Managed Care Cast

On this edition of Managed Care Cast, we present a short excerpt from a January webinar titled “Color and COVID-19: The Virus’ Disproportionate Impact” hosted by the MJH Life Sciences™ COVID-19 Coalition about how the pandemic has had an unequal, devastating impact on communities of color.

This week, the top managed care news included Entresto winning the first FDA nod in a hard-to-treat type of heart failure; President Joe Biden nominates a new CMS administrator; experts discuss the potential for Biden health reforms.

On this episode of Managed Care Cast, we highlight a new feature on AJMC.com, the website of The American Journal of Managed Care (AJMC®) called Clinical Spotlight, where our editors provide a series of interviews with leading experts in certain specialties. Over the past few months, we’ve talked with specialists in chronic obstructive pulmonary disease (COPD), small-cell lung cancer, and chimeric antigen receptor (CAR) T-cell therapy.

The first interview excerpt is with Rose McNulty, editor at AJMC, who speaks with Charles Rudin, MD, chief of the Thoracic Oncology Service at Memorial Sloan Kettering Cancer Center and principal investigator of the National Cancer Institute Small Cell Lung Cancer Consortium. He provides insights into the state of SCLC treatment, clinical trials, and what the future may hold.

The second is with Gianna Melillo, associate editor, who interviews Antonio Anzueto, MD, a professor of medicine at University of Texas Health in San Antonio and a member of the science committee for the Gold Initiative for Chronic Obstructive Lung Disease (GOLD). He discusses the latest updates to the GOLD guidelines for COPD, which pertain to treatment recommendations for patients with coronavirus disease 2019 (COVID-19) as well as the benefits of triple therapy for COPD and adherence issues.

This week, the top managed care news included President Biden’s DOJ reversing course in case seeking to overturn the Affordable Care Act; once-weekly semaglutide and lifestyle changes slashed body weight by 15%; updates on COVID-19 vaccines and treatments.

With the growth of alternative payment models and value-based contracting, policy makers and researchers are looking to other sectors that offer the potential for cooperation with the health care system, including education. Schools and health care organizations are a natural fit to work together to improve outcomes for children, but value-based alignment between the 2 systems will require the development of both contracting mechanisms and a foundation of trust.

On this episode of Managed Care Cast, we’re talking with two coauthors of a commentary published in our February 2021 issue. The commentary, “Achieving Better Value in Pediatric Care: School Systems as Clinical and Financial Partners?”, explains the opportunities for the health care and education systems to cooperate in value-based contracts to improve outcomes for students, as well as how this goal may be affected by the ongoing coronavirus disease 2019 pandemic.

The authors joining us today are Venus Wong, PhD, of the Clinical Excellence and Research Center at Stanford University, and Hoangmai Pham, MD, MPH, of Institute for Exceptional Care.

On this episode of Managed Care Cast, we speak with experts from ChristianaCare, one of the largest health care providers in the mid-Atlantic region, serving patients in Delaware and parts of Maryland, New Jersey, and Pennsylvania.

Hoping to increase the percentage of their patients with diabetes who have a hemoglobin A1C of 9% or lower, in 2019, ChristianaCare implemented a diabetes pilot program at 4 of its primary care sites, partnering each site with an endocrinologist and embedding a behavioral counselor at Primary Care Concord in Chadds Ford, Pennsylvania. With an original goal of growing this patient group by 10% by July of 2019, they instead saw 16% growth.

This week, the top managed care news included nationwide pharmacies to receive vaccine doses; experts issue recommendations for improving health care in 2021; HIV may increase risk of severe COVID-19 infection.

Findings from the latest Quest Diagnostics Health trends study, made in collaboration with The Harris Poll, underscore racial disparities in US health care brought to light by the coronavirus disease 2019 (COVID-19)pandemic.

The online survey, conducted from November 10-12, 2020, found that among over 2000 adult participants, Black and Hispanic/Latinx Americans are nearly 2 times as likely as White Americans to say their access to COVID-19 vaccines, treatments, and health care, once available, is worse than other racial/ethnic groups.

To help combat these disparities, Quest Diagnostics launched the Quest for Health Equity Initiative in August 2020. On this episode of Managed Care Cast, we speak with Harvey Kaufman, MD, the senior medical director at Quest Diagnostics about the Health Trends Study results, the organization’s mission to mitigate testing disparities, and the importance of access to preventive services.

This week, the top managed care news included Biden reopening Affordable Care Act insurance marketplaces; medical claim denial rates highest in initial COVID-19 hotspots; obesity linked with mortality in acute lymphoblastic leukemia.

On this episode, we speak with Andrew Smith, PhD, Huntsman Mental Health Institute at the University of Utah School of Medicine, coauthor of a paper looking at the mental health stressors facing first responders and health care workers during the coronavirus disease 2019 (COVID-19) pandemic. The paper found that a sizable number of these frontline workers are at risk for psychiatric illnesses at severity levels higher than other national disasters, including 9/11 and Hurricane Katrina.