Managed Care Cast

By Managed Care CastScience

Managed Care Cast episodes

October 30, 2018 Dr Barbara McAneny Discusses New Payment Models, Transforming Care, and the AMA
Recently, Barbara McAneny, MD, the current president of the American Medical Association (AMA), visited The American Journal of Managed Care® (AJMC®)’s office for a wide-ranging discussion on new payment models, transforming care, and the work of the AMA.
McAneny is an oncologist who has been at the forefront of transforming care for patients with cancer. In 2012 she and her organization, Innovative Oncology Business Solutions, received a $19.76 million grant by the Center for Medicare and Medicaid Innovation to develop a community oncology medical home model. The model was implemented in 7 practices and aimed to improve patient care, outcomes, and satisfaction, while reducing costs.
She will be the keynote speaker November 16 in Philadelphia at Patient-Centered Oncology Care®, AJMC®’s annual multistakeholder meeting featuring payers, providers, and patient advocates.
Read more:
The Future of Oncology? COME HOME, the Oncology Medical Home: https://www.ajmc.com/journals/evidence-based-oncology/2013/2013-1-vol19-sp1/the-future-of-oncology-come-home-the-oncology-medical-home/
AMA Chooses Oncologist Dr Barbara McAneny to Lead as President-Elect: https://www.ajmc.com/newsroom/ama-chooses-oncologist-dr-barbara-mcaneny-to-lead-as-president-elect
Patient-Centered Oncology Care®: www.ajmc.com/pcoc2018
Implications of OCM Reports and the Future of the Program: https://www.ajmc.com/newsroom/implications-of-ocm-reports-and-the-future-of-the-program
The Price of Innovation When Improving Cancer Care Delivery: https://www.ajmc.com/conferences/accc-2018/the-price-of-innovation-when-improving-cancer-care-delivery
21 min
October 27, 2018 This Week in Managed Care—States Gain Power to Alter ACA Offerings and Other Health News
Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.
This week, the top managed care news included the Trump administration giving governors the power to overhaul section 1332 waivers under the Affordable Care Act (ACA); CMS disclosed a breach in the portal that agents and brokers use to assist consumers signing up for health coverage under the ACA; about one-third of all US healthcare payments in 2017 were tied to alternative payment models.
Read more about the stories in this podcast:
Trump Administration Gives States More Power to Alter ACA Exchange Offerings: https://www.ajmc.com/newsroom/trump-administration-gives-states-more-power-to-alter-aca-exchange-offerings
CMS Reports Data Breach in ACA Agent and Broker Portal: https://www.ajmc.com/focus-of-the-week/cms-reports-data-breach-in-aca-agent-and-broker-portal
CMS Cuts Budget for ACA Marketing to $10 Million for 2019 Plan Year: https://www.ajmc.com/newsroom/cms-cuts-budget-for-aca-marketing-to-10-million-for-2019-plan-year
Payments Are Increasingly Tied to Value, but More Risk-Based Models Needed: https://www.ajmc.com/newsroom/payments-are-increasingly-tied-to-value-but-more-riskbased-models-needed
Drug Market to See More Competition, Launch of Biosimilars in 2019: https://www.ajmc.com/conferences/amcpnexus2018/drug-market-to-see-more-competition-launch-of-biosimilars-in-2019
The Academy of Managed Care Pharmacy Nexus 2018: https://www.ajmc.com/conferences/amcpnexus2018
Psych Congress 2018: https://www.ajmc.com/conferences/psychcongress2018
Dr Barbara McAneny Discusses the Effect of OCM's Second Performance Period Results: https://www.ajmc.com/interviews/dr-barbara-mcaneny-discusses-the-effect-of-ocms-second-performance-period-results
Patient-Centered Oncology®: https://www.ajmc.com/pcoc2018
8 min
October 22, 2018 Looking Back at CAR T: PROs From a Patient's Perspective
A survivor of chronic lymphocytic leukemia who participated in the first CAR T trial in 2010 looks back at his experience and also discusses his views on how patient-reported outcomes (PROs) should be used, if at all, by the Centers for Medicare and Medicaid (CMS).
18 min
October 20, 2018 This Week in Managed Care—Drug Prices in TV Ads and Other Health News
Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.
This week, the top managed care news included the Trump administration unveiling plans to include drug prices in television ads; CMS touted Medicare Advantage at the beginning of open enrollment for Medicare; research found Medicare beneficiaries who live in housing with support services stay out of the hospital.
Read more about the stories in this podcast:
Trump Officials Outline Plan to Put Drug Prices in TV Ads: https://www.ajmc.com/newsroom/trump-officials-outline-plan-to-put-drug-prices-in-tv-ads
Verma Talks Up Medicare Advantage Growth at Insurance Industry Meeting: https://www.ajmc.com/newsroom/verma-talks-up-medicaid-advantage-growth-at-insurance-industry-meeting
CMS Will Allow Medicare Advantage Plans to Use Step Therapy to Negotiate Drug Prices: https://www.ajmc.com/newsroom/cms-will-allow-medicare-advantage-plans-to-use-step-therapy-to-negotiate-drug-prices
UnitedHealthcare Names 3 Biosimilars Preferred Treatments in 2019 MA Plans: https://www.centerforbiosimilars.com/news/unitedhealthcare-names-3-biosimilars-preferred-treatments-in-2019-ma-plans
What We're Reading: Promoting Pediatric Cancer Research; Mystery Paralysis; Cost of Being Sick: https://www.ajmc.com/newsroom/what-were-reading-promoting-pediatric-cancer-research-mystery-paralysis-cost-of-being-sick
Affordable Housing With Supportive Services Leads to Reduced Hospital Use Among Seniors: https://www.ajmc.com/focus-of-the-week/affordable-housing-with-supportive-services-leads-to-reduced-hospital-use-among-seniors
Evidence-Based Oncology—October 2018: https://www.ajmc.com/journals/evidence-based-oncology/2018/october-2018
5 min
October 16, 2018 Examining Health-Related Challenges Puerto Rico Still Faces a Year After Hurricane Maria
Examining Health-Related Challenges Puerto Rico Still Faces a Year After Hurricane Maria by Managed Care Cast
29 min
October 13, 2018 This Week in Managed Care—DOJ Approves CVS–Aetna Merger and Other Health News
Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.
This week, the top managed care news included the Department of Justice giving the green light for the CVS–Aetna merger; premiums for employer insurance plans are on the rise; and the new North American trade deal includes protections for drug makers that will hurt biosimilars.
Read more about the stories in this podcast:
Justice Department Clears $68 Billion CVS–Aetna Merger: https://www.ajmc.com/newsroom/justice-department-clears-68-billion-cvsndashaetna-merger
Premiums for Employer-Sponsored Family Insurance Increased 5% in 2018: https://www.ajmc.com/focus-of-the-week/premiums-for-employersponsored-family-insurance-increased-5-in-2018
What We're Reading: HealthCare.gov Maintenance; USMCA Drug Exclusivity; Medicare Telemedicine Proposal: https://www.ajmc.com/newsroom/what-were-reading-healthcaregov-maintenance-usmca-drug-exclusivity-medicare-telemedicine-proposal
Food Insecurity, Unaffordable Care Linked With Widening Disparities in Cancer Deaths: https://www.ajmc.com/focus-of-the-week/food-insecurity-unaffordable-care-linked-with-widening-disparities-in-cancer-deaths
National Association of ACOs Fall 2018: https://www.ajmc.com/conferences/naacos-fall2018
6 min
October 12, 2018 Changing Physician Behavior With Feedback Reports
As healthcare costs continue to increase, health systems are trying to better understand resource utilization among providers. The use of feedback reports can document physician practice patterns and increase accountability for resource use to prevent overuse and misuse.
A new paper in the October issue of The American Journal of Managed Care measured changes in ordering rates for 4 resource use measures before and after dissemination of physician feedback reports. Lead author Eva Chang, PhD, of RTI International, discussed the findings and how the impact of the feedback reports varied depending on physician experience.
Read the study and related research:
Primary Care Physician Resource Use Changes Associated With Feedback Reports: https://www.ajmc.com/journals/issue/2018/2018-vol24-n10/primary-care-physician-resource-use-changes-associated-with-feedback-reports
The American Journal of Managed Care—October 2018: https://www.ajmc.com/journals/issue/2018/2018-vol24-n10
Tackling Antibiotic Prescribers' Behaviors for Respiratory Infections at the VA: https://www.ajmc.com/newsroom/tackling-antibiotic-prescribers-behaviors-for-respiratory-infections-at-the-va
Impact of Weekly Feedback on Test Ordering Patterns: https://www.ajmc.com/journals/issue/2015/2015-vol21-n11/impact-of-weekly-feedback-on-test-ordering-patterns
11 min
October 09, 2018 Heard at NAACOS: Focus on Proposed MSSP Changes
CMS’ accountable care organization program, the Medicare Shared Savings Program, could potentially be undergoing some big changes. During the recent fall 2018 meeting of the National Association of ACOs, the proposed changes were top of mind. Attendees were most concerned about how the faster timeline to taking on risk would impact participation, but were pleased with changes to the benchmark and risk adjustment.
In this episode of Managed Care Cast, stakeholders at accountable care organizations (ACOs) and policy experts discuss the proposed changes and what impact they believe they will have on ACO participation.
Read more about the stories in this podcast:
CMS Plans to Overhaul MSSP Program to Force More Risk on ACOs: https://www.ajmc.com/newsroom/cms-plans-to-overhaul-mssp-program-to-force-more-risk-on-acos
Proposed Rule for Medicare ACOs Includes Notable Changes for Rural Providers: https://www.ajmc.com/contributor/caravan-health/2018/09/proposed-rule-for-medicare-acos-includes-notable-changes-for-rural-providers
CMS Proposal Is a Start for Making Risk More Appealing to ACOs: https://www.ajmc.com/contributor/travis-broome/2018/08/cms-proposal-is-a-start-for-making-risk-more-appealing-to-acos
MSSP Proposal Better Measures Risk With Changes to the Benchmark Methodology: https://www.ajmc.com/contributor/travis-broome/2018/09/mssp-proposal-better-measures-risk-with-changes-to-the-benchmark-methodology
MSSP Changes Present Opportunities, but Likely to Decrease Number of ACOs, NAACOS Says: https://www.ajmc.com/newsroom/mssp-changes-present-opportunities-but-likely-to-decrease-number-of-acos-naacos-says
Physician ACOs Associated With Growing MSSP Savings Over 3 Years: https://www.ajmc.com/newsroom/physician-acos-associated-with-growing-mssp-savings-over-3-years
19 min
October 08, 2018 This Week in Managed Care—Nobel Prize for Immunotherapy and Other Health News
Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.
This week, the top managed care news included the Nobel Prize in Medicine was awarded to 2 people for research into immunotherapy; physician-run accountable care organizations bring savings for Medicare; research highlights the health impacts of sexual harassment and assault.
Read more about the stories in this podcast:
Nobel Prize Recognizes Discoveries With T Cells in Immunotherapy: https://www.ajmc.com/focus-of-the-week/nobel-prize-recognizes-discoveries-with-t-cells-in-immunotherapy
The Long Road: Nobel Prize Winner James Allison Highlights the Value of Research: https://www.ajmc.com/newsroom/the-long-road-nobel-prize-winner-james-allison-highlights-the-value-of-research
Physician ACOs Associated With Growing MSSP Savings Over 3 Years: https://www.ajmc.com/newsroom/physician-acos-associated-with-growing-mssp-savings-over-3-years
What We're Reading: Demand for Antibiotics; FDA Inspects Juul; Fast Food Consumption: https://www.ajmc.com/newsroom/what-were-reading-demand-for-antibiotics-fda-inspects-juul-fast-food-consumption
Sexual Assault, Harassment Raise Women's Risk for Physical and Mental Health Issues: https://www.ajmc.com/focus-of-the-week/sexual-assault-harassment-raise-womens-risk-for-physical-and-mental-health-issues
Evidence-Based Diabetes Management—September 2018: https://www.ajmc.com/journals/evidence-based-diabetes-management/2018/september-2018
5 min
October 02, 2018 Employers Take a Vested Interest in Healthcare
Employers may not look forward to purchasing healthcare, but they are in the position to transform the market. Key opinion leaders like Suzanne Delbanco, PhD, MPH, of Catalyst for Payment Reform; Brian Marcotte of the National Business Group on Health; and Judy Berger of Southwest Airlines, discuss how employers are getting more involved in healthcare by championing alternative payment models and other more services to their employees.
Learn more about the most recent news and updates in Medicaid:
Employers Play an Increasingly Important Role in the Move to Value-Based Care: www.ajmc.com/conferences/acdc-spring-2018/employers-play-an-increasingly-important-role-in-the-move-to-valuebased-care
Employer Support Is Needed to Help Payment Reform Succeed: www.ajmc.com/newsroom/employer-support-is-needed-to-help-payment-reform-succeed
Percent of Employers Offering Health Coverage Increases for First Time Since 2008: www.ajmc.com/focus-of-the-week/percent-of-employers-offering-health-coverage-increases-for-first-time-since-2008
Employers Actively Exploring, Offering New Ways of Delivering Healthcare to Employees: www.ajmc.com/newsroom/employers-actively-exploring-offering-new-ways-of-care-delivering-healthcare-to-employees
When Employee Healthcare Costs Move Stocks: www.ajmc.com/contributor/joseph-andelin/2018/09/when-employee-healthcare-costs-move-stocks
11 min