On this episode of Managed Care Cast, we speak with Kashyap Patel, MD, the chief executive officer of Carolina Blood and Cancer Care Associates—a leading OCM practice—and associate editor of Evidence-Based Oncology™ (EBO), as well as Tennessee Oncology’s Stephen M. Schleicher, MD, MBA, to discuss Oncology Care First.

On this Managed Care Cast, we speak with a health policy researcher who got the idea for a study about medical billing appearing in the December 2019 issue of The American Journal of Managed Care® after she received one that was unexpected. While efforts to abate surprise medical billing, such as the kind that come from out-of-network emergency department visits, are currently being debated in Washington, DC, the kind of billing discussed here occurs when patients struggle to understand the difference between preventive health services, which are covered at no cost under the Affordable Care Act, and billing for services at a doctor’s visit for an illness, condition, or injury.

Katie Schmitz, a graduate student pursuing a master’s degree in health communication from Purdue University, is one of the coauthors of "Preventive/Office Visit Patient Knowledge and Their Insurance Information Gathering Perceptions."

Read the full paper: https://www.ajmc.com/journals/issue/2019/2019-vol25-n12/preventiveoffice-visit-patient-knowledge-and-their-insurance-information-gathering-perceptions

On this episode of KOL Corner, Amy Ellis, director of quality and value-based care at Northwest Medical Specialties, talks with Amanda Hodges, BSN, RN, OCN, the director of implementation of ReVital Cancer Implementation.

In today’s Managed Care Cast, we bring you portions of the panel discussion during the the last Institute for Value-Based Medicine® (IVBM®) event for 2019, where oncologists and others shared their thoughts, successes, and frustrations with the current Oncology Care Model, as well as the question and answer session.

Every week, The American Journal of Managed Care® recaps the top managed care news of the week.

This week, the top managed care news included research that may hold the key to slowing progression of multiple sclerosis; Humana says it is saving billions of dollars through value-based care; the challenges of rural healthcare delivery.

Read more about the stories in this podcast:

Researchers May Have Identified How to Slow the Progression of MS: https://www.ajmc.com/newsroom/researchers-may-have-identified-how-to-slow-the-progression-of-ms

Humana Saves $3.5B, Drives Down Hospital Use Through Value-Based Care in Medicare Advantage: https://www.ajmc.com/focus-of-the-week/humana-saves-35b-drives-down-hospital-use-through-valuebased-care-in-medicare-advantage

Tackling Rural Health Challenges During Rural Health Month and Beyond: https://www.ajmc.com/contributor/kelly-munson/2019/11/tackling-rural-health-challenges-during-rural-health-month-and-beyond

Hope and Some Skepticism Whether Oncology Payment Models Will Work: https://www.ajmc.com/focus-of-the-week/hope-and-some-skepticism-whether-oncology-payment-models-will-work

Women in the United States suffer from maternal mortality rates not seen elsewhere in developed countries, and nowhere is that more true than in patients served by Medicare. Although it is a national epidemic, inadequate maternal care disproportionately affects minority women and the 43% of US births financed by Medicaid. On this episode, we speak with  an executive vice president of Avia Health Solutions, which is trying to address this issue in conjunction with 30 healthcare systems.

Every week, The American Journal of Managed Care® recaps the top managed care news of the week.

This week, the top managed care news included research that shows stents may offer no more value than drugs for some heart patients; a ban on flavored tobacco products gains momentum; a survey finds most American families struggle with social factors that impact health.

Read more about the stories in this podcast:

In Stable Heart Disease, Study Finds Stents Might Be No Better Than Drugs: https://www.ajmc.com/conferences/aha-2019/in-stable-heart-disease-study-finds-stents-might-be-no-better-than-drugs

American Heart Association Scientific Sessions 2019: https://www.ajmc.com/conferences/aha-2019

What We're Reading: Vaping Ban Bill; Anal Cancer Rates; Medical Bill Protections: https://www.ajmc.com/newsroom/what-were-reading-vaping-ban-bill-anal-cancer-rates-medical-bill-protections

Social Factors of Health Impacting Majority of US Families, Survey Says: https://www.ajmc.com/focus-of-the-week/social-factors-of-health-impacting-majority-of-us-families-survey-says

Patients Need More Education Regarding the Purpose of Precision Medicine Trials: https://www.ajmc.com/focus-of-the-week/patients-need-more-education-regarding-the-purpose-of-precision-medicine-trials

One Size Does Not Always Fit All in Value Assessment: https://www.ajmc.com/journals/issue/2019/2019-vol25-n11/one-size-does-not-always-fit-all-in-value-assessment

Value Assessment and Heterogeneity: Another Side to the Story: https://www.ajmc.com/journals/issue/2019/2019-vol25-n11/value-assessment-and-heterogeneity-another-side-to-the-story

The American Journal of Managed Care—November 2019: https://www.ajmc.com/journals/issue/2019/2019-vol25-n11

Healthcare is changing due to a combination of technological improvements and rising costs. For instance, more than half of surgical procedures now take place in an outpatient environment, but, as with many things in healthcare, there isn’t a lot of transparency. Today on Managed Care Cast, we speak with Michael Abrams, managing partner of Numerof & Associates, about patient safety and outpatient settings.

Chronic disease affects most employees in the United States, and today, on World Diabetes Day, Managed Care Cast speaks with the lead author of a study about chronic disease that appears in the November issue of The American Journal of Managed Care®. Author Maren S. Fragala, PhD, CSCS.D, talks about how employer-sponsored health screenings can help identifiy previously undiagnosed disease, enabling early detection and treatment, and help keep workers healthier.

During this week’s podcast, we sit down with Mark Lewis, MD, a gastrointestinal oncologist at Intermountain Healthcare. In addition to being a practicing oncologist, Lewis has been living with cancer himself with a hereditary tumor syndrome that’s been passed down in his family, giving him a unique experience that has driven his approach to treating his own patients.

During the interview, Lewis discusses his personal history with cancer, how he’s seen the cancer landscape change over the last 2 decades, and his experience with treating neuroendocrine tumors.