In addition to shining a light on health disparities, medical misinformation, and public health infrastructure, the COVID-19 pandemic has also propelled calls for the transition to value-based care in the United States.

To discuss this topic, among others, we sat down with Mara McDermott, the executive director of the Value Based Care Coalition, formerly known as the Next Gen ACO Coalition.

On this episode of Managed Care Cast, McDermott discusses the organization’s recent re-brand, how its goals align with the Center for Medicare and Medicaid Innovation’s strategic refresh, and the future of value-based care.

In November, the Pharmacy Quality Alliance (PQA) and Patient Advocate Foundation (PAF) announced a collaboration aimed at developing a patient-centered outcomes research agenda to improve social determinants of health screenings and interventions in pharmacy settings.

The year-long project received funding from the Eugene Washington PCORI Engagement Awards program and will feature an in-person workshop held in conjunction with the PQA Annual Meeting in May.

To learn more about this initiative, why it is needed, and how it will be carried out, The American Journal of Managed Care® (AJMC®) spoke with Melissa Castora-Binkley, PhD, the senior director of research at PQA and Rebekah Angove, PhD, vice president for patient experience at PAF.

In this episode of Managed Care Cast, Castora-Binkley and Angove discuss why pharmacists are in a unique position to help address social determinants of health and the importance of incorporating patients’ perspectives into research agendas.

Are millennial patients with multiple sclerosis (MS) different from older patients? If they are different, is it partly because the MS field has benefitted from new therapeutic options and increased knowledge about the role of diet and exercise and modifiable behaviors, such as smoking?

On a recent episode of Medical World News®, Matt Hoffman, managing editor of Neurology Live®, sat down for a conversation with Mitzi Joi Williams, MD, a board-certified neurologist and MS specialist in Smyrna, Georgia, about the trends she see in younger patients with MS and how they approach treatment decisions and other disease considerations. We invite you to listen to an excerpt of the broadcast here on Managed Care Cast, and you can find a link to the full episode in the show notes.

https://www.medicalworldnews.com/view/deep-dive-into-treating-millennials-with-multiple-sclerosis

The Alliance of Community Health Plans (ACHP) recently released its 2021 Report on Affordability. In this episode of Managed Care Cast, we speak with Ceci Connolly, the president and CEO of ACHP, about the steps that its payer members are taking to lower costs through offerings such as virtual-first care, remote patient monitoring, and other new products, some of which were created because of the pandemic.

Proponents of price transparency hope that publishing health care prices can enable patients to shop for their health care services and better understand the bills that they receive. However, little is known about the value of marketwide transparency tools that reveal charges for out-of-network care.

On this episode of Managed Care Cast, we’re talking with an author of a study published in our November 2021 issue. The article, “Assessing Utilization of a Marketwide Price Transparency Tool,” describes how consumers use a shopping tool to research health care prices in their area. Joining us today is Grace Kim, MHA, a PhD student at New York University.

COVID-19’s effects on the body are now known to be far-reaching—and long-lasting in the most severe cases—but when it started spreading across the world in early 2020, initial attention was focused on the lungs. That concern led to worries about the impact of infection for individuals with respiratory diseases, such as chronic obstructive pulmonary disease (COPD) and asthma.

On this episode of Managed Care Cast, we speak with Meilan K. Han, MD, MS, the author of a book released this month called Breathing Lessons: A Doctor’s Guide to Lung Health. Han, a pulmonologist, gives an inside tour of the lungs and how they work, zooms out to examine the drivers of poor respiratory health, and addresses policy changes that are needed to improve lung health.

Han, who started writing the book at the beginning of the pandemic, is a professor of medicine in the Division of Pulmonary and Critical Care at the University of Michigan. She also serves on the scientific advisory committees for both the COPD Foundation and the American Lung Association (ALA) and is a spokesperson for the ALA.

On this episode of Managed Care Cast, we speak with Dr Abi Sundaramoorthy, MD, MBA, executive vice president of clinical enterprise at Somatus, a national value-based care company serving patients with underlying kidney disease, on the potential of value-based arrangements to address disparities in chronic kidney disease and promote preventive, effective care.

Fragmented health care is a known issue for patients and providers, and nowhere is the problem as acute as it is in the over-65 population. Studies have shown that patients who have a strong relationship with a primary care provider (PCP) who coordinates their care have better outcomes. But care provided by specialists has expanded over the past 2 decades, and the average PCP has twice as many specialists involved in the care of their fee-for-service Medicare patients as they did 20 years ago, according to research published in Annals of Internal Medicine this week.

On this episode of Managed Care Cast, we speak with one of the coauthors of the study, "Trends in Outpatient Care for Medicare Beneficiaries and Implications for Primary Care, 2000 to 2019," which illustrates the changing trends in a PCP’s panel of Medicare patients and how that translates to an increased workload for primary care doctors.

Michael L. Barnett, MD, MS, an assistant professor in the Department of Health Policy and Management at the Harvard TH Chan School of Public Health, is also an assistant professor of medicine at Brigham and Women’s Hospital in Boston. He earned his medical degree from Harvard Medical School and holds a master of science in health policy and management from the Harvard TH Chan School of Public Health.

The 340 drug pricing program was first established in 1992 and allows participating hospitals to manufacture discounts on drugs used in an outpatient setting. In years since, federal agencies have clarified savings from the program should be directed at improving care for underserved patients. One method of doing this is providing uncompensated care, or charity care and other unreimbursed care, to uninsured or underinsured patients.

In the years since its inception, debates around the program have centered on whether savings actually benefit the underserved as intended.

To determine whether hospital provision of uncompensated care increased following hospital entry into the 340B program, Sunita M. Desai, PhD, and J. Michael McWilliams, MD, PhD, analyzed secondary data on 340B participation and uncompensated care provision from general acute care and critical access hospitals between 2003 and 2015.

Their study “340B Drug Pricing Program and Hospital Provision of Uncompensated Care,” was published in the October issue of The American Journal of Managed Care and is now available online.

On this episode of Managed Care Cast, Desai discusses the study’s findings, what they mean, and next steps for the 340B program.

In this podcast, The American Journal of Managed Care's associate editorial director, Mary Caffrey, speaks with Michelle Afkhami, MD, from City of Hope, about best practices for oncology organizations to leverage molecular/genomic testing, the importance of identifying RET-positive patients early so they can receive targeted treatment, and more.