Many hoped the 2013 declaration by the American Medical Association that obesity is a disease would open the door for payer coverage of pharmacotherapy to treat it. While that did not happen right way, a new commentary in Evidence-Based Diabetes Management by Ted Kyle, RPh, MBA, and Fatima Cody Stanford, MD, MPH, MPA, outlines how the tide appears to be turning for coverage of evidence-based treatment.
The fourth annual meeting of Patient-Centered Oncology Care, set for November 19-20, 2015, in Baltimore, Maryland, will feature a premiere multi-stakeholder lineup where leading payers, providers, and leaders from pharma will discuss how to deliver value-based care as cost of breakthrough therapies continues to climb. Julie Vose, MD, MBA, FASCO, the president of the American Society of Clinical Oncology, will give the keynote address.
The American Journal of Managed Care and the Robert Wood Johnson Foundation will host a Tweetchat September 29 from 11 am to noon EDT on the Culture of Health and the impact of accountable care organizations (ACOs).
Rising costs in cancer care, especially for new therapies, have gained attention in recent years. However, a study just published in The American Journal of Managed Care finds about half of patients are interested in discussing cost on the front end, but only a minority actually have a cost discussion with their oncologist.
The evolution of healthcare quality as a matter of public policy is the subject of the latest commentary marking the 20th anniversary of The American Journal of Managed Care. Charles N. Kahn III, MPH, president and CEO of the Federation of American Hospitals, traces how quality's components emerged in the wake of a groundbreaking report on hospital safety.
Leah Binder, president and CEO of The Leapfrog Group, will be the keynote speaker at the upcoming meeting of the ACO and Emerging Healthcare Delivery Coalition, to be held October 15-16, 2015, in Palm Harbor, Florida. The Coalition, an initiative of The American Journal of Managed Care, brings together stakeholders from across healthcare to share ideas for navigating the changing reimbursement landscape.
The latest installment in the 20th anniversary commentary series in The American Journal of Managed Care explores the concept of "clinical efficacy." This healthcare delivery model asks stakeholders to make use of data and value-based contracts that reward early intervention in high-risk patients.
The deadly nature of colorectal cancer merited attention in the Affordable Care Act, which called for eliminating cost-sharing for screening to prevent deaths. The future of colorectal screening, its cost-effectiveness, and a possible way to limit unneeded tests are the topic of a recent series of papers in The American Journal of Managed Care.
As the United States progresses toward improving health and healthcare while lowering cost, the need for standardized, evidence-based measures becomes all the more important.
New resources are being directed toward precision medicine, particularly in cancer care. With that in mind, Evidence-Based Oncology, a publication of The American Journal of Managed Care, devotes its current issue to articles and commentaries on this growing field.
Commercial health plans will soon face a new Federal rule that will require them to provide counseling to obese and some overweight beneficiaries-and most will need help complying. Omada Health co-founder and CEO Sean Duffy, writing this month in Evidence-Based Diabetes Management, tells how the CDC has opened the door for digital health programs to offer a scalable, effective solution.
Before "value" became a cancer care buzzword, The American Journal of Managed Care was the first to create a conference where stakeholders discussed how to deliver the best care possible-and figure out how to pay for it. The fourth installment of Patient-Centered Oncology Care on November 19-20, 2015, in Baltimore, Maryland, will address the regulation of molecular diagnostics and ongoing efforts at payment reform.
What are managed care readers following so far in 2015? At the midway point of celebrating its 20th year of publication, The American Journal of Managed Care lists the most-read articles from its print journals over the first 6 months.
On July 27 at 10 am EDT, The American Journal of Managed Care will host a tweetchat with the University of Michigan Center for Value Based Insurance Design to discuss moving from volume to value in healthcare and changing the cost discussion from "how much" to "how well."
The arrival of Sovaldi caused pharmacy benefit managers to adjust their strategies for controlling prices for breakthrough therapies. On the eve of a new drug class for cholesterol hitting the market, Express Scripts' Dr. Steve Miller tells Evidence-Based Diabetes Management in an interview how the PBM is working on behalf of managed care in a changed environment.
A special issue of Evidence-Based Oncology, a publication of The American Journal of Managed Care, covers clinical sessions, updates on new trial designs, and coverage of the discussion of "value" in cancer care from the 2015 meeting of the American Society of Clinical Oncology. The meeting took place May 29 to June 2, 2015, at Chicago's McCormick Convention Center.
A study by Kaiser Permanente published today in The American Journal of Managed Care confirms that patients with chronic pain are seeking complementary treatments, and that if physicians must ask if they want to know about them.
The Affordable Care Act mandated an end to cost sharing for mammograms and colonoscopies if these screenings were preventive. So far, according to a study just published in The American Journal of Managed Care, the change has had little impact, but the verdict may still be out.
The link between getting patients to take medication correctly and keeping down healthcare costs is strong enough that adherence is being tied to reimbursement for healthcare providers. A study published recently in The American Journal of Managed Care examines connections at the health plan level between good plan-level adherence, lower rates of disease complications, and lower medical spending.
When The American Journal of Managed Care's ACO and Emerging Healthcare Delivery Coalition met for the most recent Web-based session, the speakers discussed the importance of accountable care organizations as CMS moves forward with new reimbursement schemes and managing high-risk patients through coordinated care.
Margaret E. O'Kane, president of the National Committee for Quality Assurance will join The American Journal of Managed Care for a Tweetchat on June 26 at 1 pm EST. Follow the discussion and ask your own questions using #AJMCchat.
The "Patient-Centered Medical Home," which promises better coordination of care for those with multiple medical conditions, has been touted as a vehicle for improved health, satisfaction, and cost-savings: the so-called triple aim. A study of PCMH adoption within the Veterans Health Administration found little effect on patient satisfaction, at least in the early going.
In the June issue of The American Journal of Managed Care, Kaiser Permanente Chairman and CEO Bernard J. Tyson calls for shifting healthcare resources forward in the life span to improve quality deliver more value for the healthcare dollar. His commentary is part of a series marking the 20th year of the journal's publication.
With the explosion of new therapies in cancer care, the risk of each new therapy must be clearly understood in making treatment decisions. In a special issue on cardio-oncology in Evidence-Based Oncology, a publication of The American Journal of Managed Care, Texas Oncology's Dr. Debra Patt discusses the challenge of translating what is known from clinical trials to real-world patients, who may be older and have more health problems.
With more patients surviving cancer comes more effort to ensure that treatment itself does not shorten life, especially by damaging the heart. A special issue of Evidence-Based Oncology that takes a look at the growing specialty of cardio-oncology starts with a feature on the program at Massachusetts General Hospital.
The competition seeks innovative and sustainable strategies for cost sharing to reduce inequality and promote access, affordability, and adherence to treatment.
Seema S. Sonnad, PhD, associate editor of The American Journal of Managed Care, died May 27, 2015, after suffering a cardiac arrhythmia during an ultramarathon. A new award for an emerging leader in managed care, to be given for the first time later this year, will be named in her honor.
In a commentary just published in The American Journal of Managed Care, Christine K. Cassel, MD, president and CEO of the National Quality Forum, discusses what can be done to scale back the number of measures providers must use, what is being done to address socioeconomic differences, and other issues. This commentary is part of a series appearing for the journal's 20th anniversary.
A study of more than 195,000 Medicare clients who were in the hospital for observation in 2010 found that only a tiny fraction were discharged to a skilled nursing facility, and fewer still had their care covered by Medicare. The findings have implications in light of the two-midnight rule and other policies that may not affect large numbers of beneficiaries, but can have a sizable impact on those who are affected.
The realm of cancer care remains a holdout in the movement toward value-based payment models, with implications for cost and health outcomes, according to authors of a new article in The American Journal of Managed Care. Authors from the Center for Health Policy at the Brookings Institution assert that new payment models can be adopted by all payer and provider types, with benefits over the traditional fee-for-service model.
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