Managed Care Cast

This week, the top managed care news included a pause in distribution of J&J’s COVID-19 vaccine; FDA clears first AI device to find possible cancerous hot spots during colonoscopies; lessons from years of public health budgetary neglect.

Neglecting public health in state budgets for more than 10 years created an environment that was ill-suited to deal with the challenges of COVID-19 as well as other issues. On this episode of Managed Care Cast, we speak with one of the authors of a recent paper that examined state funding trends from 2008 to 2018 and discuss what could be done in the future to avoid past mistakes. In an article published this month in Health Affairs, researchers from the Johns Hopkins Bloomberg School of Public Health, the University of Minnesota School of Public Health, and the College of Health Solutions from Arizona State University, took a close look at state spending in 8 categories of public health spending during an 11-year period to understand the extent to which funding has not kept up with pressing and emerging issues. The stagnation in public health spending occurred during a time of rising mortality in the United States and funding, which was cut during the Great Recession, was not restored. On this episode of

This week, the top managed care news included a European safety committee finding very rare blood clot links with AstraZeneca’s COVID-19 vaccine; new report predicts shifts in the cancer landscape by 2040; the connected nature of type 1 diabetes with other autoimmune diseases.

The Centre for Sexual Health and HIV/AIDS Research Zimbabwe, or CeSHHAR, was founded in 2012 and is headquartered in Harare (hurrahree), Zimbabwe. CeSHHAR conducts evidence-based research related to HIV/AIDS, its prevention, and policy making, along with providing and implementing sexual and reproductive health education and interventions among several at-risk populations. On this episode of Managed Care Cast, we speak with the executive director of CeSHHAR, Frances Cowan, MD, MSc, MRCP, MBBS, professor of global health at the Liverpool School of Tropical Medicine, about CeSHHAR’s history, its programs, and continuing to make inroads against this 4-decades-old pandemic.

This activity is supported by an educational grant from Boehringer Ingelheim. Today, we are bringing you part 2 of a 2-part podcast series discussing chronic obstructive pulmonary disease (COPD). In part 2, moderator Neil Minkoff, MD, chief medical officer of Coeus Healthcare, leads a discussion with a panel of experts about personalized approaches to COPD management and treatment efficacy.

This week, the top news in managed care included COVID-19 cases surging as vaccine eligibility expands nationwide; Senate bill seeks to limit use of step therapy in employer health plans; a look into local and global awareness of the ongoing HIV/AIDS epidemic.

Early on in the pandemic, having the ability to predict where outbreaks were going to take place was something to be desired. Cotiviti developed a COVID-19 tracker map using big data models and artificial intelligence (AI) technologies, which can accurately predict where in the United States new COVID-19 outbreaks would occur and show the relative risk of infection for people with underlying health conditions. On this episode of Managed Care Cast, we speak with Nicole Neumarker, the executive vice president of development and innovation at Cotiviti. Nicole shared Cotiviti’s results with their tracker map at the 2021 AcademyHealth National Health Policy Conference and provided us some insight into what impact this technology could have in the future.

This week, the top managed care news included efficacy data on AstraZeneca’s COVID-19 vaccine questioned; coverage from the NCCN 2021 Virtual Annual Conference; COVID-19 poses risks to children with poorly controlled type 1 diabetes.

Addressing vaccine hesitancy, which may take the form of refusing a vaccine or putting oneself in the “wait and see” camp while thinking it over, has never been more urgent as health authorities race to try and vaccinate as much of the population as possible against the virus that causes COVID-19 in 2021. On this episode of Managed Care Cast, Pat Salber, MD, MBA, of the Doctor Weighs In, discusses education for patients on the topic of vaccine hesitancy and COVID-19. Her guest is Eve Gaus, who directs the development of interactive, people-centered, multimedia programs for Wolters Kluwer Health. The programs are used by health care systems to address questions raised by patients about the vaccines, how they were approved, how they work, and more.

This week, the top managed care news included AstraZeneca refuting blood clot links to COVID-19 vaccine; 2021 V-BID Summit celebrates 20 years of policy achievements for value-based insurance design; Managed Care Cast discusses 4 strategies payers can use to ensure opioid use disorder care.

The upheaval created by the pandemic over the past year has particularly affected individuals struggling with opioid use disorder (OUD) and other substance use issues in the United States, which set an unfortunate record in the first half of last year. More than 81,000 people died of drug overdoses between June 2019 and May 2020, largely driven by illicit fentanyl, as synthetic opioid overdose deaths increased 38%. The March issue of The American Journal of Managed Care® includes a commentary about what payers can do to meet the needs of patients who need care for OUD. Chethan Bachireddy, MD, MSc, the chief medical officer for Virginia’s Medicaid program, and coauthor Mishka Terplan, MD, MPH, outline 4 things that payers can do to make sure that patients can get the treatment they need, and what’s at risk if they don’t. On this episode of Managed Care Cast, Bachireddy discusses the commentary as well as how these strategies are being used in Virginia, where he continues to work one day a week as a primary c

This week, the top news in managed care included CDC guidance on safe activities for fully vaccinated individuals; American Rescue Plan signed into law; new lung cancer screening criteria expand eligibility.

This activity is supported by an educational grant from Boehringer Ingelheim. Today, we are bringing you part 1 of a 2-part podcast series discussing chronic obstructive pulmonary disease (COPD). In part 1, moderator Neil Minkoff, MD, chief medical officer of Coeus Healthcare, leads a discussion with a panel of experts about the burden of COPD, available treatments, and more.

This week, the top managed care news included President Biden updating production timeline for nationwide vaccine availability; efforts by the National Quality Forum to measure telehealth quality and value; FDA approves first treatment for rare genetic metabolic pediatric disorder.

As the COVID-19 pandemic has led to a nation-wide boom in telehealth use, new questions are emerging regarding reimbursement, accessibility, data protection, and quality measurement. Although the practice has greatly aided in maintaining care for many Americans throughout the past year, several challenges have been reported. To create a measurement framework linking quality of care delivered by telehealth, health care system readiness, and health outcomes in rural areas specifically, the National Quality Forum (NQF) recently announced a committee of 25 individuals to discuss, update, and enhance NQF’s telehealth framework, first released in 2017. Currently, there are no nationally endorsed telehealth quality measures. On this episode of Managed Care Cast, we speak with Sheri Winsper, RN, MSN, MHA, the senior vice president for quality measurement at NQF. For the past 20 years, the forum has worked to advance health care quality across the nation by endorsing measures that assess quality of care and value.

An FDA panel meets to discuss J&J's COVID-19 vaccine ahead of an expected emergency use authorization decision, cemiplimab approved for first-line advanced non–small cell lung cancer with PD-L1 expression, and real-world outcomes contrast cancer clinical trial results in Medicare patients.

On this edition of Managed Care Cast, we present a short excerpt from a January webinar titled “Color and COVID-19: The Virus’ Disproportionate Impact” hosted by the MJH Life Sciences™ COVID-19 Coalition about how the pandemic has had an unequal, devastating impact on communities of color.

This week, the top managed care news included Entresto winning the first FDA nod in a hard-to-treat type of heart failure; President Joe Biden nominates a new CMS administrator; experts discuss the potential for Biden health reforms.

On this episode of Managed Care Cast, we highlight a new feature on AJMC.com, the website of The American Journal of Managed Care (AJMC®) called Clinical Spotlight, where our editors provide a series of interviews with leading experts in certain specialties. Over the past few months, we’ve talked with specialists in chronic obstructive pulmonary disease (COPD), small-cell lung cancer, and chimeric antigen receptor (CAR) T-cell therapy. The first interview excerpt is with Rose McNulty, editor at AJMC, who speaks with Charles Rudin, MD, chief of the Thoracic Oncology Service at Memorial Sloan Kettering Cancer Center and principal investigator of the National Cancer Institute Small Cell Lung Cancer Consortium. He provides insights into the state of SCLC treatment, clinical trials, and what the future may hold. The second is with Gianna Melillo, associate editor, who interviews Antonio Anzueto, MD, a professor of medicine at University of Texas Health in San Antonio and a member of the science committee for

This week, the top managed care news included President Biden’s DOJ reversing course in case seeking to overturn the Affordable Care Act; once-weekly semaglutide and lifestyle changes slashed body weight by 15%; updates on COVID-19 vaccines and treatments.