Managed Care Cast

On this episode of Managed Care Cast, The American Journal of Managed Care® speaks with Jonathan Gabison, MD, DABOM, and Stephen Lott, PharmD, MS. At the University of Michigan, Gabison is an obesity medicine specialist and family physician, while Lott serves as director of the postgraduate year one managed care residency program and manager of the university's prescription drug plan. Their qualit...

Precision medicine has long guided cancer treatment by matching therapies to tumor mutations, but the emerging field of predictive genomics aims to take this further by factoring in a patient’s genetics, health history, and environment to better predict drug response.

Managed Care Cast News Roundup: July 8, 2025 by Managed Care Cast

Explore how the Collaborative Care Model enhances mental health access in this episode featuring Anna Bob, executive director of the Path Forward coalition.

Gastropsychiatrist Eva Szigethy, MD, PhD, and Benjamin Cohen, MD, Cleveland Clinic, discuss quality of life improvement in terms of behavioral health and inflammatory bowel disease (IBD).

Delays, denials, and endless paperwork—prior authorization isn’t just a headache for providers; it’s a barrier for patients who need timely care. From shocking patient delays to the surprising role of fax machines in 2025, in this episode, we explore why prior auths are driving burnout, potentially harming outcomes, and what’s being done to streamline the process.

A quick roundup episode of major news and health policy developments from The American Journal of Managed Care.

On this episode of Managed Care Cast, The American Journal of Managed Care® speaks with Julia Lucaci, PharmD, MS, the senior director of global health economics and outcomes research at Becton, Dickinson and Company (BD), an international medical technology company. Her commentary, "Should Payers Incentivize Pharmacies to Blister-Package Chronic Medications?" argues that payers should consider off...

A quick roundup episode of major health policy developments, from shifting COVID-19 vaccine guidance and scientific publishing controversies to rising cancer care costs and the impact of oncology biosimilars.

On this episode of Managed Care Cast, The American Journal of Managed Care® speaks with Lindsey Leininger, PhD, health policy professor and faculty director of the Center for Health Care at the Tuck School of Business at Dartmouth College, and Allister Chang, MPA, co-founder of Fabric Health, a social-impact startup that aims to improve community well-being by transforming everyday moments in laun...

Victor Murray, senior director of Community Engagement and Capacity Building at the Camden Coalition, discusses the evolving role of social workers, emphasizing their expanded scope to include systems change, health equity, and policy work. He highlights the Camden Core Model, which addresses complex health and social needs through trauma-informed care and holistic support.

Explore how employers enhance workplace mental health by fostering a culture of support and engagement, focusing on holistic well-being strategies in this interview with Jim Kinville, University of Pittsburgh Medical Center.

On this episode of Managed Care Cast, The American Journal of Managed Care® speaks with Larragem Raines, MS, director of research at the Center for Innovation & Value Research, about her organization's open-source value model for major depressive disorder (MDD). She also defines dynamic pricing and explains how it is incorporated into the MDD value model, topics she expands upon in a recent contri...

Colleen Ereditario, MPH, RD, LDN, program manager, shares how the “Food as Medicine” approach of Allegheny Health Network (AHN) addresses food insecurity and guides patients to improve their health.

On this episode of Managed Care Cast, The American Journal of Managed Care® speaks with Brady Post, PhD, assistant professor at Northeastern University and lead author of a study published in this month's issue. His study, "Impact of Hospital-Physician Integration on Medicare Patient Mix," found no evidence that hospital-employed physicians treated a higher proportion of complex patients, at least...

Using commercial insurance claims data and the US launch of tirzepatide as their dividing point, John Ostrominski, MD, and his team studied trends in the use of both glucose-lowering and weight-lowering medications, comparing outcomes between adults with and without type 2 diabetes. Overall, their findings show a significant uptick in tirzepatide dispensations, alongside other glucose- and weight-...

Today we are bringing you a conversation the use of continuous glucose monitoring technology and its transformative potential in diabetes care. Davida Kruger, a certified nurse practitioner at Henry Ford in the division of endocrinology, spoke with Jaime Murillo, MD, senior vice president and chief medical officer, medical affairs, United Health Group; Jeremy Wigginton, MD, chief medical officer a...

On this episode of Managed Care Cast, we speak with Arthur L. Jenkins III, MD, FACS, CEO of Jenkins NeuroSpine, to explore the intersection of advanced surgical care for sport-related neurospine injuries and managed care systems.

On this episode of Managed Care Cast, we are speaking with Jai N. Patel, PharmD, the associate director of shared resources management at Atrium Health Wake Forest Baptist Comprehensive Cancer Center. His study, "Medical Policy Determinations for Pharmacogenetic Tests Among US Health Plans," uncovered significant differences in coverage decisions for pharmacogenetic tests across major US health in...

On this episode of Managed Care Cast, we speak with George Jones, chief operating officer at UpScript Health, an online pioneer of eprescribing 20 years ago, to learn how telemedicine has progressed from asynchronous conferencing to real-time video consultation, enabling the treatment of complex conditions beyond primary care.

On this episode of Managed Care Cast, we speak with Perry N. Halkitis, PhD, MS, MPH, dean of the Rutgers School of Public Health. Our conversation centers on the potential withdrawal of the United States from the World Health Organization, the new directive for the CDC to stop communications with the WHO, and their public health implications. We also touch on the importance of accurate public heal...

Today, we're diving deep into a crucial aspect of preventive healthcare: the Annual Wellness Visit. Our guest is Dr. Christopher Wheelock, a clinical transformation physician executive at Highmark Health, responsible for developing payer and provider collaborations to move toward value-based care. In the past, he was heavily involved with developing the workflow, patient scripting and templating f...

On this episode of Managed Care Cast, we're talking with Allison Ju-Chen Hu, PhD, a postdoctoral associate in the Department of Population Health Sciences at Weill Cornell Medicine. Her study, "Medicaid Managed Care Network Adequacy Standards and Mental Health Care Access," examined the association between quantitative network adequacy standards (NAS) and mental health care access among adult Medi...

Joining us for this episode of Managed Care Cast is Robert H. Hopkins, Jr, MD, mnedical director at the National Foundation for Infectious Diseases and NFID liaison to the Advisory Committee on Immunization Practices, who will help separate fact from fiction about avian influenza and discuss what needs to be done to prevent a future escalation.

Today, we do a deep dive into psychedelic-assisted therapy with Jessica Tracy, head of Growth and Partnerships at Enthea. She shares how employers and unions can support mental health and address access barriers to evidence-based ketamine treatments.