Bevey Miner: Unpacking the 21st Century Cures Act, the Role of Open Comment Periods
February 1st 2024Bevey Miner, executive vice president of health care strategy and policy, Consensus Cloud Solutions, discusses the complex landscape of proposed health care rules, and the potential impact of CMS' Advancing Interoperability and Prior Authorizations Rule.
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Navigating Single Motherhood, Mental Health, and Finding Support Amidst Challenges
January 30th 2024UPMC Health Plan member Marjorie Robinson, of Monroeville, Pennsylvania, tells of her experiences with Pittsburgh-based Fabric Health as a single mom of 2 teenagers and why she believes that mental health–related concerns can be significant obstacles to overall good health.
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Dr Lucy Langer: How UnitedHealthcare Is Enhancing Oncology Pathway Adherence and Promoting Equity
January 28th 2024UnitedHealthcare's oncology payment mode initially involved a pay-for-performance program based on pathways adherence, and will be transitioning in 2024 to a broader system with graded quartiles to incentivize greater participation and pathway adherence.
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Housing Stability and Adequate Health Care Are Crucial for Mental and Physical Health
January 28th 2024Serena Sloane, a Pittsburgh-based certified nursing assistant, took advantage of a chance meeting at her laundromat with someone from Fabric Health to learn more about her options for bettering her health care benefits
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Dr Melinda Aldrich on Disparities and the Importance of Screening in Lung Cancer
January 25th 2024Melinda Aldrich, PhD, MHE, associate professor in the Vanderbilt University School of Medicine in the division of genetic medicine, discussed her ongoing research aiming to identify the drivers of disparities in lung cancer outcomes in the US.
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Dr Sandra Stein Shares Takeaways From Banner|Aetna IVBM
January 13th 2024According to Sandra Stein, MD, of Banner Health Plans, the event highlighted the significant influence of social determinants of health on health care costs and outcomes, emphasizing the shift in focus from traditional medical care to addressing crucial factors like housing, food, transportation, and utilities for positive health outcomes.
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Dr Michael Gieske on Successes and Challenges in Increasing Lung Cancer Screening in Rural Regions
January 12th 2024Michael Gieske, MD, director of lung cancer screening at St. Elizabeth Health Care, speaks to the success of the Rural Appalachian Lung Cancer Screening Initiative, along with challenges to implementing increased lung cancer screening.
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Improving Eye Care Through Community Service With the UPMC eyeVan
January 12th 2024Amrish Selvam is a fourth-year medical student at the University of Pittsburgh whose research and career interests lay in ophthalmology and who volunteers with the UPMC Vision Institute’s mobile eye clinic, the eyeVan.
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Fabric Health: Navigating Complex Health Care Systems Through Community Engagement
January 10th 2024A social-impact startup, Pittsburgh-based Fabric Health is adept at using community engagement to help members and their families navigate the complex world of health care—meeting customers where they are at, knowing time is often their most valuable resource.
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Dr Margaret Liang on Mitigating Financial Toxicity for Patients With Cancer
January 6th 2024Margaret Liang, MD, MSHPM, gynecologic oncologist and health services researcher and director, Gynecologic Oncology Fellowship Program, Cedars-Sinai Cancer Center, discusses financial toxicity in cancer care and how institutions can help alleviate the financial burden for patients.
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Dr Michael Gieske on Addressing Lung Cancer Screening Disparities in Rural America
January 5th 2024Michael Gieske, MD, director of lung cancer screening at St. Elizabeth Health Care, discusses disparities in lung cancer incidence and mortality that the Rural Appalachian Lung Cancer Screening Initiative aims to address.
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UPMC’s eyeVan Expands Accessible Eye Care by Addressing Health Equity Barriers
January 5th 2024In this interview with Katie Cecconi, community service program coordinator at the UPMC Vision Institute, we learn more about the institute’s mobile eye care initiatives and how its services are working to overcome care equity gaps.
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Dr Jonathan Silverberg Lists Which Patients With AD Benefit Most From JAK Inhibitors
January 4th 2024Jonathan Silverberg, MD, PhD, MPH, of George Washington University School of Medicine and Health Sciences, explains the benefits of using Janus kinase (JAK) inhibitors to treat patients with atopic dermatitis (AD).
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Community and Connection Drive UPMC Health Plan’s Multifaceted Success
December 22nd 2023In September, The American Journal of Managed Care® joined 4 individuals whose involvement with UPMC Health Plan, a Strategic Alliance Partner of AJMC®, has proved to be instrumental in furthering health equity and providing high-quality care in Pennsylvania, Ohio, West Virginia, and Maryland.
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Dr Bruce Sherman Explores the Role of Equitable Health Benefit Design in the US
December 16th 2023"From a health benefit standpoint, specifically, the employees have to be able to access care, they have to be able to afford the care that they are going to receive, and the benefits also have to be relevant to employees," Bruce Sherman, MD explains.
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Dr Jeffrey Sippel: Medicare Advantage NIV Denials Take Time From Patients With ALS
November 24th 2023Jeffrey Sippel, MD, MPH, addresses the increasing denial of insurance claims for non-invasive ventilators (NIV) in Medicare Advantage plans, particularly impacting ALS patients, emphasizing the time crunch on patients, and criticizing the financial focus over patients' well-being.
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Expanding Horizons: Launching a Rare Disease Nonprofit Amid Government Funding Challenges
November 23rd 2023Geri Landman, MD, MPH, cofounder and chair of Moonshots for Unicorns, talks about how the lack of government funding for PGAP3 research led her to take it upon herself to work toward a cure for her daughter.
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In this interview with The American Journal of Managed Care®, Katie Queen, MD, addresses the complexity of obesity as a medical condition, pivoting to virtual care while ensuring that patients who lived in a rural location continued to receive adequate care, and the importance of integrating awareness of obesity and chronic disease prevention into local food culture.
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Dr Jeffrey Sippel: The Impact of Insurance Denials for Patients With ALS
November 16th 2023Due to the frequent rejection of claims for noninvasive ventilators by Medicare Advantage plans, individuals with amyotrophic lateral sclerosis (ALS) are experiencing disproportionately high rates of hospital admissions.
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Amal Trivedi, MD, MPH, professor at Brown University, discusses the qualities that led him to nominate David J. Meyers, PhD, to receive the Seema S. Sonnad Emerging Leader in Managed Care Research Award. The American Journal of Managed Care® presented the award to Dr Meyers at the 2023 Patient-Centered Oncology Care® meeting.
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