Managed Care Cast

In this episode of Managed Care Cast, we speak with the lead author of a study in the June issue of The American Journal of Managed Care® about the nationwide dearth of suppliers of the Medicare Diabetes Prevention Program, which aims to reach older adults with prediabetes.

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.

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.

Women in the United States suffer from maternal mortality rates not seen elsewhere in developed countries, and nowhere is that more true than among patients served by Medicaid. Although it is a national epidemic, inadequate maternal care disproportionately affects minority women and the 43% of US births financed by Medicaid. On this episode, we speak with an executive vice president of Avia Health Innovation, which is trying to address this issue in conjunction with 30 healthcare systems.

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.

Healthcare is changing due to a combination of technological improvements and rising costs. For instance, more than half of surgical procedures now take place in an outpatient environment, but, as with many things in healthcare, there isn’t a lot of transparency. Today on Managed Care Cast, we speak with Michael Abrams, managing partner of Numerof & Associates, about what we know about patient safety in outpatient settings.

Chronic disease affects most employees in the United States, and today, on World Diabetes Day, Managed Care Cast speaks with the lead author of a study about chronic disease that will appear in the November issue of The American Journal of Managed Care®. Author Maren S. Fragala, PhD, CSCS.D, talks about how employer-sponsored health screenings can help identifiy previously undiagnosed disease, enabling early detection and treatment, and help keep workers healthier.

In addition to being a practicing oncologist, Mark Lewis, MD, a gastrointestinal oncologist at Intermountain Healthcare, has been living with cancer himself with a hereditary tumor syndrome that’s been passed down in his family, giving him a unique experience that has driven his approach to treating his own patients.

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 2002, Bill Allman, working for Washington State, heard from a widow with a $75,000 bill from Medicaid, which was incurred as part of her spouse's long-term care costs. Like Allman, the man was a veteran. On this episode of Managed Care Cast, we learn how Allman, who is retiring at the end of 2019, launched a program to connect veterans to health benefits they didn't know they had, and in the process, figured out that states could reduce Medicaid spending.

Accountable care organizations (ACOs) face a learning curve before they start achieving savings. David Carmouche, MD, president of the Ochsner Health Network and executive director of the Ochsner Accountable Care Network, explains how the Ochsner ACO was able to find success and how other ACOs can get over the learning curve to achieve savings.

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.