- Center on Health Equity and Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
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- Value-Based Care
Episode 9 - The Payer Approach to Immunotherapy
In this segment, the panelists explain how coverage policies vary by payer, and explore the factors that affect the costs associated with different immunotherapy agents.
Michael Kolodziej, MD, discusses how Aetna reviews evidence and takes several factors into account when making payer decisions about supporting cancer research, and explains that different organizations have different processes. Jeffrey Weber, MD, PhD, continues the conversation with an explanation of how different immunotherapy agents have different dosage and administration requirements, which affect overall costs.
Addressing cost differentials and coverage policy inconsistencies is important because what is covered by payers directly impacts the types of treatments that are recommended to patients. As concluded by Daniel J. George, MD, providers want to be able to recommend a clinical trial or other treatment modality in situations where standard therapy is not likely to be effective for the patient.
Navigating Health Policy in an Election Year: Insights From Dr Dennis Scanlon
April 2nd 2024On this episode of Managed Care Cast, we're talking with Dennis Scanlon, PhD, the editor in chief of The American Journal of Accountable Care®, about prior authorization, price transparency, the impact of health policy on the upcoming election, and more.
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Commonwealth Fund Report Details Pervasive Racial and Ethnic Disparities in US Health Care, Outcomes
April 18th 2024Using 25 health system performance indicators, the Commonwealth Fund 2024 State Health Disparities Report evaluated racial and ethnic disparities in health care and health outcomes both within and across US states and highlighted the urgent need for equitable health care policies and practices in the US.
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Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
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The Biden administration recently launched the Global Health Security Strategy, a new effort to combat the spread of infectious diseases; lawmakers zeroed in on the risks of massive consolidation in health care during the first congressional hearing on the Change Healthcare hack; the FDA recently announced the recall of a pair of heart devices linked to numerous deaths and injuries.
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