Tuning In to The C-Suite

In this latest episode of Tuning In to the C-Suite podcast, Briana Contreras, an editor with MHE had the pleasure of meeting Loren McCaghy, director of consulting, health and consumer engagement and product insight at Accenture, to discuss the organization's latest report on U.S. consumers switching healthcare providers and insurance payers. One of those surveys were on payer experiences and the other on patient experiences. McCaghy shared that ease of interaction, rather than clinical experience, is a primary reason for switching. He stressed the importance of building trust through positive experiences and meeting patient needs digitally, starting with basic functionalities could help patient turnover.

In our latest "Meet the Board" podcast episode, Managed Healthcare Executive Editors caught up with board member, Eric Hunter, CEO of Care Oregon, to discuss a number of topics, with one including the merger that never closed with SCAN Health Plan due to local opposition from Oregonians, emphasizing the need for partnerships to meet scaling and capital requirements. 

On the other hand, Hunter also praised Oregon's careful Medicaid redetermination, resulting in a smaller enrollment decline than expected. 

He also highlighted a new preventive medicine residency program with Oregon Health and Science University to improve healthcare for populations most at need. 

Before concluding the conversation with a question on what public official or figure of past or present he'd love to sit down over dinner with, Hunter briefly covered cybersecurity challenges and the potential impact of healthcare issues in the upcoming election.

In the latest episode of the Meet the Board podcast series, Managing Editor, Peter Wehrwein, catches up with Chief Clinical Officer at Optum Rx and EAB member, David Calabrese, about his new role alongside his team's progress in improving quality, patient safety and health equity in healthcare. David highlights efforts to address pharmacy deserts and medication shortages; and the two discuss the challenges and future of retail pharmacies, the impact of cell and gene therapies and the rise of GLP-1 weight loss drugs, noting their cost and regulatory scrutiny. David also emphasized the importance of comprehensive patient support programs.

A limited pharmacy benefit manager (PBM) reform bill may be used as a "pay for" to offset the costs of extending Medicare telehealth flexibilities, shares Kelly, of Capitol Advocacy & Government Affairs.

In this month’s episode of Meet the Board, MHE’s Managing Editor Peter Wehrwein and spoke with a new member of our editorial advisory board, Marci J. Chodroff, MD, FACP, VP of Medical Affairs at Magellan Rx Management, a Prime Therapeutics company. The two discussed Chodroff's career transition from clinical practice to pharmacy benefits management, then crossed over to highlight challenges like Medicare regulations and the growth of specialty pharmacy, focusing on oncology and GLP-1 agonists. The conversation also touched on Magellan's acquisition by Prime Therapeutics and Chodroff's focus which remains on ensuring seamless healthcare access, especially for Medicare beneficiaries, and addressing emerging challenges like cell and gene therapies.

In this episode, MHE's Peter Wehrwein spoke with Patrick Cooney, president of The Federal Group, discussing Washington's focus on Pharmacy Benefit Managers (PBMs). Cooney highlighted increased federal attention on PBMs, with legislative activity indicating bipartisan interest in reform. Despite recent setbacks in negotiations over PBM-related provisions, both Democrats and Republicans aim for transparency and change. Cooney also predicts eventual PBM legislation in 2024, emphasizing the bipartisan recognition of reform necessity.

As we bring back our "Meet the Board" Series podcast series, Managed Healthcare Executive welcomes our newest Editorial Advisory Board member Greg Baker, CEO of AffirmedRx. In this conversation, Baker and Peter Wehrwein, MHE managing editor, discussed insights from Baker's career journey. Drawing from his experiences at Walgreens and Premise Health, Baker highlighted the importance of patient-centered care and process orientation. He discussed AffirmedRx's mission to bring transparency to the PBM industry through innovative approaches such as a cloud-based system and clinically-driven formulary. Expressing concerns about opaque pricing practices, he shared the need for industry reform and cautioned against the proliferation of corporate entities within PBMs.

In this second part of a two-part podcast episode, Managed Healthcare Executive's Managing Editor Peter Wehrwein spoke with Ceci Connolly and Margaret "Meg" Murray about Medicare Advantage utilization and challenges, highlighting proposed CMS payment cuts and prior authorization issues. Murray emphasized MA's growth and benefits, while Connolly introduced MA for Tomorrow proposals. They also tackled drug pricing transparency concerns, Medicaid coverage challenges, and predicted affordability as a key issue in the 2024 elections.

In this first part of a two-part podcast episode, Managed Healthcare Executive's Managing Editor Peter Wehrwein kicks off our new podcast series "DC Roundtable," with guests Margaret "Meg" Murray, CEO of the Association of Community Affiliated Plans, and member of MHE's Editorial Advisory Board, and CeCi Connolly, president and CEO of the Alliance of Community Health Plans, for a discussion on healthcare policy issues. The trio addressed the impact of Medicaid redetermination, emphasizing ongoing challenges and the need for policy flexibility. While recognizing the ACA's success in expanding access, they highlighted affordability concerns and partisan divides. The conversation also highlighted efforts to advocate for solutions prioritizing access, affordability and quality care.

In this month’s episode of Tuning In to the C-Suite, Briana Contreras, an editor of Managed Healthcare Executive, got to chatting with Sanjula Jain, Ph.D., chief research officer at Trilliant Health. 

In the conversation, Sanjula shared the concerning rise in cancer cases among those in their 30s and 40s, despite declining mortality rates. In this age range, neoplasm-related deaths are notably increasing, which could possibly be linked to pandemic-induced declines in primary care and screenings. 

Sanjula added that rising cancer care costs and increased pharmaceutical investments highlight the need for a comprehensive approach in this space.