Managed Care Cast

Amid COVID-19, patients with Parkinson disease have had to adjust to the physical and mental challenges precipitated by the pandemic. Notably, those with Parkinson disease, who are already linked with heightened feelings of stress and anxiety, may be further at risk. On this episode of Managed Care Cast, we speak with Rachel Dolhun, MD, vice president of Medical Communications at The Michael J. Fo...

In a prior study, nearly 7 in 10 employees indicated in a survey that the COVID-19 pandemic is the most stressful time of their entire professional career. Researchers from Lyra Health, an employee behavioral health provider, recently conducted a study examining the efficacy, in real-world circumstances, of a structured, cognitive behavioral coaching program delivered through video or telephone. O...

Against a backdrop of the health care and cost concerns stemming from the COVID-19 pandemic, the April issue of The American Journal of Managed Care® features an interview with Dr. Sherry Glied,  health economist and dean of New York University’s Robert F. Wagner Graduate School of Public Service, about the Affordable Care Act and Medicaid, as well as the vital role that public service leadership...

The 2020 Community Oncology Conference, hosted by the Community Oncology Alliance (COA), will take place virtually on April 23 and April 24. The American Journal of Managed Care® (AJMC®) is bringing you a series of previews so you can learn more about what to expect when you attend this virtual meeting. In this interview we speak with Debra Patt, MD, MPH, MBA, executive vice president of policy an...

The 2020 Community Oncology Conference, hosted by the Community Oncology Alliance (COA), takes place virtually on April 23 and April 24. The American Journal of Managed Care® (AJMC®) is bringing you a series of previews so you can learn more about what you'll hear when you attend this virtual meeting. In this interview we're speaking with Lee Schwartzberg, MD, FACP, the chief medical director of W...

Complex care management programs aim to improve health outcomes of high-cost, high-need patients through coordinating medical and social services. In general, Medicaid patients have high rates of chronic conditions and often utilize preventable acute care, leading to avoidable spending. To determine the impact complex care management programs can have on Medicaid beneficiaries, researchers conduct...

Efforts to ensure that veterans have timely access to healthcare include community partnerships and the Veterans Choice Program, but new research suggests that women veterans may be receiving less care, particularly those who report unstable housing or mental/behavioral health issues, On this episode of Managed Care Cast, we speak with Laurel A. Copeland, PhD, about the paper “Gender Differences i...

Prior authorizations play a key role in checking on the safety and appropriateness of medical treatments among patients, but when they take too long, efficiency of care suffers. On this episode of Managed Care Cast, we speak with April Todd, senior vice president, CORE and Explorations for CAQH, on CAQH CORE’s recent approval of a 2-day rule for health plans in requesting additional supporting inf...

This week, top managed care stories included an additional setback for Medicaid work rules; another study finding more benefits from SGLT2 inhibitors; researchers finding unwanted end-of-life care causes stress.

When implemented as intended, preventive drug lists (PDLs) can help high-deductable health plan members save money by covering preventive medications at lower or no costs. However, after conducting a series of interviews, researchers found this is not always the case among patients with asthma who have PDLs. Some patients were unaware their plans had PDLs, while other PDLs did not cover the cost o...

Although genomic testing is recognized in national oncology guidelines as key to determining the right therapy for metastatic colorectal cancer (MCC), overall biomarker testing rates remain poor. On this episode of Managed Care Cast, we speak with one of the authors of a recent study about this issue published in JCO Precision Oncology. Stuart Goldberg, MD, a hematologist oncologist at the John Th...

On this episode of Managed Care Cast, we speak with John Showalter, MD, chief product officer at Jvion and an internal medicine physician, and Soy Chen, MS, director of data science at Jvion and part of their data science team. We discuss their research about using applied machine learning to predict healthcare utilization based on social determinants of health, appearing in the January 2019 Healt...

Nearly 75% of Americans will consider healthcare a main factor when they vote in the 2020 presidential election, according to a survey published by Wolters Kluwer late last year. The survey, called Mending HealthCare in America 2020: Consumers & Cost, showed alignment and deep divisions among patients and providers, with issues around transparency, cost, and care variability causing concern. On th...

On this episode of Managed Care Cast, we speak with Kashyap Patel, MD, the chief executive officer of Carolina Blood and Cancer Care Associates—a leading OCM practice—and associate editor of Evidence-Based Oncology™ (EBO), as well as Tennessee Oncology’s Stephen M. Schleicher, MD, MBA, to discuss Oncology Care First.

On this Managed Care Cast, we speak with a health policy researcher who got the idea for a study about medical billing appearing in the December 2019 issue of The American Journal of Managed Care® after she received one that was unexpected. While efforts to abate surprise medical billing, such as the kind that come from out-of-network emergency department visits, are currently being debated in Was...

On this episode of KOL Corner, Amy Ellis, director of quality and value-based care at Northwest Medical Specialties, talks with Amanda Hodges, BSN, RN, OCN, the director of implementation of ReVital Cancer Implementation.

In today’s Managed Care Cast, we bring you portions of the panel discussion during the the last Institute for Value-Based Medicine® (IVBM®) event for 2019, where oncologists and others shared their thoughts, successes, and frustrations with the current Oncology Care Model, as well as the question and answer session.

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 research that may hold the key to slowing progression of multiple sclerosis; Humana says it is saving billions of dollars through value-based care; the challenges of rural healthcare delivery. Read more about the stories in this podcast: Researchers May Have...

Women in the United States suffer from maternal mortality rates not seen elsewhere in developed countries, and nowhere is that more true than in patients served by Medicare. Although it is a national epidemic, inadequate maternal care disproportionately affects minority women and the 43% of US births financed by Medicaid. On this episode, we speak with  an executive vice president of Avia Health S...

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 research that shows stents may offer no more value than drugs for some heart patients; a ban on flavored tobacco products gains momentum; a survey finds most American families struggle with social factors that impact health. Read more about the stories in th...

Healthcare is changing due to a combination of technological improvements and rising costs. For instance, more than half of surgical procedures now take place in an outpatient environment, but, as with many things in healthcare, there isn’t a lot of transparency. Today on Managed Care Cast, we speak with Michael Abrams, managing partner of Numerof & Associates, about patient safety and outpatient...

Chronic disease affects most employees in the United States, and today, on World Diabetes Day, Managed Care Cast speaks with the lead author of a study about chronic disease that appears in the November issue of The American Journal of Managed Care®. Author Maren S. Fragala, PhD, CSCS.D, talks about how employer-sponsored health screenings can help identifiy previously undiagnosed disease, enablin...

During this week’s podcast, we sit down with Mark Lewis, MD, a gastrointestinal oncologist at Intermountain Healthcare. In addition to being a practicing oncologist, Lewis has been living with cancer himself with a hereditary tumor syndrome that’s been passed down in his family, giving him a unique experience that has driven his approach to treating his own patients. During the interview, Lewis di...

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 CMS started planning for life after the Oncology Care Model; a judge blocked a rule requiring immigrants to have health coverage; Election Day brought news for Medicaid work rules. Read more about the stories in this podcast: CMS, CMMI Seek Feedback on Oncol...

In 2002, Bill Allman, working for Washington State, heard from a widow with a $75,000 bill from Medicaid, which was incurred as part of his long-term care costs. Like Allman, the man was a veteran. On this episode of Managed Care Cast, we learn how Allman, who is retiring at the end of 2019, launched a program to connect veterans to health benefits they didn't know they had, and in the process, fi...