Policy

Robin Shah, CEO of Thyme Care, which he founded in 2020 with Bobby Green, MD, president and chief medical officer, joins hosts Emeline Aviki, MD, MBA, and Stephen Schleicher, MD, MBA, to discuss his evolution as an entrepreneur in oncology care innovation and his goal of positively changing how patients experience the cancer system.

A new grant aims to address maternal mortality in predominantly Black rural areas; Eli Lilly's drug to treat atopic dermatitis has not received FDA approval; a preliminary injunction is granted to Planned Parenthood South Atlantic.

FDA action is no longer expected in Q3 of 2023.

ViiV Healthcare is developing a self-injectable HIV drug similar to Cabenuva; HHS met with insurance companies to resolve COVID-19 vaccine coverage issues; the FDA has greenlit drugmaker Novo Nordisk to add reports of ileus, or intestinal blockage, to its Ozempic label.

A government shutdown could impact Medicaid and Medicare in important ways; new Medicare Advantage plans personalize offerings to special populations; nursing homes are still waiting for COVID-19 shots since the US government has stepped back.

Medicare Advantage and Medicare Part D prescription drug plans will maintain stability in 2024; a report found that women encounter disadvantages in cancer prevention and care; prescriptions for semaglutide, similar drugs surpass 9 million.

Chemotherapy drug shortages put young patients at risk; restrictions and challenges cause concerns of a rise in teen births; at least 28 companies failed to prove sufficient product testing for cough syrups.

The CDC recommends pregnant women receive RSV vaccinations; 6 states expand their Medicaid programs to offer dental coverage; a new bill aims to address issues in the US organ transplant system

On this episode of Managed Care Cast, we speak with the senior author of a study published in the September 2023 issue of The American Journal of Managed Care® on the importance of adequate and effective lung cancer risk factor documentation to determine a patient's eligibility for screening.

Drugmakers turn to artificial intelligence (AI); new reports of vaccine appointment cancellations or insurance issues; Biden plans to clear Americans’ credit scores of medical debt.

Public health professionals are the backbone of our health system, and their contributions are vital to the well-being of our communities. As a society, we must value their work, provide the support they need, and ensure that public health remains a rewarding and viable career choice.

A new study aimed to summarize publicly available coverage policies of commercial health insurers for digital medicine services.

Laurie Sobel, the associate director for women’s health policy at KFF, moderated a panel discussion with Christine Gilroy, MD, MPH; Victoria Nichols, MPH; and Don Downing, RPh, about insurance coverage of FDA-approved Opill and other OTC contraceptives.

We are in the midst of a transformative time in oncology that could also be a little scary if you are not prepared, said Nicolas Ferreyros, managing director of policy, advocacy, and communications, Community Oncology Alliance.

Ryan Haumschild, PharmD, MS, MBA, director of pharmacy at Emory Winship Cancer Institute, shares his unique perspectives as both a provider and payer on the use of prior authorizations (PAs) and "Gold Cards" in patients with rare diseases.

Various health programs may shut down at the end of September without congressional action; maternal health experts push for midwife workforce expansion amidst high maternal mortality rates in the United States; studies find that heightened screen time in teens and tweens before bed can result in a lack of sleep.

Medicare Advantage enrollment was higher among immigrants compared with US-born residents, but the highest enrollment was found among immigrants with limited English proficiency.

During this session at the National Comprehensive Cancer Network (NCCN) Policy Summit, Yelak Biru, MSc, and Crystal S. Denlinger, MD, explained the importance of screening for and addressing health-related social needs.

Artificial intelligence (AI) tools offer potential solutions to the growing demand in mental health; patients face weight loss drug shortages and insurance complications; updated mask guidelines cause worry among health care workers.

Medicare’s administered pricing system has never had to deal with labor scarcity before.

Senate and House Democrats again attempt to expand fertility treatments for veterans and active-duty personnel; CDC expects high hospitalization numbers due to “tripledemic” of COVID-19, respiratory syncytial virus, and the flu; a study found that MDMA, also known as ecstasy, can reduce posttraumatic stress disorder (PTSD) symptoms.

Millions are invested in researchers for the Cancer Moonshot initiative; some providers are charging patients for communicating online; health insurance coverage increased for half of states.

Legal actions aim to ensure abortions can be provided in emergencies; cold medication ingredient phenylephrine found to be ineffective; American nursing homes are scoring low on care quality.

FDA approves updated COVID-19 booster vaccines; low donor turnout and climate disasters result in a national blood shortage; minority patients discouraged by lack of doctor diversity.

Ryan Haumschild, PharmD, MS, MBA, director of pharmacy at Emory Winship Cancer Institute, discusses treatment options available to patients with rare diseases, as well as the challenges these patients and their pharmacists face in accessing these treatments.

Navigating mask mandates and vaccine recommendations; Biden administration wants employers to have naloxone on hand; NIH nominee to receive a confirmation hearing.

Specialty pharmacy is a big area of growth, with opportunity for patients, and specialty pharmacists can help payers and insurers ensure that patients get the full value of oncology medications, noted Andre Harvin, PharmD, MS, MBA, chief pharmacy officer, Oncology Services, Cone Health Cancer Centers.

Nathan Walcker, CEO at Florida Cancer Specialists & Research Institute (FCS), highlights some of the recent partnerships and initiatives at FCS to improve community-based oncology care from a value-based perspective.

Care quality is high in both the United States and Canada, but there are commonalities in regard to drug access and cost issues, particularly with advanced medications, noted G. B. John Mancini, MD, University of British Columbia.

The CDC reports an increase in respiratory syncytial virus (RSV) cases among young children and babies; the deadline looms for reauthorizing the United States’ global AIDS program as it has become a topic within the abortion debate; an eye-tracking device may help to diagnose autism spectrum disorder earlier.