This Week in Managed Care: January 30, 2016

Top managed care news of the week includes new recommendation to screen all adults for depression, new issue of The American Journal of Managed Care places attention on mental health care, and Donald Trump calls for Medicare to negotiate drug prices.

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.

Depression Screening

This week, the US Preventive Services Task Force called for screening all adults for depression, especially pregnant women and new mothers.

The recommendation means that physicians and health plans will need places to refer patients who screen positive for depression, which raises questions about where those who need help will go for care. Until now, the lack of resources for mental health is one reason why doctors have been told to screen only when risk factors are present or when they know the patient can be treated.

The National Institute of Mental Health estimates that 15.7 million American adults suffer major depressive disorder, which is a leading cause of disability in the United States.

Mental Health Cost

The cost of treating depression received attention in this month’s issue of The American Journal of Managed Care.

Alesia Ferguson, PhD, and her co-authors explore using value-based insurance design to create incentives for physicians to provide better mental health care. One example would be giving primary care physicians an incentive to get patients to follow through on mental health referrals.

The concept of value-based insurance design, or VBID, was pioneered 15 years ago by AJMC’s co-editors-in-chief, Drs Michael Chernew and Mark Fendrick, and is reflected in the Affordable Care Act.

Read the current journal article.

Colorectal Cancer Screening

A study published this week suggests that colorectal cancer screening should occur much earlier than the current benchmark at age 50. The study, which appeared in the journal Cancer, found that 15 percent of all patients with colorectal cancer were diagnosed before age 50, and these cases were typically more difficult to treat, requiring both surgery and radiation.

Author Samantha Hendren, MD, MPH, of the University of Michigan, called the study “a wake-up call to the medical community,” and said physicians should be more alert to warning signs of this cancer.

Trump Sides with Clinton and Sanders

With the Iowa caucuses set for Monday, Donald Trump is staking out a different position from his fellow Republicans when it comes to Medicare. Like Democrats Hillary Clinton and Bernie Sanders, Trump wants Medicare to be able to negotiate drug prices, and he told a crowd in New Hampshire the change could save $300 billion.

The author of “The Art of the Deal” said there’s one reason why Medicare doesn’t have the right to negotiate savings right now. He told the crowd, “It’s because of the drug companies.” Other Republicans are not expected to back Trump’s position, but the Nasdaq biotechnology index dipped slightly after reports of his comments.

Republicans in Congress, meanwhile, are facing a budget deficit of more than $500 billion due to rising healthcare costs, much of it due to the number of Americans who now qualify for Medicaid under the Affordable Care Act. Republican leaders are calling for spending cuts in Social Security, Medicare and Medicaid.

Physician Leadership

Anthony Slonim, MD, president and CEO of Renown Health in Nevada, discussed the importance of having the “clinical lens” in healthcare leadership in a new interview with AJMC. He spoke about its importance in accountable care organizations: “I think physician leadership is essential for an ACO. The things that we’re talking about as we improve the value proposition, which is to improve quality and lower cost, can only be done with doctors at the table.”

ACO Coalition Spring Live Meeting

Dr Slonim, who is the chair of the ACO and Emerging Healthcare Delivery Coalition, will bring his expertise to Scottsdale, Arizona, on April 28th and 29th when he leads the Coalition’s spring meeting. Read our interview with Dr Slonim and learn more about the spring meeting.

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

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