Managed Care Cast

Pharmaceutical manufacturers sought to improve patient access to treatments through the use of co-payment assistance cards. But, while these cards reduce the out-of-pocket cost for enrollees, employers worry that they could result in increased medication use and associated expenditures, thus negating efforts made with benefit designs. To mitigate the issue, pharmacy benefit managers have introduce...

Just halfway through the year, and 2019 has been busy for biosimilars with new guidance and approvals, but the loss of a big advocate of biosimilars from the FDA. In this episode of Managed Care Cast, Kelly Davio, senior editor of The Center for Biosimilars®, a sister site of The American Journal of Managed Care®, discusses new approvals, what the loss of Scott Gottlieb, MD, as FDA commissioner me...

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 uncertainty surrounding the fate of the Affordable Care Act's individual mandate; a study finding Medicare beneficiaries may be paying more for some generics than brand-name drugs; the Trump adm...

While many women in healthcare report experiencing subtle or not-so-subtle bias and microaggressions at work, a recently published study sought to determine how healthcare professionals associate men and women with career and family, and also how surgeons associate men and women with surgery and family medicine. In this podcast, we speak with the lead author, Arghavan Salles, MD, PhD, about the fi...

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, we recap the top managed care news from the first half of 2019, including outcomes from some of the biggest diabetes trials, research into the annual Medicare wellness visit, and an experimental treatment in Parkinson disease. Re...

Working Toward More Transparency in Healthcare 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 President Trump issuing an executive order for more healthcare transparency; provisional data indicating that overdose deaths may be falling; the Supreme Court agreeing to hear insurers' Afforda...

Today on Managed Care Cast, we speak with Benjamin Isgur, leader of PwC’s Health Research Institute, about their latest report, Medical Cost Trend Report 2020: Beyond the Numbers. We talk about what is making the medical cost trend start to move upwards and what employers are trying to do about it.

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 finding slow progress in reducing low-value care; a study finding savings by accountable care organizations may be overstated; CMS proposing a rule to allow for electronic prior authori...

Value-based care has been a big prerogative of CMS for the last decade, and it's not going away, Brian Kern, a lawyer with Frier Levitt, told Amy Ellis, director of quality and value-based care at Northwest Medical Specialties. The government programs, such as the Bundled Payments for Care Improvement, Medicare Shared Savings Program, and Oncology Care Model, are important because practices learn...

Today we’re speaking with Dr Mark Simon, the chief medical officer of OB Hospitalist Group. OB Hospitalist contracts with hospitals across the United States to create OB emergency departments. The group employs more than 600 experienced OBs who are available 24 hours a day, 7 days a week to ensure that an OB is always in the hospital, rather than on call. OB Hospitalist also works with hospitals t...

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 the Community Oncology Alliance submitting an alternative to the Oncology Care Model; more study results demonstrating diabetes drugs can prevent renal failure; US task force recommending pre-ex...

The rate of innovation in oncology has been impressive, with novel therapies, such as chimeric antigen receptor T-cell therapies, and new diagnostics that make it easier to understand which patients will benefit from certain targeted therapies. With all of these innovations coming to market and being tested in clinical trials, it might make sense that some people are ready to move on from the trea...

The burden of medical expenses, whether incurred through a catastrophic illness or surprise medical bills, affects the uninsured and insured alike. A 5-year-old charity called RIP Medical Debt buys medical debt incurred, so far, by more than 250,000 Americans. We talk to one of the cofounders and coauthors of "End Medical Debt," the book they wrote about the issue.

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 the American Society of Clinical Oncology discussing drug pricing; community oncologists seeking a delay in taking on downside risk in the Oncology Care Model; CDC finding a drop in new diabetes...

Heard at ISPOR: Debating the Benefits and Pitfalls of the QALY by Managed Care Cast

We sit down with David Smith, the executive director of the Medicaid Transformation Project, to get an update about the integration challenges health systems are facing, including system issues, infrastructure issues, coding and payment issues, and more.

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 the FDA's approval of a $2.1 million gene therapy; a study revealing that the worldwide need for palliative care will nearly double by 2060; the FDA granting priority review to Amarin’s Vascepa...

In the first of a series of interviews with key opinion leaders, Amy Ellis, director of quality and value-based care at Northwest Medical Specialties, discusses practice transformation with Jess Quiring, a patient navigator at New Mexico Cancer Center. During the converation, Quiring explained how her practice modified the depression and distress screening tools for the different populations it tr...

Exploring the Increased Prevalence, Evolving Role of Physician Assistants 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 study questioning the Hospital Readmissions Reduction Program; FDA issuing a warning about do-it-yourself artificial pancreas systems; measles cases reach the highest level since 1994. Read mo...

As the cost of healthcare continues to rise, employers are getting more involved in their employees’ health and identifying ways they can intervene to help get employees who have chronic conditions healthy or access to care they need and also keep employees who are already healthy from getting sick. At the Midwest Business Group on Health (MBGH)’s 39th annual conference, Cheryl Larson, president a...

Patients with Parkinson disease can suffer complications in the hospital if the individualized, highly structured care plans that manage their disease are not followed. We interviewed neurologist Hooman Azmi, MD, the co-author of Parkinson's Disease for the Hospitalist: Managing the Complex Care of a Vulnerable Population, about what it takes to improve patient care for this population. He is the ...

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 44 states suing drug makers for price fixing; Gilead pledging to donate pre-exposure prophylaxis for up to 200,000 people for up to 11 years; Philadelphia soda tax reduced consumption of sugary...

Do Machine-Readable Directories Improve Provider Directory Accuracy? by Managed Care Cast