Managed Care Cast

On this episode of Managed Care Cast, we speak with Dr Joanne Armstrong, vice president and chief medical officer for Women’s Health and Genomics at CVS Health, on the distinct pathophysiology of cardiovascular disease in women, applicability of current screening and care delivery guidelines for heart health in regards to minority populations, and how her own health experiences have influenced her perspective on cardiovascular disease management.

April is Parkinson’s Disease Awareness month, and on this episode of Managed Care Cast, we take a look at the Parkinson's Progression Markers Initiative (PPMI), a study from the Michael J. Fox Foundation for Parkinson's Research (MJFF). The multicenter, international study aims to end Parkinson disease, which is expected to double worldwide by 2040, to more than 14 million people.

The study is investigating the biomarkers and other data collected from a wide range of individuals—those without the disease, those with very early disease, and those with more advanced disease.

Originally launched in 2010, the study is expanding online where it wants to collect information from more than 100,000 people, particularly those with a first-degree relative with Parkinson, those with a genetic mutation for the disease, or those who act out their dreams in their sleep.

Our guest on this episode is Roseanne D. Dobkin, PhD, a clinical psychologist and associate professor of psychiatry at the Robert Wood Johnson Medical School at Rutgers University, and one of the investigators of the study.

In 2018, the FDA approved a record 66 novel drugs. Among them were cancer treatments, orphan drugs for rare diseases, drugs under expedited review, and biosimilars. However, access to each of these drugs for patients covered by different health plans was not uniform. On this episode of Managed Care Cast, we speak with Ari D. Panzer, BS, a master of public policy candidate at Duke University, and lead author of “Patients’ Access to 2018 FDA-Approved Drugs 1 Year Post Approval,” which was published in the April issue of The American Journal of Managed Care®. He delves into why it’s important to ensure patients receive optimal treatment and maximize their outcomes, understanding why health plans vary in their coverage decisions despite having access to the same evidence, and the difficulty of striking the right balance between drug access, cost, and coverage to ensure patients can get the drug therapies they require when appropriate.

Entering its 51st year, the American Kidney Fund has made it its mission to help all patients affected by chronic kidney disease (CKD), which is the fastest-growing noncontagious disease in the United States: from those at risk for chronic kidney disease through patients requiring dialysis and/or transplant. First and foremost is uncovering the primary cause of their kidney failure. Unfortunately, for 14% of low-income patients, the origins of their CKD remain a medical mystery.

In December of 2020, the American Kidney Fund convened the Unknown Causes of Kidney Disease Summit, bringing together government agencies, industry, patients, researchers, and rare disease organizations, hoping that by helping underserved patients get to the root cause of their kidney disease, they could also help solve this mystery for a broader patient population. From this, a roadmap was born for what would become the Unknown Causes of Kidney Disease Project, launched in mid-2021, with goals that include advocating for equitable kidney disease care, educating and empowering patients through culturally competent information, and overcoming financial and communication barriers to treatment.

On this episode of Managed Care Cast, we speak with Mike Spigler, vice president of patient support and education for the American Kidney Fund, who is spearheading the Unknown Causes of Kidney Disease Project. He addresses why patients are the key to all the American Kidney Fund hopes to accomplish, using the organization’s voice to address rare kidney diseases, and emphasizing the necessity of policy change for care coverage support, including for genetic testing.

It’s well known the state of maternal morbidity and mortality in the United States is subpar. From stark racial disparities in maternal deaths to a severe shortage of midwives and doulas, birthing people in the United States face unique challenges not seen in other high-income countries.

Plus, the recent increase in legislation aimed at curbing abortion access throughout the nation may serve to exacerbate these problems, as more women are forced to carry unwanted pregnancies to term.

To better understand how we got here and examine some potential solutions to these problems, The American Journal of Manage Care® sat down with Breana Lipscomb, the senior advisor of Maternal Health & Rights at the Center for Reproductive Rights.

This week also marks Black Maternal Health Week, and on this episode of Managed Care Cast, Lipscomb outlines steps needed to improve care for Black mothers in the US—a demographic that is more than 3 times more likely to have a maternal death compared with their white counterparts.

National Public Health Week, the annual initiative from the American Public Health Association, falls within the first full week of April. On this episode of Managed Care Cast, to mark the conclusion of National Public Health Week this year, which ran from April 4-10, we speak with Perry N. Halkitis, PhD, MS, MPH, dean of the Rutgers School of Public Health, who is also a public health psychologist, infectious disease epidemiologist, applied statistician, researcher, educator, and advocate. He discusses training the next generation of public health professionals, why a paradigm shift is necessary around integrating mental health awareness into public health education, and the importance of activism and advocacy to eliminating health disparities.

In January 2022, Vanderbilt University Medical Center, Meharry Medical College, and the University of Miami Miller School of Medicine announced the receipt of a $12.4 million grant from the National Institutes of Health to develop the Southeast Collaborative for Innovative and Equitable Solutions to Chronic Disease Disparities.

The center’s work aims to reduce disparities seen in the southeast United States, with particular focus on cardiovascular disease, obesity, diabetes, and other related conditions among African Americans and Latino populations.

Currently, over 20% of this region lives in poverty, while racial and ethnic minorities comprise nearly 40% of the population. Southern states also tend to be the least healthy in the nation and account for the majority of Medicaid expansion holdouts under the Affordable Care Act.

To learn more about geographic disparities in chronic disease rates, The American Journal of Managed Care® (AJMC®) sat down with Consuelo Wilkins, MD, MSCI, professor of medicine, senior vice president and senior associate dean for health equity and inclusive excellence at Vanderbilt University Medical Center in Nashville, Tennessee.

On this episode of Managed Care Cast, Wilkins discusses factors that impede progress on chronic disease prevention and outlines the next steps for the Southeast Collaborative.

This episode of Managed Care Cast is part of the new AJMC® Podcast Prevention Series, bringing you the latest news on prevention advancements in disease.

An unprecedented level of detail and robustness around interoperability standards is on its way, and on this episode of Managed Care Cast, we speak with Donald Rucker, MD, the former National Coordinator for Health Information Technology in HHS, about what the opportunities and responsibilities for payers are.

The change is precipitated by 2020 rulemaking regarding the 21st Century Cures Act requirement regarding application programming interfaces. The new requirement will enable access to patient-level data across a patient population, allowing for more analysis that can inform clinical decisions, track those decisions to costs, and even influence future policy.

Rucker, who received his medical degree from the University of Pennsylvania and also has an MBA in business and an MS in medical computer science and informatics from Stanford University, is currently chief strategy officer at 1upHealth.

Within Virginia, one of 13 states that fall within the Appalachian region of the United States, the current overall poverty rate is 10.6%, giving the state a 10th place ranking on a list of the top 10 states with the lowest poverty rates. However, the average poverty rate of the southwest corner of the state, which includes the 6 counties of Buchanan, Dickenson, Russell, Lee, Scott, and Wise, is double that of the state, at 21.9%.

Supported entirely by grants and donations, The Health Wagon has been providing free health care services for the often medically underserved and indigent individuals—who are either underinsured or uninsured—in this part of Virginia for more than 4 decades.

On this episode of Managed Care Cast, we speak with The Health Wagon’s President and CEO Teresa Tyson, DNP, MSN, FNP-BC, FAANP, and Clinical Director Paula Hill-Collins, DNP, MSN, FAANP, to learn more about the often urgent services they provide, to discover how the not-for-profit innovates care through culturally sensitive services for its rural residents, and to discuss the importance of health care equity.

CMS first implemented the Comprehensive Primary Care Plus, or CPC+, Initiative in January 2017. The medical home model is a large-scale redesign effort meant to improve primary care through payer reform and care delivery transformation. However, an interim data analysis of the initiative’s first 3 years among Medicare fee-for-service beneficiaries did not demonstrate improvements in either care continuity or care fragmentation.

On this episode of Managed Care Cast, we speak with Lori Timmins, PhD, senior researcher, and Eugene Rich, MD, senior fellow, both of Mathematica. With their fellow authors, Carol Urato, MA, researcher at Mathematica; Lisa M. Kern, MD, MPH, associate professor of medicine at Weill Cornell Medicine in New York; and Arkadipta Ghosh, PhD, principal researcher at Mathematica, they published their study, “Primary Care Redesign and Care Fragmentation Among Medicare Beneficiaries,” in the March issue of The American Journal of Managed Care®.