent a potential force for change in the US healthcare system. In order to control costs and provide better care to their employees, employers have been banding together through local coalitions. Many coalitions across the country have coalesced under the National Alliance of Healthca...

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast. This week, the top managed care stories included the Trump administration looking to bar legal immigrants from using public benefits; a study in The American Journal of Managed Care® finding that a law to limit surprise medical bills is wor...

On this episode of Managed Care Cast, we’re bringing you a portion of a panel discussion about the Oncology Care Model, held in July 2019 during a meeting of The Institute for Value-Based Medicine (IVBM), an initiative of The American Journal of Managed Care®. At IVBM events, we gather thought leaders to share best practices across medicine, pharmacy, and management in regional locations around th...

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast. This week, the top managed care stories included CMS giving chimeric antigen receptor T-cell payments a boost; a US task force announcing that those at risk for pancreatic cancer should be screened; FDA revealing Novartis withheld data abou...

Transitioning to value-based care is a marathon, not a race, and should be viewed as a mission and a culture, Jeff Hunnicutt, chief executive officer at Highlands Oncology Group, told Amy Ellis, director of quality and value-based care at Northwest Medical Specialties. In order to successfully transform a practice, there needs to be a clear message and set values ingrained in the mindset of staff...

As a progressive disease diabetes presents an ongoing challenge for physicians to provide adequate control of patients’ diabetes, and new agents with novel mechanisms of action help reduce the burden in the management of diabetes. In a recent Peer Exchange discussion, Dr Peter Salgo, of Columbia University College of Physicians and Surgeons and NewYork-Presbyterian Hospital, led a discussion on no...

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast. This week, the top managed care news included HHS laying out a plan for importing certain prescription drugs from other countries; a potential new standard of care for chronic lymphocytic leukemia; 3 insulin makers get subpoenaed over their...

While precision medicine has started to inch its way to becoming a norm in healthcare, there are still barriers holding back widespread implementation amomg providers and organizations. From reimbursement challenges to primary use in oncology to proving the return on investment of implementing a precision medicine program, addressing these barriers could open the door to more providers and oragniz...

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast. This week, the top managed care news included bipartisan Senate bills taking aim at drug prices, especially insulin; a study linking payer refusal to pay for proprotein convertase subtilisin/kexin type 9 inhibitors with heart attacks and de...

Addressing the Complexities of Value-Based Payment Models by Managed Care Cast

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast. This week, the top managed care news included CMS pushing for bundled payments in radiation oncology; reports detailing deficiencies in hospice care; a study finding widening disparities in life expectancy among white Americans. Read more a...