Managed Care Cast

In 2018, the Ochsner Accountable Care Network was able to reduce expected costs of care by more than $12.78 million for its Medicare beneficiaries, and it increased its savings 12% over 2017. This comes amidst research and claims that accountable care organizations may not be successful at reducing costs while improving outcomes. David Carmouche, MD, president of the Ochsner Health Network and exe...

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 average Affordable Care Act premiums falling 4%; the FDA approving a triple combination treatment for cystic fibrosis; House Republicans releasing part 1 of their healthcare plan. Read more about the stories in this podcast: While Waiting for ACA Decisio...

Healthcare is increasingly trying to use big data and clinical pharmacists are no exception. On today's episode of Managed Care Cast, we talk with an assistant professor at Geisinger’s Center for Pharmacy Innovation and Outcomes about his work with big data.

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 a new guide that balances curbs on opioid abuse with the needs of patients with chronic pain; HHS proposed reforming antikickback rules to help boost value-based care; a report found flaws with Medicaid work requirements.

Who will care for America's growing aged population in the coming decades? Today on the podcast, we're speaking with PHI, a New York-based nonprofit organization that works to improve long-term services and care for the elderly and those with disabilities by focusing on the job quality of those providing day-to-day hands-on care—low-paid home health care aides and nursing assistants.

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 an effort by the Trump administration to bolster Medicare Advantage; an abortion case from Louisiana reached the Supreme Court; the study of adapting to changing oxygen levels wins the Nobel Prize. Read more about the stories in this podcast: Trump Executive...

This month’s issue of The American Journal of Managed Care® took a look at differences in coverage of orphan and nonorphan drugs to get insight into variation in orphan drug coverage across the largest commercial plans in the United States. The study, which analyzed a data set of private health plan coverage decisions for specialty drugs in 3 ways, found that health plans restrict access to orphan...

Exploring the Rise of Obesity-Related Cancers: A Conversation With Dr Debra Patt 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 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...