Managed Care Cast

On this episode of Managed Care Cast, Andrea Gelzer, MD, senior vice president and corporate chief medical officer for AmeriHealth Caritas, discusses the vital role telehealth has played during the pandemic, and how providers and payers can work together to encourage patients to continue routine care.

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

Oral 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.

Amid 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.

On 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.

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

In 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.

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

On 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.

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

On 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.

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

In 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.

On 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.

On 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.

In 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.

On 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®.

On this episode of Managed Care Cast, we speak with the lead author of a recent study who explored gender differences in veterans’ healthcare after leaving the military.

On 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.

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

On 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.

We speak with one of the authors of a recent study examining why overall biomarker testing rates remain poor for metastatic colorectal cancer.

On 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®.

On 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.

On 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.

While 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.

Amy 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.

In 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.