Managed Care Cast

Early on in the pandemic, having the ability to predict where outbreaks were going to take place was something to be desired. Cotiviti developed a COVID-19 tracker map using big data models and artificial intelligence (AI) technologies, which can accurately predict where in the United States new COVID-19 outbreaks would occur and show the relative risk of infection for people with underlying health conditions.

On this episode of Managed Care Cast, we speak with Nicole Neumarker, the executive vice president of development and innovation at Cotiviti. Nicole shared Cotiviti’s results with their tracker map at the 2021 AcademyHealth National Health Policy Conference and provided us some insight into what impact this technology could have in the future.

This week, the top managed care news included efficacy data on AstraZeneca’s COVID-19 vaccine questioned; coverage from the NCCN 2021 Virtual Annual Conference; COVID-19 poses risks to children with poorly controlled type 1 diabetes.

Addressing vaccine hesitancy, which may take the form of refusing a vaccine or putting oneself in the “wait and see” camp while thinking it over, has never been more urgent as health authorities race to try and vaccinate as much of the population as possible against the virus that causes COVID-19 in 2021.

On this episode of Managed Care Cast, Pat Salber, MD, MBA, of the Doctor Weighs In, discusses education for patients on the topic of vaccine hesitancy and COVID-19. Her guest is Eve Gaus, who directs the development of interactive, people-centered, multimedia programs for Wolters Kluwer Health. The programs are used by health care systems to address questions raised by patients about the vaccines, how they were approved, how they work, and more.

This week, the top managed care news included AstraZeneca refuting blood clot links to COVID-19 vaccine; 2021 V-BID Summit celebrates 20 years of policy achievements for value-based insurance design; Managed Care Cast discusses 4 strategies payers can use to ensure opioid use disorder care.

The upheaval created by the pandemic over the past year has particularly affected individuals struggling with opioid use disorder (OUD) and other substance use issues in the United States, which set an unfortunate record in the first half of last year. More than 81,000 people died of drug overdoses between June 2019 and May 2020, largely driven by illicit fentanyl, as synthetic opioid overdose deaths increased 38%.

The March issue of The American Journal of Managed Care® includes a commentary about what payers can do to meet the needs of patients who need care for OUD. Chethan Bachireddy, MD, MSc, the chief medical officer for Virginia’s Medicaid program, and coauthor Mishka Terplan, MD, MPH, outline 4 things that payers can do to make sure that patients can get the treatment they need, and what’s at risk if they don’t.

On this episode of Managed Care Cast, Bachireddy discusses the commentary as well as how these strategies are being used in Virginia, where he continues to work one day a week as a primary care physician at Virginia Commonwealth University.

This week, the top news in managed care included CDC guidance on safe activities for fully vaccinated individuals; American Rescue Plan signed into law; new lung cancer screening criteria expand eligibility.

This activity is supported by an educational grant from Boehringer Ingelheim.

Today, we are bringing you part 1 of a 2-part podcast series discussing chronic obstructive pulmonary disease (COPD). In part 1, moderator Neil Minkoff, MD, chief medical officer of Coeus Healthcare, leads a discussion with a panel of experts about the burden of COPD, available treatments, and more.

This week, the top managed care news included President Biden updating production timeline for nationwide vaccine availability; efforts by the National Quality Forum to measure telehealth quality and value; FDA approves first treatment for rare genetic metabolic pediatric disorder.

As the COVID-19 pandemic has led to a nation-wide boom in telehealth use, new questions are emerging regarding reimbursement, accessibility, data protection, and quality measurement. Although the practice has greatly aided in maintaining care for many Americans throughout the past year, several challenges have been reported.

To create a measurement framework linking quality of care delivered by telehealth, health care system readiness, and health outcomes in rural areas specifically, the National Quality Forum (NQF) recently announced a committee of 25 individuals to discuss, update, and enhance NQF’s telehealth framework, first released in 2017. Currently, there are no nationally endorsed telehealth quality measures.

On this episode of Managed Care Cast, we speak with Sheri Winsper, RN, MSN, MHA, the senior vice president for quality measurement at NQF. For the past 20 years, the forum has worked to advance health care quality across the nation by endorsing measures that assess quality of care and value. It also develops specific measurement frameworks for gap areas.

An FDA panel meets to discuss J&J's COVID-19 vaccine ahead of an expected emergency use authorization decision, cemiplimab approved for first-line advanced non–small cell lung cancer with PD-L1 expression, and real-world outcomes contrast cancer clinical trial results in Medicare patients.