Managed Care Cast

By Managed Care CastScience

Managed Care Cast episodes

May 13, 2018 This Week in Managed Care—Uninsured Rates Rise Nationwide 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 stories included another report that shows uninsured rates are rising; FDA confirms shortages of the EpiPen, but the manufacturer insists the delay will be short; a Senate panel examines the need for transparency in insulin pricing.
Read more about the stories in this podcast:
No States Reported a Decline in the Uninsured Rate From 2016 to 2017: www.ajmc.com/focus-of-the-week/no-states-reported-a-decline-in-the-uninsured-rate-from-2016-to-2017
FDA Confirms Short-Term Shortages of EpiPen: www.ajmc.com/newsroom/fda-confirms-shortterm-shortages-of-epipen
ADA's Cefalu Calls for Transparency Across Supply Chain to Address Insulin Costs: www.ajmc.com/newsroom/adas-cefalu-calls-for-transparency-across-supply-chain-to-address-insulin-costs
Daratumumab Approved as Frontline Treatment in Newly Diagnosed Multiple Myeloma: www.ajmc.com/newsroom/daratumumab-approved-as-frontline-treatment-in-newly-diagnosed-multiple-myeloma
Single-Payer System Is the Solution for Mental Health Care, Panelists Say: www.ajmc.com/conferences/apa-2018/singlepayer-system-is-the-solution-for-mental-health-care-panelists-say
American Psychiatric Association 2018 Annual Meeting: www.ajmc.com/conferences/apa-2018
6 min
May 10, 2018 Drs Barnett and McWilliams Discuss Whether Specialty Care Leakage Matters for ACOs
Accountable care organizations are incentivized to reduce spending and improve quality of care. One way they have tried to do achieve these goals is by establishing control over a patient’s full continuum of care by minimizing the care patients receive from other providers outside of the ACO, including specialists.
Michael Barnett, MD, and J. Michael McWilliams, MD, PhD, have a paper in the May issue of The American Journal of Managed Care® on leakage of specialty care among ACOs and the changes in specialty care leakage and use associated with the Medicare Shared Savings Program.
Read the paper: http://www.ajmc.com/journals/issue/2018/2018-vol24-n5/changes-in-specialty-care-use-and-leakage-in-medicare-accountable-care-organizations
27 min
May 08, 2018 The Challenge of Hospital Observation Status: A Discussion With Andria Jacobs
Patients who get care at a hospital often receive bills that are bigger than they were expecting. In the case of Medicare, this can happen when a beneficiary receives care at a hospital for several days but was never formally admitted to the hospital. The result is higher out-of-pocket expenses and fewer Medicare benefits—the biggest being the qualification of a nursing home stay after being discharged from a hospital. While hospitals must now inform Medicare recipients when they are being held under observation status, the use of observation still places an undue burden on seniors.
Andria Jacobs, chief operating officer for PCG Software, discusses the impact of being held in observation, what CMS has done to try to alleviate the situation, and what else needs to be done.
Read Andria's past articles: http://www.ajmc.com/contributor/andria-jacobs-rn-ms-cen-cphq
16 min
May 07, 2018 This Week in Managed Care—Insurance Coverage Gains Reverse 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 stories included a report that insurance coverage gains are reversing; a deal to lower the cost of Praluent for Express Scripts members; findings that synthetic opioids are playing a bigger role in overdose deaths.
Increases in Insurance Coverage Rates From ACA Beginning to Reverse: www.ajmc.com/focus-of-the-week/increases-in-insurance-coverage-rates-from-aca-beginning-to-reverse
Sanofi, Regeneron to Cut Praluent Prices Under Exclusive Express Scripts Deal That Ends Prior Approval Delays: www.ajmc.com/newsroom/sanofi-regeneron-to-cut-praluent-prices-under-exclusive-express-scripts-deal-that-ends-prior-approval-delays
Dr Jay Edelberg on Safety, Efficacy of Praluent and Remaining Payment Challenges: www.ajmc.com/conferences/aha-2017/dr-jay-edelberg-on-safety-efficacy-of-praluent-and-remaining-payment-challenges
Synthetic Opioids Overtake Prescription Opioids as Driver of Overdose Deaths in 2016: www.ajmc.com/newsroom/synthetic-opioids-overtake-prescription-opioids-as-driver-of-overdose-deaths-in-2016
FDA Approves CAR T-Cell Treatment Kymriah for Adult B-Cell Lymphoma: www.ajmc.com/newsroom/fda-approves-cart-cell-treatment-kymriah-for-adult-bcell-lymphoma
Verma Highlights CMS Initiatives to Empower Patients and Promote Competition: www.ajmc.com/conferences/whcc-2018/verma-highlights-cms-initiatives-to-empower-patients-and-promote-competition
Former HHS Secretary Price Identifies a Path to Moving Forward in Healthcare Reform: www.ajmc.com/conferences/whcc-2018/former-hhs-secretary-price-identifies-a-path-to-moving-forward-in-healthcare-reform
15th Annual World Health Care Congress: www.ajmc.com/conferences/whcc-2018
6 min
May 01, 2018 Low-Value Services: Their Impact and Challenges With Addressing Them
Low-Value Services: Their Impact and Challenges With Addressing Them by Managed Care Cast
16 min
April 27, 2018 This Week in Managed Care—CMS' Health IT Guidance 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 stories included an announcement from CMS of creating direct provider contracting, plus a broad set of proposed rules for health information technology; new recommendations to improve postpartum care; a look at future competition among specialty drugs.
Read more about the stories in this podcast:
CMS: "Meaningful Use" Is Out, "Interoperability" Is In: www.ajmc.com/newsroom/cms-meaningful-use-is-out-interoperability-is-in
Humana Launches Bundled Payment Model to Improve Maternity Outcomes and Cost: www.ajmc.com/newsroom/humana-launches-bundled-payment-model-to-improve-maternity-outcomes-and-cost
What We're Reading: VA Pick's Hearing Delayed; Hospital Profits Fall; Re-Imagining Postpartum Care: www.ajmc.com/newsroom/what-were-reading-va-picks-hearing-delayed-hospital-profits-fall-reimagining-postpartum-care
ACOG Annual Clinical and Scientific Meeting: www.ajmc.com/conferences/acog-2018
Newsletter Sign-up: www.ajmc.com/email-profile
Specialty Drug Pipeline Review Focuses on Competition, Cancer Drugs: www.ajmc.com/conferences/amcp-2018/specialty-drug-pipeline-review-focuses-on-competition-cancer-drugs
Dr Aimee Tharaldson Discusses Key Market Trends in Specialty Pharmacy: www.ajmc.com/conferences/amcp-2018/dr-aimee-tharaldson-discusses-key-market-trends-in-specialty-pharmacy
The Academy of Managed Care Pharmacy (AMCP) 2018: www.ajmc.com/conferences/amcp-2018
5 min
April 24, 2018 Special Considerations in HIV Management
At the beginning of the year, The American Journal of Managed Care® convened a panel of experts in infectious disease and managed care to discuss management of HIV, including the need for individualized care the role for newer treatments options. Here, we provide some of that conversation.
Watch the full discussion:
Special Considerations in HIV Management: www.ajmc.com/peer-exchange/special-considerations-in-hiv-management/
15 min
April 20, 2018 This Week in Managed Care—Bill Addresses Opioid Epidemic 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 stories included a new bill in Congress to tackle the opioid epidemic; an analysis that warns against including drug costs in bundled payment models; the FDA commissioner shares ideas to improve innovation and access to next-generation sequencing.
Read more about the stories in this podcast:
Congress, Medical Societies Move on Ways to Attack Opioid Problem: www.ajmc.com/newsroom/congress-medical-societies-move-on-ways-to-attack-opioid-problem
Bundled Payments That Include Drug Costs Would Penalize Practices Based on Patient Mix: www.ajmc.com/newsroom/bundled-payments-that-include-drug-costs-would-penalize-practices-based-on-patient-mix
FDA Finalizes Guidances to Accelerate Development of Next-Generation Sequencing Tests: www.ajmc.com/newsroom/fda-finalizes-guidances-to-accelerate-development-of-next-generation-sequencing-tests
Commissioner Gottlieb Updates Community Oncologists on the FDA's Mission to Improve Access: www.ajmc.com/conferences/coa-2018/commissioner-gottlieb-updates-community-oncologists-on-the-fdas-mission-to-improve-access
2018 Community Oncology Conference: www.ajmc.com/conferences/coa-2018
Keytruda results: http://www.mrknewsroom.com/news-release/oncology/mercks-keytruda-pembrolizumab-plus-pemetrexed-alimta-and-platinum-chemotherapy
Evidence-Based Oncology—April 2018: www.ajmc.com/journals/evidence-based-oncology/2018/april-2018
5 min
April 18, 2018 Examining Consumer Cost Sharing and a Precision Benefit Design With Dr Mark Fendrick
Current policies being employed to limit spending can have serious consequences for patients. In the April issue of The American Journal of Managed Care, A. Mark Fendrick, MD, co-authored a paper that examined the relationship between consumer cost sharing for branded antidepressants and the initiation of branded therapy among patients who were filling a prescription for a generic medication to treat major depressive disorder.
Read the paper:
Cost Sharing and Branded Antidepressant Initiation Among Patients Treated With Generics: www.ajmc.com/journals/issue/2018/2018-vol24-n4/cost-sharing-and-branded-antidepressant-initiation-among-patients-treated-with-generics
10 min
April 14, 2018 This Week in Managed Care—Work Requirements for Benefits 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 stories included President Donald Trump signing an executive order requiring the poor to get jobs or lose food and healthcare benefits; a CMS report found ethnic, racial, and gender disparities in Medicare Advantage plans; CDC highlighted the impact of HIV on America's youth.
Read more about the stories in this podcast:
What We're Reading: Trump Signs Executive Order; VA Staffing Crisis; Texas Hospital Firm Draws Scrutiny: www.ajmc.com/newsroom/what-were-reading-trump-signs-executive-order-va-staffing-crisis-texas-hospital-firm-draws-scrutiny-
CMS Creates New ACA Penalty Mandate Exemptions, Including Opposition to Abortion: www.ajmc.com/newsroom/cms-creates-new-aca-penalty-mandate-exemptions-including-opposition-to-abortion
CMS Report Details Extent of Medicare Advantage Racial, Gender Disparities: www.ajmc.com/newsroom/cms-report-details-extent-of-medicare-advantage-racial-gender-disparities
Sanofi to Start Offering Discounts on Two Insulin Products: www.ajmc.com/newsroom/sanofi-to-start-offering-discounts-on-2-insulin-products
National Youth HIV/AIDS Awareness Day: Highlighting the Impact of Disease on the Age Group: www.ajmc.com/newsroom/national-youth-hivaids-awareness-day-highlighting-the-impact-of-disease-on-the-age-group
With the Oncology Care Model, "Everyone Has to Be Engaged," Including Patients: www.ajmc.com/newsroom/with-the-oncology-care-model-everyone-has-to-be-engaged-including-patients
5 min