- Center on Health Equity and Access
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- Value-Based Care
Episode 9 - The Payer Approach to Immunotherapy
In this segment, the panelists explain how coverage policies vary by payer, and explore the factors that affect the costs associated with different immunotherapy agents.
Michael Kolodziej, MD, discusses how Aetna reviews evidence and takes several factors into account when making payer decisions about supporting cancer research, and explains that different organizations have different processes. Jeffrey Weber, MD, PhD, continues the conversation with an explanation of how different immunotherapy agents have different dosage and administration requirements, which affect overall costs.
Addressing cost differentials and coverage policy inconsistencies is important because what is covered by payers directly impacts the types of treatments that are recommended to patients. As concluded by Daniel J. George, MD, providers want to be able to recommend a clinical trial or other treatment modality in situations where standard therapy is not likely to be effective for the patient.
Health Equity and Access Weekly Roundup: May 4, 2024
May 4th 2024This week, the Center on Health Equity and Access highlights a variety of gaps that exist in health care, spanning women's health, the rising rate of metabolic disease, and policy for LGBTQ+ and immigrant populations. The consensus among featured experts points to comprehensive care models.
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Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
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A new federal rule will enable thousands of immigrants in the Deferred Action for Childhood Arrivals (DACA) program to obtain health care through the Affordable Care Act; a forthcoming CMS rule is expected to lower home-based care wait times and raise caregiver wages; the HHS Office for Civil Rights has finalized 2 rules that strengthen the ACA’s health care discrimination ban.
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Navigating Health Policy in an Election Year: Insights From Dr Dennis Scanlon
April 2nd 2024On this episode of Managed Care Cast, we're talking with Dennis Scanlon, PhD, the editor in chief of The American Journal of Accountable Care®, about prior authorization, price transparency, the impact of health policy on the upcoming election, and more.
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Shelly Lanning on How Employers Can Reduce Costs by Bridging Gaps in Women's Health Care
May 3rd 2024In a presentation at the Greater Philadelphia Business Coalition on Health Women’s Health Summit, Shelly Lanning, cofounder and president of Visana Health, addressed the need for comprehensive approaches in women’s health care and their coverage options.
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