Payers

What We're Reading: Biden Reportedly Reopening ACA Enrollment; Moderna Developing COVID-19 Booster; Brazil Variant Now in US

January 26th 2021, 3:30pm

Article

President Joe Biden reportedly will take executive action to reopen federal marketplaces selling Affordable Care Act (ACA) health plans; Moderna investigating booster shot designed to be more effective against emerging variants of coronavirus disease 2019 (COVID-19); Brazil coronavirus variant is found in Minnesota.

Contributor: Implementing Pharmacy-Led Telehealth Strategies to Help Medicare Advantage SNPs Improve Care for Older Adults Amid COVID-19 and Beyond

January 24th 2021, 1:00pm

Article

Pharmacy-led telehealth strategies will position Special Needs Plans (SNPs) for Star Ratings success during the pandemic and for years to come.

Rethinking Deprescribing: Who Should Monitor “Drug Overload?”

January 22nd 2021, 2:00pm

Article

Health plan pharmacists are in the perfect position to see overprescribing as it happens.

Endocrine Society Calls for Negotiated Insulin Prices in Medicare

January 13th 2021, 9:17pm

Article

The statement is aimed at drug companies, policymakers, pharmacy benefit managers, employers, and others, and calls to attention soaring insulin costs, which were the subject of several Congressional hearings in 2019.

Examining the Shift to Value-Based Kidney Care Delivery in 2021

January 12th 2021, 7:20pm

Podcast

On this episode of Managed Care Cast, we speak with the new chief financial officer of Strive Health, a value-based kidney care company that works with payers and providers to create an integrated care delivery system for chronic kidney disease and end-stage renal disease (ESRD). We discuss the changes coming to nephrology practices, as well as new ways of looking at the whole patient to halt the slide to irreversible ESRD.

Telehealth Claim Lines Increase in October 2020 as COVID-19 Pandemic Surges

January 7th 2021, 1:00pm

Article

Telehealth services have saw a spike in October as COVID-19 cases continued to rise, as seen in claims tracked by FAIR Health.

Managing Social Determinants of Health During COVID-19

January 6th 2021, 4:30pm

Podcast

Addressing the social health needs of those ill with coronavirus disease 2019 (COVID-19) is a challenge for providers and health care systems. On this episode of Managed Care Cast, we speak with Bechara Choucair, MD, senior vice president and chief health officer for Kaiser Permanente, who discusses the organization's guide that walks clinicians through considerations to keep in mind when screening patients in order to improve health outcomes as well as reduce community transmission.

Dr Basit Chaudhry Expects CMS to Take Feedback From the Field to Improve OCF

January 6th 2021, 2:00pm

Video

Feedback from the field is incredibly important when participating in new payment models like the Oncology Care Model, said Basit Chaudhry, MD, PhD, founder of Tuple Health.

A Timeline of COVID-19 Developments in 2020

January 1st 2021, 10:00pm

Article

Coronavirus disease 2019 (COVID-19) dominated 2020. This is a look back at how the pandemic evolved and progressed through the year, which closed with the arrival of vaccines, but also continued challenges.

Kashyap Patel, MD, Elected President of Community Oncology Alliance

December 15th 2020, 6:15pm

Article

Kashyap Patel, MD, associate editor of Evidence-Based Oncology, a publication of The American Journal of Managed Care, will serve a 1-year term beginning in January.