Managed Care Cast

On the After Hours section of Medical World News, we like to show you what scientists, researchers, health care providers, and others are doing in their spare time to relax and recharge. On this episode of Managed Care Cast, we’re highlighting a hobby from a biosimilar expert who says he can make whisky more accessible and affordable through—you guessed it—his own biosimilar whisky. Sarfaraz K. Niazi, PhD, is an adjunct professor of biopharmaceutical sciences at the University of Illinois and the University of Houston, and a member of the advisory board of The Center for Biosimilars®', a sister site to AJMC.com, the website of The American Journal of Managed Care. On a recent episode of After Hours, he spoke with Matthew Gavidia, an assistant editor at AJMC.com, about his unusual whiskey-making hobby, the history of the traditional process, and how he distills his own biosimilar version.

The pandemic highlighted deep partisan divisions in the United States over public health measures. Disputes over masking and beliefs about science and vaccines that prevent severe illness and death from infection with SARS-CoV2, the virus that causes COVID-19, affected nearly every area of life. That rancor impacted death rates in counties that voted Republican in the 2020 presidential election, according to a new study out Monday in the journal Health Affairs. In counties where 70% or more of eligible voters chose the Republican party, there were nearly 73 additional deaths from COVID-19 per 100,000 people compared with Democratic counties (where less than 30% voted Republican). On today’s episode of Managed Care Cast, we speak with the lead author of the study, Neil J. Sehgal, PhD, MPH, assistant professor of health policy and management in the University of Maryland (UMD) School of Public Health. He discusses the findings of the paper, coauthored with other scholars from UMD, as well as the Universi

Income inequality is a hot topic in politics today, and while the rising role of social determinants of health is being recognized in care delivery and research, a new study published in Social Science & Medicine aimed to determine to what extent income gaps are associated with Americans’ declining health. On this episode of Managed Care Cast, we speak with Hui Zheng, PhD, an associate professor in the Department of Sociology at Ohio State University and co-author of “Rising Childhood Income Inequality and Declining Americans’ Health.” The American Journal of Managed Care® sat down with Zheng to learn more about how income inequality has shifted throughout the 20th and 21st centuries and the potential implications of this shift, along with some solutions to the problem.

Cholangiocarcinoma—or biliary duct cancer—affects about 8000 US patients a year. On this episode of Managed Care Cast, we bring you an excerpt of an interview with Jesper B. Andersen, PhD, associate professor and group leader at the University of Copenhagen and the Biotech Research and Innovation center at the Department of Health. There have been 3 FDA drug approvals for drugs that treat cholangiocarcinoma, but only for patients that have certain mutations or rearrangements, signifying an unmet need, noted Andersen. And due to the limited number of patients, clinical trials are challenging. Dr Anderson spoke recently with Brielle Benyon, senior editor of CURE®, a publication by MJH Life Sciences. You can watch this interview and many others with by Visiting Medicalworldnews.com, where you can get expert insights you won’t find anywhere else.

On this episode of Managed Care Cast, we speak with Tham Le, PhD, MPH, and Linda Wastila, PhD, MSPH, lead and senior authors, respectively, of “Patterns of Opioid Use in Commercially Insured Patients With Cancer,” which was published in the May issue of The American Journal of Managed Care®. They took up their investigation after finding that most previous similar studies of opioid use focused on problems with opioid use among general populations and that patients with cancer are an often overlooked population where opioid use is concerned. They sought a greater understanding of which patients with cancer are at risk for undertreatment and who is at risk for a substance use disorder. Overall, they believe that policies concerning opioid misuse need strengthening while continuing to address the genuine pain needs of patients with cancer and that they need to balance the benefits of opioid prescribing with the risks.

Drug overdose deaths are skyrocketing, with more than 100,000 people dying in 2021, according to the CDC. Obtaining treatment for substance use disorders (SUDs) has never been easy, and this month in Health Affairs, a recent paper examined trends in the use of treatment services to see what, if anything, changed from 2010 to 2019. Despite an increase in insurance coverage over much of that time period and other policy changes, the results were disappointing, according to one of the authors interviewed about the findings on today’s Managed Care Cast. Brendan Saloner, PhD, is an associate professor at the Johns Hopkins Bloomberg School of Public Health who specializes in health policy, particularly policies that affect vulnerable populations, including those with drug problems and behavioral or mental health issues.

On this episode of Managed Care Cast, we speak with Dr Joanne Armstrong, vice president and chief medical officer for Women’s Health and Genomics at CVS Health, on the distinct pathophysiology of cardiovascular disease in women, applicability of current screening and care delivery guidelines for heart health in regards to minority populations, and how her own health experiences have influenced her perspective on cardiovascular disease management.

April is Parkinson’s Disease Awareness month, and on this episode of Managed Care Cast, we take a look at the Parkinson's Progression Markers Initiative (PPMI), a study from the Michael J. Fox Foundation for Parkinson's Research (MJFF). The multicenter, international study aims to end Parkinson disease, which is expected to double worldwide by 2040, to more than 14 million people. The study is investigating the biomarkers and other data collected from a wide range of individuals—those without the disease, those with very early disease, and those with more advanced disease. Originally launched in 2010, the study is expanding online where it wants to collect information from more than 100,000 people, particularly those with a first-degree relative with Parkinson, those with a genetic mutation for the disease, or those who act out their dreams in their sleep. Our guest on this episode is Roseanne D. Dobkin, PhD, a clinical psychologist and associate professor of psychiatry at the Robert Wood Johnson Medical

In 2018, the FDA approved a record 66 novel drugs. Among them were cancer treatments, orphan drugs for rare diseases, drugs under expedited review, and biosimilars. However, access to each of these drugs for patients covered by different health plans was not uniform. On this episode of Managed Care Cast, we speak with Ari D. Panzer, BS, a master of public policy candidate at Duke University, and lead author of “Patients’ Access to 2018 FDA-Approved Drugs 1 Year Post Approval,” which was published in the April issue of The American Journal of Managed Care®. He delves into why it’s important to ensure patients receive optimal treatment and maximize their outcomes, understanding why health plans vary in their coverage decisions despite having access to the same evidence, and the difficulty of striking the right balance between drug access, cost, and coverage to ensure patients can get the drug therapies they require when appropriate.

Entering its 51st year, the American Kidney Fund has made it its mission to help all patients affected by chronic kidney disease (CKD), which is the fastest-growing noncontagious disease in the United States: from those at risk for chronic kidney disease through patients requiring dialysis and/or transplant. First and foremost is uncovering the primary cause of their kidney failure. Unfortunately, for 14% of low-income patients, the origins of their CKD remain a medical mystery. In December of 2020, the American Kidney Fund convened the Unknown Causes of Kidney Disease Summit, bringing together government agencies, industry, patients, researchers, and rare disease organizations, hoping that by helping underserved patients get to the root cause of their kidney disease, they could also help solve this mystery for a broader patient population. From this, a roadmap was born for what would become the Unknown Causes of Kidney Disease Project, launched in mid-2021, with goals that include advocating for equitable k

It’s well known the state of maternal morbidity and mortality in the United States is subpar. From stark racial disparities in maternal deaths to a severe shortage of midwives and doulas, birthing people in the United States face unique challenges not seen in other high-income countries. Plus, the recent increase in legislation aimed at curbing abortion access throughout the nation may serve to exacerbate these problems, as more women are forced to carry unwanted pregnancies to term. To better understand how we got here and examine some potential solutions to these problems, The American Journal of Manage Care® sat down with Breana Lipscomb, the senior advisor of Maternal Health & Rights at the Center for Reproductive Rights. This week also marks Black Maternal Health Week, and on this episode of Managed Care Cast, Lipscomb outlines steps needed to improve care for Black mothers in the US—a demographic that is more than 3 times more likely to have a maternal death compared with their white counterparts.

National Public Health Week, the annual initiative from the American Public Health Association, falls within the first full week of April. On this episode of Managed Care Cast, to mark the conclusion of National Public Health Week this year, which ran from April 4-10, we speak with Perry N. Halkitis, PhD, MS, MPH, dean of the Rutgers School of Public Health, who is also a public health psychologist, infectious disease epidemiologist, applied statistician, researcher, educator, and advocate. He discusses training the next generation of public health professionals, why a paradigm shift is necessary around integrating mental health awareness into public health education, and the importance of activism and advocacy to eliminating health disparities.

In January 2022, Vanderbilt University Medical Center, Meharry Medical College, and the University of Miami Miller School of Medicine announced the receipt of a $12.4 million grant from the National Institutes of Health to develop the Southeast Collaborative for Innovative and Equitable Solutions to Chronic Disease Disparities. The center’s work aims to reduce disparities seen in the southeast United States, with particular focus on cardiovascular disease, obesity, diabetes, and other related conditions among African Americans and Latino populations. Currently, over 20% of this region lives in poverty, while racial and ethnic minorities comprise nearly 40% of the population. Southern states also tend to be the least healthy in the nation and account for the majority of Medicaid expansion holdouts under the Affordable Care Act. To learn more about geographic disparities in chronic disease rates, The American Journal of Managed Care® (AJMC®) sat down with Consuelo Wilkins, MD, MSCI, professor of medicine,

An unprecedented level of detail and robustness around interoperability standards is on its way, and on this episode of Managed Care Cast, we speak with Donald Rucker, MD, the former National Coordinator for Health Information Technology in HHS, about what the opportunities and responsibilities for payers are. The change is precipitated by 2020 rulemaking regarding the 21st Century Cures Act requirement regarding application programming interfaces. The new requirement will enable access to patient-level data across a patient population, allowing for more analysis that can inform clinical decisions, track those decisions to costs, and even influence future policy. Rucker, who received his medical degree from the University of Pennsylvania and also has an MBA in business and an MS in medical computer science and informatics from Stanford University, is currently chief strategy officer at 1upHealth.

Within Virginia, one of 13 states that fall within the Appalachian region of the United States, the current overall poverty rate is 10.6%, giving the state a 10th place ranking on a list of the top 10 states with the lowest poverty rates. However, the average poverty rate of the southwest corner of the state, which includes the 6 counties of Buchanan, Dickenson, Russell, Lee, Scott, and Wise, is double that of the state, at 21.9%. Supported entirely by grants and donations, The Health Wagon has been providing free health care services for the often medically underserved and indigent individuals—who are either underinsured or uninsured—in this part of Virginia for more than 4 decades. On this episode of Managed Care Cast, we speak with The Health Wagon’s President and CEO Teresa Tyson, DNP, MSN, FNP-BC, FAANP, and Clinical Director Paula Hill-Collins, DNP, MSN, FAANP, to learn more about the often urgent services they provide, to discover how the not-for-profit innovates care through culturally sensitive ser

CMS first implemented the Comprehensive Primary Care Plus, or CPC+, Initiative in January 2017. The medical home model is a large-scale redesign effort meant to improve primary care through payer reform and care delivery transformation. However, an interim data analysis of the initiative’s first 3 years among Medicare fee-for-service beneficiaries did not demonstrate improvements in either care continuity or care fragmentation. On this episode of Managed Care Cast, we speak with Lori Timmins, PhD, senior researcher, and Eugene Rich, MD, senior fellow, both of Mathematica. With their fellow authors, Carol Urato, MA, researcher at Mathematica; Lisa M. Kern, MD, MPH, associate professor of medicine at Weill Cornell Medicine in New York; and Arkadipta Ghosh, PhD, principal researcher at Mathematica, they published their study, “Primary Care Redesign and Care Fragmentation Among Medicare Beneficiaries,” in the March issue of The American Journal of Managed Care®.

Sexual orientation and gender identity change efforts (SOGICE), more commonly known as conversion therapy, is a discredited practice opposed by a number of medical, mental health, and human rights organizations, including the American Academy of Pediatrics and the American Academy of Child and Adolescent Psychiatry. Yet annually, the practice’s harms lead to estimated direct and indirect costs of $9.23 billion in the United States, according to a new study published in JAMA Pediatrics. SOGICE can take the form of individual or group psychotherapy, inpatient treatment, or administration by religious leaders, while many individuals undergo multiple modalities, typically as youths. The practice relies on the false belief that being LGBTQ+ is pathologic, and its enforcers promote sexual and gender identify rejection often to the mental health detriment of recipients. Currently, 25 states; Washington, DC; and Puerto Rico all have bans in place prohibiting SOGICE for minors. However, unlicensed individuals, li

On this episode of Managed Care Cast, we speak with Tim Gronniger, the CEO of Caravan Health, about what to look for as accountable care organizations (ACOs) and policy makers try to encourage more providers to join value-based care arrangements.

Since 1999, nearly 841,000 Americans have died of drug overdoses, according to data from the CDC, while opioids serve as the main driver of these deaths. Synthetic opioids account for 73% of opioid-involved overdose deaths. The COVID-19 pandemic exacerbated the opioid epidemic as individuals encountered disruptions in routine treatment, alongside steep increases in depression and anxiety rates. One group of individuals susceptible to opioid use disorder are those with chronic, non-cancer pain. Although interventions such as full mu agonist chronic opioid analgesic therapy (COAT) cessation exist for this population, data show this practice can actually impede vocational and social return to function and to increase length of disability. In a study published in the October issue of The American Journal of Managed Care® (AJMC®) Marcelina Jasmine Silva DO, and colleagues outlined outcomes from the Focus on Opioid Transitions (FOOT Steps) Program, which was created to help patients with chronic non-cancer pain

Human papillomavirus, or HPV, is the most common sexually transmitted infection in the United States and causes the majority of cervical cancer cases in the country. But screening for HPV can catch the virus early and potentially prevent it from developing into cervical cancer. In addition, safe and effective vaccines against HPV exist, essentially making cervical cancer a preventable disease. However, uptake of HPV vaccines remains sporadic throughout the United States compared with other nations like the United Kingdom, where cervical cancer is nearly eliminated in young women. Furthermore, despite its prevalence, an HPV diagnosis gap exists among racial groups in the US, as White women are 3 times more likely to be told they have HPV than Black women. To dig deeper into racial disparities in HPV, Leslie Cofie, PhD, MPH, an assistant professor of health education and promotion at the College of Health and Human Performance, East Carolina University, conducted a study to understand HPV vaccination up