Managed Care Cast

The rate of innovation in oncology has been impressive, with novel therapies, such as chimeric antigen receptor T-cell therapies, and new diagnostics that make it easier to understand which patients will benefit from certain targeted therapies. With all of these innovations coming to market and being tested in clinical trials, it might make sense that some people are ready to move on from the treatments of the past. In a new commentary published in the June issue of The American Journal of Managed Care®, Bruce Feinberg, DO, of Cardinal Health, explains why people shouldn’t count out chemotherapy just yet. In the latest podcast interview, Feinberg explains his views on chemotherapy and how important it still is in cancer care. Reports of the Demise of Chemotherapy Have Been Greatly Exaggerated: www.ajmc.com/journals/issue/2019/2019-vol25-n6/reports-of-the-demise-of-chemotherapy-have-been-greatly-exaggerated Phase 3 TAILORx Results Confirm Chemotherapy Unnecessary in 70% of Women With Early-Stage Breast Canc

The burden of medical expenses, whether incurred through a catastrophic illness or surprise medical bills, affects the uninsured and insured alike. A 5-year-old charity called RIP Medical Debt buys medical debt incurred, so far, by more than 250,000 Americans. We talk to one of the cofounders and coauthors of "End Medical Debt," the book they wrote about the issue.

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 American Society of Clinical Oncology discussing drug pricing; community oncologists seeking a delay in taking on downside risk in the Oncology Care Model; CDC finding a drop in new diabetes cases in the United States. Read more about the stories in this podcast: ASCO Town Hall Brings Tense Conversation About Drug Pricing: https://www.ajmc.com/conferences/asco-2019/asco-town-hall-brings-tense-conversation-about-drug-pricing Cannabis Risks and Benefits in Cancer Symptom Management: Much Remains Unknown: https://www.ajmc.com/conferences/asco-2019/cannabis-risks-and-benefits-in-cancer-symptom-management-much-remains-unknown American Society of Clinical Oncology Annual Meeting 2019: https://www.ajmc.com/conferences/asco-2019 COA Urges Delay in Downside Risk Deadline for OCM: https://www.ajmc.com/newsroom/

Heard at ISPOR: Debating the Benefits and Pitfalls of the QALY by Managed Care Cast

We sit down with David Smith, the executive director of the Medicaid Transformation Project, to get an update about the integration challenges health systems are facing, including system issues, infrastructure issues, coding and payment issues, and more.

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 FDA's approval of a $2.1 million gene therapy; a study revealing that the worldwide need for palliative care will nearly double by 2060; the FDA granting priority review to Amarin’s Vascepa for a cardiovascular indication. Read more about the stories in this podcast: FDA Approves Gene Therapy With $2.1M Price Tag for Spinal Muscular Atrophy in Pediatric Patients: https://www.ajmc.com/newsroom/fda-approves-gene-therapy-with-21m-price-tag-for-spinal-muscular-atrophy-in-pediatric-patients Serious Health-Related Suffering to Nearly Double by 2060, Highlighting Need to Ramp Up Palliative Care Efforts: https://www.ajmc.com/focus-of-the-week/serious-healthrelated-suffering-to-nearly-double-by-2060-highlighting-need-to-ramp-up-palliative-care-efforts What We're Reading: FDA Grants Priority Review for Amarin's

In the first of a series of interviews with key opinion leaders, Amy Ellis, director of quality and value-based care at Northwest Medical Specialties, discusses practice transformation with Jess Quiring, a patient navigator at New Mexico Cancer Center. During the converation, Quiring explained how her practice modified the depression and distress screening tools for the different populations it treated. For instance, it changed the language based on what was more acceptable to Native Americans receiving treatment. She also explained the various programs the practice offers to patients, such as yoga, an art workshop, and meal preparation assistance, as well as several support groups.

Exploring the Increased Prevalence, Evolving Role of Physician Assistants by Managed Care Cast

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 a study questioning the Hospital Readmissions Reduction Program; FDA issuing a warning about do-it-yourself artificial pancreas systems; measles cases reach the highest level since 1994. Read more about the stories in this podcast: Study Questions Penalizing, Incentivizing PCPs for Readmission Rates: https://www.ajmc.com/focus-of-the-week/study-questions-penalizing-incentivizing-pcps-for-readmission-rates FDA Issues Warning on Do-It-Yourself Artificial Pancreas: https://www.ajmc.com/newsroom/fda-issues-warning-on-do-it-yourself-artificial-pancreas What We're Reading: Tobacco Age Legislation; Most Measles Cases Since 1994; Hidden Dangers of Heart Device: https://www.ajmc.com/newsroom/what-were-reading-tobacco-age-legislation-most-measles-cases-since-1994-hidden-dangers-of-heart-device Alkermes' Novel Schiz

As the cost of healthcare continues to rise, employers are getting more involved in their employees’ health and identifying ways they can intervene to help get employees who have chronic conditions healthy or access to care they need and also keep employees who are already healthy from getting sick. At the Midwest Business Group on Health (MBGH)’s 39th annual conference, Cheryl Larson, president and chief executive officer of MBGH, and Denise Giambalvo, vice president of MBGH, discussed a range of topics affecting employers, including trust with employees, popular initiatives, the cost of specialty drugs, and various proposals and policies from the Trump administration, such as getting rid of drug rebates and including drug prices in TV ads. Read coverage from the Midwest Business Group on Health’s annual conference: https://www.ajmc.com/conferences/mbgh-2019

Patients with Parkinson disease can suffer complications in the hospital if the individualized, highly structured care plans that manage their disease are not followed. We interviewed neurologist Hooman Azmi, MD, the co-author of Parkinson's Disease for the Hospitalist: Managing the Complex Care of a Vulnerable Population, about what it takes to improve patient care for this population. He is the director of the Division of Movement Disorders at Hackensack University Medical Center and is also a member of the neuro-oncology team at the John Theurer Cancer Center at Hackensack UMC.

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 44 states suing drug makers for price fixing; Gilead pledging to donate pre-exposure prophylaxis for up to 200,000 people for up to 11 years; Philadelphia soda tax reduced consumption of sugary drinks. Read more about the stories in this podcast: What We're Reading: Drug Makers Accused of Price-Fixing; Washington State Public Option Insurance; Vaccine Exemptions Stall: https://www.ajmc.com/newsroom/what-were-reading-drug-makers-accused-of-pricefixing-washington-state-public-option-insurance-vaccine-exemptions-stall Reactions Are Mixed as Gilead Announces PrEP Donations, Early Launch of Generic: https://www.ajmc.com/newsroom/reactions-are-mixed-as-gilead-announces-prep-donations-early-launch-of-generic Sales of Sweetened Drinks Fell 38% After Philadelphia Beverage Tax: https://www.ajmc.com/newsroom/sales-o

Do Machine-Readable Directories Improve Provider Directory Accuracy? by Managed Care Cast

Outcomes for patients with cancer are continuously improving, but the increasingly complex healthcare system, new payment and delivery models that place more risk on practices, and rising costs of therapies has made it difficult for independent oncology practices to thrive and survive. However, independent practices present an important part of cancer care, delivering care to patients who are not near large hospital-based systems at lower costs. Sibel Blau, MD, explains how Quality Cancer Care Alliance is bringing together independent practices and helping them succeed by providing them with best business models, practice efficiencies, and financial advantages. Read more about the stories in this podcast: Data and Collaboration Are Key for Value-Based Care Success: https://www.ajmc.com/journals/evidence-based-oncology/2018/december-2018/data-and-collaboration-are-key-for-valuebased-care-success Strategies for Fighting Consolidation in Community Oncology: https://www.ajmc.com/conferences/coa-2019/strategies-

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 HHS announcing a finalized rule requiring the disclosure of drug prices in television ads; a report finding high satisfaction with employer health coverage despite the cost; a study finding heart failure is surging among young adults. Read the articles in this podcast: HHS Finalizes Rule Requiring Disclosure of Drug Prices in TV Ads: https://www.ajmc.com/newsroom/hhs-finalizes-rule-requiring-disclosure-of-drug-prices-in-tv-ads High Satisfaction With Employer Coverage, but Financial Challenges Persist: https://www.ajmc.com/focus-of-the-week/high-satisfaction-with-employer-coverage-but-financial-challenges-persist Amgen, Syapse Join Forces for Precision Medicine in Oncology: https://www.ajmc.com/newsroom/amgen-syapse-join-forces-for-precision-medicine-in-oncology What We're Reading: Medicaid Fraud Settlemen

The Louisiana Department of Health and Corrections announced in March 2019 their selection of Asegua Therapeutics, a subsidiary arm of Gilead Sciences, as their pharmaceutical partner for the state’s subscription model for hepatitis C virus treatment. The alternative payment model, the first of its kind in the United States, was first announced in August 2018 by the Louisiana Department of Health, who explained that HCV infections are a public health crisis within the state. Though highly effective antiviral treatment exists that can largely cure patients with HCV, the price of the treatments remains high, and Medicaid patients and the Department of Corrections population are unable to access the therapies. Under this model, instead of paying for each prescription individually, the state would pay a subscription fee to the drug company whereby the state would then receive unlimited access to the drug, similar to how consumers pay a monthly fee to stream unlimited television shows and movies. Today, we’r

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 CMS Administrator Seema Verma calling for more disruption to the healthcare system; former FDA Commissioner Scott Gottlieb, MD, reflecting on the agency’s record of innovation; liraglutide demonstrating promise for youth with type 2 diabetes. Read more about the stories in this podcast: CMS' Verma: Upend the Status Quo to Move to Value-Based Care: https://www.ajmc.com/conferences/naacos-spring-2019/cms-verma-upend-the-status-quo-to-move-to-valuebased-care National Association of ACOs Spring 2019: https://www.ajmc.com/conferences/naacos-spring-2019 In First Speech Since Stepping Down as FDA Commissioner, Gottlieb Reflects on Agency's Push for Innovation: https://www.ajmc.com/conferences/whcc-2019/in-first-speech-since-stepping-down-as-fda-commissioner-gottlieb-reflects-on-agencys-push-for-innovation World

Heard at COA: Improving Cancer Care in Community Practices With OneOncology by Managed Care Cast

Earlier this year a paper published in Health Affairs discussed the reasons why patients seek out medical cannabis. We spoke with one of the authors, Kevin F. Boehnke, PhD, a researcher in anesthesiology, about the findings that chronic pain accounted for the majority of all patient-reported qualifying conditions under which US patients sought medical marijuana. We also discuss other topics related to medical cannabis in the United States, as well as the kinds of future research that would be helpful to understanding this issue.

Today we’re speaking with Dr. Steven Goldberg, the vice president of medical affairs, population health, and chief health officer at Quest Diagnostics. He is also a co-author of a recent peer-reviewed case study that analyzed a benefits and wellness program designed by a self-insured employer. The employer, Quest Diagnostics, covers nearly 60,000 lives. The analysis of the program showed that it was able to reduce costs while maintaining program quality and promoting population health. According to the study findings, through proactive changes, physician executive leadership, health plan collaboration, disease-specific population health initiatives, and plan design, Quest Diagnostic's annual healthcare cost trend steadily improved from a year-over-year trend of 5.7% from 2014 to 2015, to 4.6% from 2015 to 2016, to -1.0% for 2016 to 2017, and most recently, 0.3% in the 2017 to 2018 year.