Managed Care Cast

This week, the top managed care news included the first coronavirus disease 2019 vaccine shipments arriving nationwide; FDA panel votes to expand use of heart failure drug; efforts to address social determinants of health amid the pandemic.

On this episode of Managed Care Cast, we speak with Bechara Choucair, MD, the chief health officer of Kaiser Permanente, about their social health playbook, which guides clinicians about how to help patients with their social health needs during the pandemic.

As 2020 ends, the last interview in a year-long series running during the 25th anniversary of The American Journal of Managed Care® (AJMC®) is with the journal’s co-editors-in-chief: Michael E. Chernew, PhD, and A. Mark Fendrick, MD. This episode of Managed Care Cast is a preview of that conversation, which appears in the December issue. Chernew and Fendrick discuss which issues they think President-elect Joe Biden should prioritize, including the sustainability of Medicare, a continued way forward for the Affordable Care Act, and value-based insurance design, particularly as the continued coronavirus disease 2019 pandemic continues to stress every aspect of health care.

Diabetes is an established risk factor for more severe cases of coronavirus disease 2019 (COVID-19). But recently reported cases of COVID-19-related diabetes among those with no preexisting risk factors suggest the 2 conditions may have a bidirectional relationship. Interested in these rare cases, which don’t appear to fit the typical 2 types of diabetes, Francesco Rubino, MD, a professor of metabolic and bariatric surgery at King’s College London, along with a cohort of clinicians from around the world, devised a global registry of COVID-19-related diabetes to better track and understand this condition. The CoviDiab Registry was created to establish the extent and characteristics of new-onset, COVID-19-related diabetes, and to investigate its pathogenesis, management and outcomes. On this episode of Managed Care Cast, we speak with Rubino about these new cases, the registry’s progress, and future implications of COVID-19-related diabetes.

Recently released vaccine data from both Pfizer and Moderna indicate encouraging steps forward in the global fight against coronavirus disease 2019 (COVID-19). But both vaccines are still a long way from becoming readily available to the wider public, prompting the question, who should be prioritized once doses become available? To provide guidance on this front, The National Institutes of Health (NIH) and Centers for Disease Control and Prevention (CDC) requested The National Academies of Science, Engineering, and Medicine (NASEM) to construct a framework assisting US policymakers and global health communities to plan for an equitable allocation of a COVID-19 vaccine. On this episode of Managed Care Cast, we speak with Jewel Mullen, (MD, MPH) the associate dean for health equity and associate professor of population health and internal medicine at the University of Texas at Austin, Dell Medical School. Mullen is the former principal deputy assistant secretary for health in the U.S. Department of Health a

Every week, The American Journal of Managed Care® recaps the top managed care news of the week. This week, the top managed care news included reports of 2 vaccines’ efficacy against coronavirus disease 2019 (COVID-19); a study finds no risk reduction in cardiac events with fish oil; calls for long-term follow-up to understand effects of lingering COVID-19. Read more about the stories in this podcast: What We’re Reading: Pfizer Vaccine 95% Effective; At-home COVID-19 Test Approved; Amazon Launches Online Pharmacy: https://www.ajmc.com/view/what-we-re-reading-pfizer-vaccine-95-effective-at-home-covid-19-test-approved-amazon-launches-online-pharmacy What We're Reading: Vaccines in EUA Process; Alkermes Receives CRL; California Tightens Restrictions: https://www.ajmc.com/view/what-we-re-reading-vaccines-in-eua-process-alkermes-receives-crl-california-tightens-restrictions Fish Oil Debate Continues as Study Finds No Risk Reduction From Omega-3 Combo: https://www.ajmc.com/view/debate-over-fish-oil-therapy-conti

The coronavirus disease 2019 (COVID-19) pandemic has required health care systems to overhaul their ways of delivering care to patients in order to keep patients, families, and clinicians safe. For medical home visit programs accustomed to visiting patients in person, this task has required creative use of new technologies and relied on regulatory flexibility to facilitate their work. On this episode of Managed Care Cast, we’re talking with the authors of a Commentary article published in our November issue. The article, “Medical Home Visit Programs During COVID-19 State of Emergency,” describes the experience of reimagining how a home health program can deliver care amid the coronavirus disease 2019 pandemic. The authors, from Northwell Staten Island University Hospital in Staten Island, New York, are Dr Donna Seminara, Dr Anita Szerszen, Dr John R. Maese, and Dr Zeel Shah.

As the health care industry continues to combat health and cost-related issues exacerbated by the COVID-19 pandemic, employers remain a key figure in the pursuit for higher value care. Recently, the Leapfrog Group partnered with the Health Transformation Alliance, or HTA, to help delineate high-value health care services with a particular focus on transparency and payment reform. On this episode of Managed Care Cast, we speak with Leah Binder, president and chief executive officer of the Leapfrog Group, about her organization’s partnership with the HTA, the significance of their 20th anniversary this year, and how transparency and employer leverage may shape the transition toward value-based health care.

Every week, The American Journal of Managed Care® recaps the top managed care news of the week. This week, the top managed care news included the Supreme Court signaling willingness to uphold the Affordable Care Act; Pfizer’s coronavirus disease 2019 vaccine shows 90% efficacy; racial disparities in lung cancer screenings and prescribing biologics. Read more about the stories in this podcast: Supreme Court Signals Willingness to Uphold ACA: https://www.ajmc.com/view/supreme-court-signals-willingness-to-uphold-aca Pfizer Says Vaccine 90% Effective; Biden Team Announces COVID-19 Transition Panel: https://www.ajmc.com/view/pfizer-says-vaccine-90-effective-biden-team-announces-covid-19-transition-panel Lung Cancer Screening Criteria Miss Young, High-Risk Black Smokers: https://www.ajmc.com/view/lung-cancer-screening-criteria-miss-young-high-risk-black-smokers Black Patients With RA Less Likely Than White Counterparts to Be Prescribed a Biologic: https://www.ajmc.com/view/black-patients-with-ra-less-likely-th

As the costs of cancer care continue to rise in the United States, eyes are increasingly turning to payment reform. Research by the Northeast Business Group on Health found that in 2015, employers spent $125 million on cancer care, and since then, cancer therapy costs have increased substantially with greater use of immunotherapy and the introduction of chimeric antigen receptor T-cell therapies that can easily cost half a million dollars for treatment. The federal government is taking the lead with the Oncology Care Model, which will transition into Oncology Care First in 2022 after a 1-year extension due to the coronavirus disease 2019 pandemic, but commercial payers are also testing payment reform models. Speakers who participated in the Quality Cancer Care Alliance’s Fall Leadership Summit, weighed in on the payment reform space for cancer care. Learn more: Speaking of Employers: Purchasers Detail the Challenges of Getting a Handle on Oncology Care Costs https://www.ajmc.com/view/speaking-of-employers-

EDIT: This podcast has been updated as of 11:45 am EST. Every week, The American Journal of Managed Care® recaps the top managed care news of the week. This week, the top news in managed care included top health care takeaways from the 2020 general election; a Q&A with William Shrank, MD, MSHS, on connecting Medicare Advantage providers and patients; Managed Care Cast discusses balancing evidence with action amid the coronavirus disease 2019 pandemic. Read more about the stories in this podcast: Top 5 Health Care Takeaways From the 2020 General Election: https://www.ajmc.com/view/top-5-health-care-takeaways-from-the-2020-general-election Medicare Advantage Providers, Patients Connect Without a Playbook: A Q&A With William H. Shrank, MD, MSHS: https://www.ajmc.com/view/medicare-advantage-providers-patients-connect-without-a-playbook-a-q-a-with-william-h-shrank-md-mshs Balancing Evidence With Action: Dr Patricia Salber Interviews Dr Denise Basow: https://www.ajmc.com/view/balancing-evidence-with-action-dr-

With the coronavirus disease 2019 pandemic, new research is quickly being released as more and more is learned. However, the flood of new research needs to be balanced with appropriate review before action is taken. In the latest Managed Care Cast, Denise Basow, MD, president and CEO of clinical effectiveness at Wolters Kluwer, speaks with Patricia Salber, MD, MBA, of The Doctor Weighs In, about the onslaught of information, the risk of misinformation, the wide range of information sources available, and more. Read more: Experts Discuss Myths of COVID-19 and Clarify Misunderstandings: https://www.ajmc.com/view/experts-discuss-myths-of-covid-19-and-clarify-misunderstandings Study Dispels Misinformation on Contact Lens, Spectacle Use and COVID-19: https://www.ajmc.com/view/study-dispels-misinformation-on-contact-lens-spectacle-use-and-covid19 In Wake of Measles Outbreaks, Another Study Dispels Myths Surrounding MMR Vaccine: https://www.ajmc.com/view/in-wake-of-measles-outbreaks-another-study-dispels-myths-s

Every week, The American Journal of Managed Care® recaps the top managed care news of the week. This week, the top managed care news included updates on coronavirus disease 2019 therapies and vaccine candidates; a discussion on keeping physicians independent through value-based care; an overview of the 2020 Community Oncology Alliance Virtual Payer Exchange Summit. Read more about the stories in this podcast: What We’re Reading: COVID-19 Vaccine Trials to Restart; Record 2-Day Infections; Stress-Reducing Strategies: https://www.ajmc.com/view/what-we-re-reading-astrazeneca-j-j-covid-19-trials-to-restart-record-2-day-infection-stress-reducing-strategies What We're Reading: Eli Lilly Ends Antibody Trial; Pros, Cons of Telehealth; AAP Issues New Opioid Guidelines: https://www.ajmc.com/view/what-we-re-reading-eli-lilly-ends-antibody-trial-pros-cons-of-telehealth-aap-issue-new-opioid-guidelines What We’re Reading: Hospitals Strained; Pfizer Trial Enrollment; Variation in Virus Mitigation: https://www.ajmc.com/v

The company Aledade was created 6 years ago to help physicians stay independent by implementing a value-based care business model. In this episode of Managed Care Cast, Patricia Salber, MD, MBA, of The Doctor Weighs in, speaks with Aledade co-founder, Farzad Mostashari, MD, about what his company has accomplished and why these efforts are important for all stakeholders. Read more about Aledade, accountable care organizations (ACOs), and value-based care: Mostashari, Gilfillan Highlight the Spillover Effect of ACOs Across the Entire Healthcare System: https://www.ajmc.com/view/mostashari-gilfillan-highlight-the-spillover-effect-of-acos-across-the-entire-healthcare-system MedPAC's MIPS Vote Meant to Encourage Physicians Into High-Risk Payment Models, Says Aledade's Broome: https://www.ajmc.com/view/medpacs-mips-vote-meant-to-encourage-physicians-into-highrisk-payment-models-says-aledades-broome ACOs and Healthcare Transformation: Dr Patricia Salber Interviews Travis Broome: https://www.ajmc.com/view/acos-and

Every week, The American Journal of Managed Care® recaps the top managed care news of the week. This week, the top managed care news included coronavirus disease 2019 (COVID-19) delays in breast cancer surgery; targeted therapies associated with decreased mortality risk for non–small cell lung cancer; an inside look at a patient’s perspective of early-onset Parkinson disease. Read more about the stories in this podcast: Cancer Care Delays in COVID-19 Could Lead to Higher Morbidity, Mortality: https://www.ajmc.com/view/cancer-care-delays-in-covid-19-could-lead-to-higher-morbidity-mortality Propelled by Targeted Therapies, NSCLC Mortality Fell Between 2013 to 2016: https://www.ajmc.com/view/propelled-by-targeted-therapies-nsclc-mortality-fell-between-2013-to-2016 A Patient Perspective on Early-Onset Parkinson Disease: https://www.ajmc.com/view/a-patient-perspective-on-early-onset-parkinson-disease CHEST 2020 Annual Meeting: https://www.ajmc.com/conference/chest The Academy of Managed Care Pharmacy Nexus:

2020 is the 25th anniversary of The American Journal of Managed Care® and October’s edition of the journal features an interview with Kavita Patel, MD, MS, a nonresident fellow at the Brookings Institution and a primary care physician.

Ten months into the coronavirus disease 2019 (COVID-19) pandemic, some states continue to struggle to keep up with new cases and protect their most vulnerable populations from bearing the brunt of the disease. However, one state was able to get ahead of the pandemic early on, and, through public private-partnerships, secured immediate care for hundreds of the highest risk individuals within weeks. On this episode of Managed Care Cast, we speak with Susan Mani, MD, the chief population health officer for LifeBridge Health, and Trenor Williams, MD, the chief executive officer and co-founder of Socially Determined. Together, Dr. Mani and Dr. Williams lay out how Maryland’s COVID-19 task force on vulnerable populations was able to leverage data on social determinants of health and analytics to rapidly pinpoint populations most at risk of severe COVID-19 complications and optimize preventive and treatment measures.

Every week, The American Journal of Managed Care® recaps the top managed care news of the week. This week, the top managed care news included the first case of coronavirus disease 2019 (COVID-19) reinfection in the United States; a positive side to halting trials to evaluate vaccine safety; a rise in employer-sponsored health insurance premiums for 2020. Read more about the stories in this podcast: First Case of COVID-19 Reinfection Detected in the US: https://www.ajmc.com/view/first-case-of-covid-19-reinfection-detected-in-the-us Dr Maura Abbott Explains How Halting Trials to Evaluate Vaccine Safety Is a Good Thing: https://www.ajmc.com/view/dr-maura-abbott-explains-how-halting-trials-to-evaluate-vaccine-safety-is-a-good-thing KFF Survey Finds Employer-Sponsored Health Insurance Premiums Rose 4% in 2020: https://www.ajmc.com/view/kff-survey-finds-employer-sponsored-health-insurance-premiums-rose-4-in-2020 Dialysis Is on the Ballot Again in California: https://www.ajmc.com/view/dialysis-is-on-the-ballot-

Addressing coronavirus disease 2019 (COVID-19) means addressing racism, wrote Ingrid Katz, MD, assistant professor at Harvard Medical School, and Abraar Karan, MD, MPH, DTM&H, an internist at the Brigham and Women's Hospital and Harvard Medical School, in an opinion piece published in British Medical Journal. In the latest Managed Care Cast, they speak with Patricia Salber, MD, MBA, of The Doctor Weighs In, about the article, why racism is an issue for doctors to address, and how well medicine is or is not doing with respect to addressing racism in admission to and graduation from medical school, teaching and studying the health impacts of racism in medical teaching, and encouraging more minority medical students to train as medical researchers. Read the original article by Katz and Karan: https://blogs.bmj.com/bmj/2020/06/05/there-is-no-stopping-covid-19-without-stopping-racism/​ Read more about racial and ethnic disparities in health care: Key Steps to Reduce Racial Cancer Disparities Include Supporti

Every week, The American Journal of Managed Care® recaps the top managed care news of the week. This week, the top managed care news included President Donald Trump’s discharge from the hospital; a poll finds Americans trust Joe Biden to lead the US health care system; Nobel Prize awarded to scientists who discovered the hepatitis C virus. Read more about the stories in this podcast: Trump to Be Discharged From Hospital Despite Continued COVID-19 Treatments: https://www.ajmc.com/view/trump-to-be-discharged-from-hospital-for-covid-19-symptoms More Americans Trust Biden to Lead US Health Care System, West Health-Gallup Poll Finds: https://www.ajmc.com/view/more-americans-trust-biden-to-lead-us-health-care-system-west-health-gallup-poll-finds Discovery of Hepatitis C Virus Brings Nobel Prize: https://www.ajmc.com/view/discovery-of-hepatitis-c-virus-brings-nobel-prize Study Highlights Persistent Racial Disparities in Insulin Pump Use Among Children With T1D: https://www.ajmc.com/view/study-highlights-persist