Managed Care Cast

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.

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 CMS started planning for life after the Oncology Care Model; a judge blocked a rule requiring immigrants to have health coverage; Election Day brought news for Medicaid work rules.

Read more about the stories in this podcast:

CMS, CMMI Seek Feedback on Oncology Care First, Successor to OCM: https://www.ajmc.com/newsroom/cms-cmmi-seek-feedback-on-oncology-care-first-successor-to-ocm

Electronic PROs a Proposed Feature of Successor Model in Oncology Care: https://www.ajmc.com/focus-of-the-week/electronic-pros-a-proposed-feature-of-successor-model-in-oncology-care

What We're Reading: Trump's Immigrant Health Insurance Rule Blocked; Tips to Choose a Health Plan; FDA Advises Zantac Recalls: https://www.ajmc.com/newsroom/what-were-reading-trumps-immigrant-health-insurance-rule-blocked-tips-to-choose-a-health-plan-fda-advises-zantac-recalls

What We're Reading: Democrats Win With Medicaid Work Rule Promise; Trump Says No to Pelosi Plan; UnitedHealthcare Biosimilar Switching: https://www.ajmc.com/newsroom/what-were-reading-democrats-win-with-medicaid-work-rule-promise-trump-says-no-to-pelosi-plan-unitedhealthcare-biosimilar-switching

Final ICER Report Finds Empagliflozin More Cost Effective Than Oral Semaglutide for Type 2 Diabetes: https://www.ajmc.com/focus-of-the-week/final-icer-report-finds-empagliflozin-more-costeffective-than-oral-semaglutide-for-type-2-diabetes

UnitedHealthcare Patients Will Switch to Biosimilar Epoetin Alfa in 2020: https://www.centerforbiosimilars.com/news/unitedhealthcare-patients-will-switch-to-biosimilar-epoetin-alfa-in-2020

In 2002, Bill Allman, working for Washington State, heard from a widow with a $75,000 bill from Medicaid, which was incurred as part of his long-term care costs. Like Allman, the man was a veteran. On this episode of Managed Care Cast, we learn how Allman, who is retiring at the end of 2019, launched a program to connect veterans to health benefits they didn't know they had, and in the process, figured out that states could reduce Medicaid spending.

In 2018, the Ochsner Accountable Care Network was able to reduce expected costs of care by more than $12.78 million for its Medicare beneficiaries, and it increased its savings 12% over 2017. This comes amidst research and claims that accountable care organizations may not be successful at reducing costs while improving outcomes.

David Carmouche, MD, president of the Ochsner Health Network and executive director of the Ochsner Accountable Care Network, explains how the Ochsner accountable care organization (ACO) was able to find success and how other ACOs can get over the learning curve to achieve savings.

Learn more about Ochsner

https://www.ajmc.com/partners/ochsner