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This Week in Managed Care: December 2, 2016


This week, the top stories in managed care included the president-elect's picks for HHS and CMS, the American Diabetes Association addressed psychosocial care for patients with diabetes, and the American Society of Clinical Oncology released criteria on creating clinical pathways.

Hello, I’m Sara Belanger with The American Journal of Managed Care. Welcome to This Week in Managed Care from the Managed Markets News Network

Trump Makes Picks for HHS, CMS

President-elect Donald Trump this week nominated Georgia Congressman and surgeon Tom Price to be the next Secretary of Health and Human Services.

Price is a longtime critic of the Affordable Care Act and has backed legislation to end federal funding for Planned Parenthood. Unlike Trump, Price has not previously supported keeping popular parts of Obamacare, such as the provision that bars health plans from refusing to cover pre-existing conditions. Price has also backed a plan supported by House Speaker Paul Ryan that would convert Medicare to a voucher system.

Price accepted the nomination in a statement: “There is much work to be done to ensure we have a healthcare system that works for patients, families, and doctors; that leads the world in the cure and prevention of illness; and that is based on sensible rules to protect the well-being of the country while embracing its innovative spirit.”

Trump’s nominee for the Centers for Medicare and Medicaid Services is a Seema Verma, a healthcare consultant who worked with incoming Vice President Mike Pence on Indiana’s Medicaid waiver, which asks recipients to make small monthly payments for their coverage. Medicaid experts consider Verma highly knowledgeable and able to work on solutions that are acceptable to conservatives.

Read the full article on Trump's picks.

Psychosocial Help for Patients With Diabetes

The American Diabetes Association (ADA) this week published a position statement integrating psychosocial care into diabetes management, preferably in a collaborative setting.

The statement, which appears in the December issue of the journal Diabetes Care, recognizes the need to assess behavioral health needs as soon as diabetes is diagnosed and at key intervals and transitions, such as when there is a change in the disease, treatment or life circumstance.

ADA’s statement calls for doctors:

  • To tailor care to cultural influences
  • To monitor patients for diabetes distress
  • To screen patients for hypoglycemia unawareness
  • To be aware of disordered eating

For more information about the position statement, read the article.

ASCO on Clinical Pathways

This week, the American Society of Clinical Oncology (ASCO) released the Criteria for High Quality Clinical Pathways in Oncology. Release of this guide comes after ASCO created 15 criteria to help providers assess the quality, utility, and integrity of pathways programs, which have become common as payers try to reduce variance and control cost in cancer care.

Robin Zon, MD, FACP, FASCO, who chaired the ASCO task force on the criteria, spoke with The American Journal of Managed Care about the process: “Like the ASCO Value Framework, clinical pathways in oncology can serve as an important tool to help oncologists identify treatment options that represent the highest quality and value for an individual patient’s disease and circumstances.”

Understanding MACRA

Does MACRA have you confused? Come January, the Medicare Access and CHIP Reauthorization Act will change the way doctors are paid, and many still have questions.

To help, The American Journal of Managed Care has created a resource center on our website, the MACRA Compendium, where you can find news stories, interviews, and work from our contributors to help you navigate the process. Visit the page here.

Check back often, because we’ll be updating our MACRA content frequently.

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

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