This Week in Managed Care: April 2, 2016

This week, the top stories in managed care include CMS paying for diabetes prevention, coverage of the American College of Cardiology conference, and improving patient education of immunotherapy.

Hello, I’m Justin Gallagher, associate publisher of The American Journal of Managed Care. Welcome to This Week in Managed Care, from the Managed Markets News Network.

Paying for Diabetes Prevention

Medicare beneficiaries will soon have access to the National Diabetes Prevention Program, under a policy change announced by HHS Secretary Sylvia Mathews Burwell. The announcement was given after a pilot study run with the YMCA found that Medicare saved $2650 for every participant over 15 months, and those who finished the program lost nearly five percent of their weight.

An expert familiar with the decision believes commercial payers who take in Medicare Advantage will eventually expand this evidence-based program to younger consumers.

Michael Payne, chief commercial officer of Omada Health, which provides diabetes prevention programs in digital formats, said that offering the NDPP to those with prediabetes offers a return on investment not always seen in broad-based wellness programs. Said Payne: “Those with prediabetes have reached a tipping point where they need more of a clinical intervention.”

Payne will take part in our panel on digital health this week at Patient-Centered Diabetes Care, which starts Thursday in Teaneck, New Jersey. For information and to register, visit our meeting page.

American College of Cardiology Conference Coverage

Starting today, the nation’s cardiologists are gathered in Chicago for the 65th Scientific Session of the American College of Cardiology. This year’s meeting focuses on prevention of heart attacks and strokes through behavioral change, as well as advances in population health.

The need for stronger prevention efforts became clear when ACC released data from the Cleveland Clinic, which showed that heart attack patients at this world-famous hospital had become younger, fatter, and sicker over the 20-year period from 1995 to 2014.

We’ll have full conference coverage from the meeting, which you can follow on our website, as well as Twitter.

Conference page

Twitter: @AJMC_Journal #ACC16

Patient Education of Immunotherapy

We hear from scientists about breakthroughs in immunotherapy, but what do patients think? Two-time cancer survivor Debra Madden offers this perspective in her essay, “The Promise of Cancer Immunotherapy: Why Patient Education is Critical.”

Because patients do not respond to immunotherapy the same way they do to older cancer drugs, Madden said it is essential for patients to know what to expect, and to understand that these new therapies are not for everyone.

Read Madden’s essay, which is the first of 2 parts.

Understanding HDHPs

High deductible plans offer a way for patients to pay lower premiums, but do patients really know how to use them effectively? Robin Wright King of Blue Cross Blue Shield of Massachusetts told AJMC recently that research shows patients can be confused by all the elements they face. Watch the full interview.

Mental Health Care and ACOs

Thanks to the Affordable Care Act, more Americans have access to mental health care. Figuring out how to integrate behavioral health into the rest of the system is the job of the accountable care organization.

Dr Roger Kathol of Cartesian Solutions will discuss this topic later this month in Scottsdale Arizona, when AJMC presents its spring meeting of the ACO & Emerging Healthcare Delivery Coalition. There’s still time to register and join us. For more information, visit our meeting page.

For all of us at the Managed Markets News Network, I’m Justin Gallagher. Thanks for joining us.