Managed Care Cast

On this episode of Managed Care Cast, we’re bringing you a portion of a panel discussion about the Oncology Care Model, held in July 2019 during a meeting of The Institute for Value-Based Medicine® (IVBM), an initiative of The American Journal of Managed Care®. At IVBM events, we gather thought leaders to share best practices across medicine, pharmacy, and management in regional locations around the country. This podcast is taken from our meeting focusing on Innovation and Quality in Oncology Care.

Transitioning to value-based care is a marathon, not a race, and should be viewed as a mission and a culture, Jeff Hunnicutt, chief executive officer at Highlands Oncology Group, told Amy Ellis, director of quality and value-based care at Northwest Medical Specialties. In order to successfully transform a practice, there needs to be a clear message and set values ingrained in the mindset of staff at the frontline of patient care.

As a progressive condition, diabetes presents an ongoing challenge for physicians to provide adequate control of patients’ disease, and new agents with novel mechanisms of action help reduce the burden in the management of diabetes.

As value-based models continue to change the payment landscape in healthcare, the models require more sophisticated data, analytics, and payment structures, which can lead to more administrative burden, as well as siloed data.

While many women in healthcare report experiencing subtle or not-so-subtle bias and microaggressions at work, a recently published study sought to determine how healthcare professionals associate men and women with career and family, and also how surgeons associate men and women with surgery and family medicine. In this podcast, we speak with the lead author, Arghavan Salles, MD, PhD, about the findings, as well as other issues affecting women in healthcare.

The Trump administration has made it clear that transparency in healthcare is a top priority and has since set its focus on several pain points that are having the biggest impact on providers and patients. During this podcast, we sit down with David Shelton, president and chief executive officer of PatientMatters, a patient financial experience solution provider, to discuss these issues.

Today we’re speaking with Dr Mark Simon, the chief medical officer of OB Hospitalist Group. OB Hospitalist contracts with hospitals across the United States to create OB emergency departments. The group employs more than 600 experienced OBs who are available 24 hours a day, 7 days a week to ensure that an OB is always in the hospital, rather than on call. OB Hospitalist also works with hospitals to reduce costs by being an outsourced provider of obstetricians.

A 5-year-old charity called RIP Medical Debt buys medical debt incurred, so far, by more than 250,000 Americans. We talk to one of the cofounders and coauthors of End Medical Debt, the book they wrote about the issue.

During the ISPOR 2019 annual meeting, a panel discussion debated the good and the bad about the quality-adjusted life-year (QALY) from various perspectives. During this podcast, we sit down with 2 of the panelists to continue the QALY discussion.

The American Journal of Managed Care® sat down with David Smith, the executive director of the Medicaid Transformation Project, to get an update about the integration challenges health systems are facing, including system issues, infrastructure issues, coding and payment issues, and more.


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