Managed Care Cast

March 11, 2025, will mark 5 years since the World Health Organization (WHO) declared COVID-19 a pandemic. Between January 22, 2020, and March 10, 2023, Johns Hopkins University recorded over 676 million confirmed COVID-19 cases worldwide and more than 6.8 million related deaths. In the US alone, it reported over 103 million cases and more than 1 million deaths during this timeframe. Although the W...

The editors in chief of The American Journal of Managed Care® discuss the key managed care research and news from 2024 and look forward to the journal’s upcoming 30th anniversary.

Today we are bringing you a conversation on treatment with Bruton tyrosine kinase inhibitors for patients with treatment-naïve chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL). Ryan Haumschild, PharmD, MS, MBA, CPEL, vice president of ambulatory pharmacy at Emory Healthcare and Winship Cancer Institute, spoke with 3 experts: Tara Graff, DO, medical oncologist, Mission Cancer and B...

Rachael Drake, pharmacy technician coordinator, University of Kansas Health System, explains how her team collaborates with insurance companies and providers to support patients with non-Hodgkin lymphoma access treatment.

Among the latest data being presented at the American Society of Hematology Annual Meeting and Exposition, held December 7-10, 2024, in San Diego, California, were 3 abstracts that focused on patient preferences and treatment choices. Sikander Ailawadhi, MD, professor of medicine in the Division of Hematology/Oncology at the Mayo Clinic Florida was a coauthor on all 3 abstracts, covering patient p...

Today we are bringing you insights from 3 separate interviews with experts about the treatment, management, and burdens of idiopathic pulmonary fibrosis (IPF). In this podcast, you’ll hear insight from the following individuals: Toby Maher, MD, PhD, professor of clinical medicine, Keck School of Medicine, USC; Martin Kolb, MD, PhD, professor of medicine, McMaster University; and Steven Nathan, MD,...

On this episode of Managed Care Cast, we're talking with Joanne Armstrong, MD, MPH, the vice president and chief medical officer for women's health and genomics at CVS Health. We explored the progress and persistent challenges in women's health, highlighting topics like care access, the role of technology, maternal health outcomes, and efforts to break the stigma around menopause.

In this special episode of Managed Care Cast, the executive editor of The American Journal of Managed Care, Mary Caffrey, speaks with Tyler Sandahl, PharmD, of Cleveland Clinic, and Michael Byrne, DO, of Tennessee Oncology, about the use of bispecific antibodies to treat patients with multiple myeloma, the importance of caregivers for this regimen, how the entire staff plays a role, the common adv...

On this episode of Managed Care Cast, we're talking with Josie Cooper, BA, executive director of the Alliance for Patient Access. Her study, "Utilization Management and Physician Burnout," involved a survey that assessed physician experiences with utilization management and burnout, investigating the potential link between the 2.

Dr Elizabeth Warner, chief medical officer at CDPHP, discusses how Wellness Way's focus on patient experience, community partnerships, and integration of physical and mental health care services sets it apart from traditional hospital-based care.

Prompt care supports mental well-being, as hidradenitis suppurativa is often associated with depression and anxiety due to its physical and social challenges.

On this episode of Managed Care Cast, we're talking with Benjamin Ukert, PhD, of Elevance Health's Public Policy Institute. His study, "Racial and Ethnic Disparities in Prior Authorizations for Patients With Cancer," evaluated prior authorization decisions in cancer care by race and ethnicity for commercially insured patients.

In our conversation with Jeff Giullian, MD, MBA, chief medical officer with DaVita Kidney Care, we dive into 4 important aspects of kidney care: prevention, social support, integrated care, and patient support

On this episode of Managed Care Cast, we're talking with Rick Chapman, PhD, chief science officer of the Center for Innovation & Value Research, formerly known as the Innovation and Value Initiative (IVI). We discussed the Center's Rare Disease project, including the primary goals, key discoveries from Phase 1, and what to expect moving forward.

To help celebrate and recognize National Recovery Month, we have brought you another limited-edition month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. In this final episode, we speak with Lyndra Bills, MD, senior medical director, and Shari Hutchison, MS, director of program evaluation and outcomes, both with Community Care Behavioral Health Organization.

Delia Orosco, MS, director of Community Wellness Centers at Inland Empire Health Plan (IEHP), shares insight into innovative initiatives like the mobile mammogram clinics.

To recognize National Recovery Month, we are bringing you another limited-edition month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. In episode 4, Amy Herschell, PhD, associate vice president, Program Implementation and Evaluation, Community Care Behavioral Health Organization, and Jessica Meyers, MSEd, senior advisor for implementation, UPMC Center for High-Value Hea...

On this episode of Managed Care Cast, we're talking with Simon F. Haeder, PhD, MPA, associate professor of public health at Texas A&M University. His study, "When is a Network Adequate? Consumer Perspectives on Network Adequacy Definitions," explored the factors that consumers consider essential for an adequate provider network, including travel times, inclusive care, and language access.

Chris Barton, senior director of Integrated Systems of Care & Network Innovation at Horizon Blue Cross Blue Shield of New Jersey, discusses how the Youth Behavioral Health Strategy program focuses on addressing the specific needs of youth with mental health and substance use issues through a comprehensive approach

To recognize National Recovery Month, we are bringing you another limited-edition month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. In episode 3, we speak with Kim MacDonald-Wilson, ScD, CPRP, senior director, Recovery and Wellness Transformation, and Tracy Carney, CPS, CPRP, senior recovery specialist, both at Community Care Behavioral Health Organization, part of t...

To recognize National Recovery Month, we are bringing you another limited-edition month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. In episode 2, we speak with Rebekah Sedlock, DSW, LCSW, Community Care Behavioral Health Organization, part of the UPMC Insurance Services Division, and Mandy Fauble, PhD, LCSW, UPMC Western Behavioral Health at Safe Harbor.

To recognize National Recovery Month, we are bringing you another limited-edition month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. In episode 1, we speak with Michael Lynch, MD, associate professor of emergency medicine at the University of Pittsburgh and an attending emergency physician and medical toxicologist at the University of Pittsburgh Medical Center.

On this episode of Managed Care Cast, we're talking with Eden Miller, DO, founder of the Diabetes and Obesity Care clinic in Bend, Oregon, which provides high-level obesity intervention and diabetes treatment and prevention. Her study, "Inadequate Insurance Coverage for Overweight/Obesity Management," reviews the US obesity epidemic and discusses insufficient insurance coverage for obesity managem...

On this episode of Managed Care Cast, we're talking with Marge Ciancetta, the product manager of Cotiviti's Star Intelligence solution, which helps health plans and providers improve their Medicare Advantage Star Ratings. We discussed all things Star Ratings, including their importance, how they are calculated, and their impact on plans in 2024. Looking ahead, we also discussed strategies to impro...

On this episode of Managed Care Cast, we're talking with Sreekanth Chaguturu, MD, chief medical officer of CVS Health; Cathy Moffitt, MD, FAAP, CHIE, chief medical officer of Aetna; and Joneigh Khaldun, MD, MPH, FACEP, chief health equity officer of CVS Health. We discuss various topics, including the current challenges in primary and preventive care engagement, the role of trust in patient-provid...