Managed Care Cast
What Barriers Inhibit Oral Anticancer Medication Use?
July 9th 2020Oral anticancer therapies have become popular alternatives to more traditional care, such as chemotherapy. However, research shows that adherence to oral anti-cancer therapies can range from 20% to 100%. Several factors contribute to medication nonadherence and access barriers. To learn more, we spoke with Ami Vyas, PhD, an assistant professor of pharmacy practice, specializing in health outcomes research, at The University of Rhode Island.
Read More
Why Amputations Are on the Rise in Some States, Even as Diabetes Care Improves
July 5th 2020Amid progress in diabetes treatments and technology, the rate of amputations rose 50% between 2009 and 2015. African American patients lose limbs at triple the rate of other groups. The mission of the Affordable Care Act—spend more to prevent disease and complications, and save money later—has bypassed many of these patients for one reason: they lack access to care.
Read More
What Is the Current State of Mental Health in the US Workforce?
June 30th 2020On this episode of Managed Care Cast, we speak with Michael Thompson, president and chief executive officer (CEO) of the National Alliance of Healthcare Purchaser Coalitions, and Louis Gagnon, CEO of Total Brain, on their findings and how employers can optimize how they monitor and support mental health in their respective workforce.
Read More
Caring for Medicare Advantage, Medicaid Beneficiaries in Puerto Rico During COVID-19
June 24th 2020In this episode of Managed Care Cast, we speak with Richard Shinto, MD, MBA, president and CEO of InnovaCare Health, about the company’s care of their Medicare Advantage and Medicaid beneficiaries in Puerto Rico during the COVID-19 pandemic. In today’s podcast, he shares how coping with the aftermath of the 2017 hurricane assisted them with the pandemic.
Read More
Analyzing the Individual Marketplace for Health Benefits Amid COVID-19
June 16th 2020On this episode of Managed Care Cast, we speak with John Barkett, MBA, senior director of Policy Affairs in Benefits Delivery and Administration for Willis Towers Watson, on the current outlook of individual markets in private exchange solutions amid the pandemic.
Read More
Beneficiaries Face Limited Access to Medicare Diabetes Prevention Program
June 15th 2020In this episode of Managed Care Cast, we speak with the lead author of a study in the June issue of The American Journal of Managed Care® about the nationwide dearth of suppliers of the Medicare Diabetes Prevention Program, which aims to reach older adults with prediabetes.
Read More
How Can Digital Care Programs Aid Those With Chronic Musculoskeletal Pain?
June 9th 2020On this episode of Managed Care Cast, we speak with Jeffrey Krauss, MD, chief medical officer of Hinge Health and Stanford Clinical assistant professor, about the efficacy of a 12-week digital care program aimed to reduce lower back and knee pain in a real-world population.
Read More
The Challenges and Strengths of Physician-Led ACOs in Difficult Times
June 4th 2020In this episode of Managed Care Cast, we speak with the lead author of a study in the May issue of The American Journal of Managed Care® about the shift in new accountable care organizations (ACOs) from being led by hospital systems to being led by physician groups, and the accompanying policy shifts that are needed.
Read More
An Inside Look at Innovations by MJFF to Assist the Parkinson Community Amid the COVID-19 Pandemic
May 26th 2020On this episode of Managed Care Cast, we speak with Rachel Dolhun, MD, vice president of Medical Communications at The Michael J. Fox Foundation for Parkinson Research, about recent innovations by The Michael J. Fox Foundation to assist patients and families of patients with Parkinson disease in adjusting to this new normal.
Read More
Addressing Mental Health Amid COVID-19 Through Cognitive Behavioral Coaching
May 19th 2020On this episode of Managed Care Cast, we speak with Connie Chen, MD, chief medical officer at Lyra Health, about a recent study examining the efficacy, in real-world circumstances, of a structured, cognitive behavioral coaching program delivered through video or telephone.
Read More
Looking at the Role of Public Programs, Public Service in the Midst of COVID-19 Crisis
May 11th 2020In this episode, we feature an interview with Sherry Glied, PhD, health economist and dean of New York University’s Robert F. Wagner Graduate School of Public Service, who spoke with The American Journal of Managed Care® about the Affordable Care Act and Medicaid, as well as the vital role that public service leadership plays in navigating public health emergencies.
Read More
How Do Medicaid Beneficiaries Benefit From Complex Care Management?
March 24th 2020On this episode of Managed Care cast, we speak with Farhad Modarai, DO, on a recent paper he co-wrote, entitled, "Impact of Complex Care Management on Spending and Utilization for High-Need, High Cost Medicaid Patients." The study can be found in the February issue of The American Journal of Managed Care®.
Read More
Accelerating the Prior Authorization Process: How a 2-Day Rule Can Optimize Efficient Care
March 4th 2020On this episode of Managed Care Cast, we speak with April Todd, senior vice president, CORE and Explorations for CAQH. We discuss CAQH CORE’s recent approval of a 2-day rule for health plans in requesting additional supporting information from providers and making final determinations on prior authorization requests.
Read More
Why Are Benefits of Preventive Drug Lists Not Fully Realized for Patients With Asthma?
February 14th 2020On this episode of Managed Care Cast, we speak with 2 authors of a recent study who researched how useful preventive drug lists are for patients with asthma and parents of children with asthma.
Read More
Predicting Healthcare Utilization With Applied Machine Learning
January 17th 2020On 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 Health IT issue of The American Journal of Managed Care®.
Read More
Concerns of Healthcare Stakeholders in the Runup to 2020 Election
January 8th 2020On this episode of the podcast, we speak with Peter Bonis, MD, chief medical officer, Clinical Effectiveness, Wolters Kluwer Health, which recently released the survey, Mending HealthCare in America 2020: Consumers & Cost.
Read More
What Are the Next Steps for Collaboration, Accountability in Oncology Care First?
December 24th 2019On 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.
Read More
Patients' Understanding of What Constitutes a Preventive Care Visit
December 14th 2019While efforts to abate surprise medical billing, such as the kind that come from out-of-network emergency department visits, are currently being debated in Washington, DC, the kind of billing discussed here occurs when patients struggle to understand the difference between preventive health services, which are covered at no cost under the Affordable Care Act, and billing for services at a doctor’s visit for an illness, condition, or injury.
Read More
KOL Corner: Amy Ellis Discusses Value-Based Cancer Rehab With Amanda Hodges
December 11th 2019Amy Ellis, director of quality and value-based care at Northwest Medical Specialties, and Amanda Hodges, director of implementation for ReVital Cancer Rehabilitation, who acts as a bridge between the oncology world and the rehabilitation world, discuss overcoming barriers in practices to help patients with cancer get the rehab care they need, how patients with cancer can benefit from rehab, and defining value.
Read More
A Frank Discussion About Implementing the OCM in Everyday Practice
December 5th 2019In 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.
Read More
Changing Outcomes for Pregnancy-Related Mortality for Vulnerable Women
November 27th 2019Women in the United States suffer from maternal mortality rates not seen elsewhere in developed countries, and nowhere is that more true than among patients served by Medicaid. 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 Innovation, which is trying to address this issue in conjunction with 30 healthcare systems.
Read More