This Week in Managed Care: March 19, 2021

AstraZeneca refutes blood clot links to COVID-19 vaccine, the 2021 V-BID Summit celebrates 20 years of policy achievements for value-based insurance design, and Managed Care Cast discusses 4 strategies payers can use to ensure opioid use disorder care.

Welcome to This Week in Managed Care, I’m Matthew Gavidia.

AstraZeneca Says No Vaccine Link to Blood Clots, More Countries Suspend Use

This week, several European countries suspended use of the COVID-19 vaccine manufactured by AstraZeneca amid links to recent deaths from blood clots.

Although AstraZeneca and the World Health Organization have both maintained that no scientific evidence supports the association and urged countries to continue use, Italy, France, Spain, and Sweden have joined those who are temporarily halting use of the vaccine.

With unproven reports potentially adding to misinformation surrounding COVID-19 vaccines, a new poll by PBS finds that nearly half of surveyed Republican men will not get a vaccine.

Currently, Republican men remain one of the key groups refusing to get vaccinated, with 47% of Americans who supported President Donald Trump in the 2020 election saying they would not be vaccinated if they had the opportunity, compared with 6% of Democratic men and 10% of those who supported President Joe Biden.

Along with conservatives, young people and people of color will be among the 3 target groups of an expansive $1.5 billion public relations campaign set to be unveiled by the White House to boost vaccine confidence and uptake nationwide, according to STAT.

Relayed through television, radio, and digital advertising, the campaign will focus on addressing skepticism of vaccines’ safety or effectiveness, as well as educating eager Americans who want the vaccine on where, when, and how they can receive it.

For more, visit AJMC.com.

V-BID Summit

Last week, the University of Michigan Center for Value-Based Insurance Design, or VBID, held its 2021 V-BID Summit in a virtual format.

Marking 20 years since Drs Mark Fendrick, MD, and Michael Chernew, PhD, current co-editors-in-chief of The American Journal of Managed Care^®, issued their first VBID publication, then called benefit-based co-pay, VBID concepts are now present in the Affordable Care Act through covered preventive services, Medicare Advantage has been running a VBID demonstration project, and the next iteration, VBID X, is being developed.

This year’s sessions included panels of experts across the health care spectrum looking at the impact of VBID and what needs to come next, including:

• using VBID as a tool to address health care affordability concerns of consumers
• policy achievements of VBID over the last 20 years
• what drove early adopters of VBID
• where VBID is today and where it needs to go

For full conference coverage, visit AJMC.com.

How Payers Can Use 4 Strategies to Ensure Opioid Use Disorder Care

Over the past year, the upheaval created by the COVID-19 pandemic has particularly affected individuals struggling with opioid use disorder and other substance use issues in the United States.

Between June 2019 and May 2020, over 81,000 people died of drug overdoses, marking an unfortunate record of the highest number of overdose deaths ever recorded in a 12-month period.

In a commentary published in the March issue of The American Journal of Managed Care^®, authors Chethan Bachireddy, MD, MSc, the chief medical officer for Virginia’s Medicaid program, and Mishka Terplan, MD, MPH, outline 4 things that payers can do to make sure that patients with opioid use disorder get the treatment they need, and what’s at risk if they don’t.

On this week’s episode of Managed Care Cast, we speak with Bachireddy on the commentary, as well as how these strategies are being used in Virginia, where he continues to work one day a week as a primary care physician at Virginia Commonwealth University.

For the podcast, visit AJMC.com.

20-Year Data Highlight Little Progress in Rural Racial Health Disparities

According to new research published this week in the Journal of the American College of Cardiology, Black adults living in rural regions of the United States between 1999 and 2018 experienced high mortality rates due to diabetes, high blood pressure, heart disease, and stroke compared with White adults.

It has been previously shown that cardiovascular mortality rates in rural regions tend to be higher than in urban areas, with heart failure documented as a contributing factor in this trend. And, despite numerous public health and policy initiatives aimed at reducing racial health disparities, “it is unclear whether these efforts have benefited Black persons living in rural and urban areas equally,” researchers wrote.

Deriving deidentified data from the CDC Wonder Database, researchers compared annual age-adjusted mortality rates per 100,000 individuals for Black and White adults stratified by rural or urban area.

Throughout the 20-year study period, data showed annual age-adjusted mortality rates were substantially higher in rural and urban areas for Black adults compared with White adults for diabetes, hypertension, heart disease, and stroke, although this gap was found to be narrowed more rapidly in urban compared with rural areas for diabetes, as well as for hypertension diagnoses.

Results also indicate that diabetes- and hypertension-related mortality are 2 to 3 times higher among Black adults compared with White adults in rural regions of America.

“While modest gains have been made in reducing racial health inequities in urban areas, large gaps in death rates between Black and white adults persist in rural areas, particularly for diabetes and hypertension,” said study author Rishi Wadhera, MP, MPP, MPhil. “Given that diabetes, hypertension, and heart disease are preventable and treatable, targeted public health and policy efforts are needed to address structural inequities that contribute to racial disparities in rural health.”

For more, visit AJMC.com.

“Disparities in Cancer Care: Sources and Solutions” Webinar on March 22

Continuing the discussion on health disparities, evidence has shown that minority groups develop cancer at higher rates and experience worse outcomes.

Speaking on these concerns, The American Journal of Managed Care^® is introducing the AJMC^® Oncology Value Coalition, with its first webinar, titled, “Disparities in Cancer Care: Sources and Solutions,” to be held on March 22.

Join Community Oncology Alliance, or COA, President Kashyap Patel, MD; COA Secretary Debra Patt, MD, PhD; and Meharry-Vanderbilt Alliance Executive Director Karen Winkfield, MD, PhD, for the landmark event!

To register, visit AJMC.com.

For all of us at AJMC^®, I’m Matthew Gavidia. Thanks for joining us!