Managed Care Cast

Metastatic breast cancer is the most advanced stage of breast cancer; it is treatable but not curable. Men with breast cancer comprise less than 1% of all patients with the disease, and most of their treatments are based on study results seen among female patients. This year alone, experts predict that 276,480 women and 2620 men will receive a breast cancer diagnosis. The American Journal of Managed Care® spoke recently with Kirby Lewis of West Virginia. Kirby was a stage 2 breast cancer survivor, for which he had a mastectomy in 2012, prior to receiving a diagnosis of metastatic breast cancer (MBC) in 2016. He is 1 of 9 patient faces participating in “Facing MBC Together” from Athenex Oncology. In this interview, he talks about what sustains him and his mission to spread awareness about male MBC.

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 president testing positive for coronavirus disease 2019 (COVID-19); progress in diabetes technology coverage and access for Medicare beneficiaries; an inside look into how colleges and universities addressed the COVID-19 pandemic. Read more about the stories in this podcast: Trump, First Lady Test Positive for Coronavirus; Trump Enters Hospital: https://www.ajmc.com/view/trump-first-lady-test-positive-for-coronavirus How Have Colleges, Universities Addressed the COVID-19 Pandemic? https://www.ajmc.com/view/how-have-colleges-universities-addressed-the-covid-19-pandemic- Patient-Centered Oncology Care: https://www.ajmc.com/conference/pcoc Moderna SARS-CoV-2 Vaccine Elicits Response in Older Adults: https://www.ajmc.com/view/moderna-sars-cov-2-vaccine-elicits-response-in-older-adults Referral Management and the Care of Patients With Diabetes: https://www.ajmc.com

Despite decades of experimentation, there have not been large increases in health care quality in the United States. What will move the needle? In this week’s Managed Care Cast, Elizabeth McGlynn, PhD, speaks with Patricia Salber, MD, MBA, of The Doctor Weighs In, about health care quality in the United States, quality measurement and incentives, what the United States can do to drive quality improvement, how social determinants fit into the picture, and more. McGlynn serves as Kaiser Permanente Bernard J. Tyson School of Medicine’s Interim Senior Associate Dean for Research and Scholarships and as a professor. She is an internationally known expert on methods for evaluating the appropriateness and quality of health care delivery. Read more about health care quality in the United States: Can Healthcare Quality Measures Benefit Patient Health https://www.ajmc.com/view/can-healthcare-quality-measures-benefit-patient-health Dr Kerin Adelson Discusses Evolution in Physician Response to Quality Care Initiative

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 a Supreme Court vacancy that could shape the fate of the Affordable Care Act; the pandemic’s effects on access to care; a look at the opportunities presented by the virtual format of Patient-Centered Oncology Care® 2020. Read more about the stories in this podcast: How a Supreme Court Vacancy Can Shape the Fate of the ACA, Reproductive Rights: https://www.ajmc.com/view/how-a-supreme-court-vacancy-can-shape-the-fate-of-the-aca-reproductive-rights Access to Parkinson Disease Medication Affected in Low-Income Countries: https://www.ajmc.com/view/access-to-parkinson-disease-medication-affected-in-low-income-countries ACR Survey Reveals Patients Struggle to Maintain Access to Care During COVID-19 Pandemic: https://www.ajmc.com/view/acr-survey-reveals-patients-struggle-to-maintain-access-to-care-during-covid-19-pandemic Patient-Centered Oncology Care: https://www.ajmc.co

Allison Brennan, MPP, senior vice president of government affairs at the National Association of Accountable Care Organizations (NAACOS) discusses legislation that would impact ACOs, the impact coronavirus disease 2019 had on ACOs, and the fall NAACOS meeting. Learn more: NAACOS Partner Page on AJMC.com: https://www.ajmc.com/partners/naacos NAACOS Fall 2020 Conference Agenda: https://www.naacos.com/fall-agenda

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 effects of wildfires and the pandemic on health; a conversation on Ochsner Health’s Connected Maternity Online Monitoring Program; a preview of discussions at Patient-Centered Oncology Care® 2020. Read more about the stories in this podcast: Concurrent Wildfire, Pandemic Hazards Test US Mental, Physical Health: https://www.ajmc.com/view/concurrent-wildfire-pandemic-hazards-test-us-mental-physical-health Dr Joseph Biggio Discusses Ochsner Health's Connected MOM Program, COVID-19 Pregnancy Challenges: https://www.ajmc.com/view/dr-joseph-biggio-discusses-ochsner-health-s-connected-mom-program-covid-19-pregnancy-challenges Patient-Centered Oncology Care 2020 Pre-Conference Videos: https://www.ajmc.com/conference/pcoc Patient-Centered Oncology Care 2020 Registration: https://event.ajmc.com/event/a8831e3f-8e98-4837-88fc-780d4f4eca61/regProcessStep1 Pain 1 of 3 in a

Surprise Medical Bills Drive Up Health Premiums for All by Managed Care Cast

As the coronavirus disease 2019 (COVID-19) continues to spread throughout the country, practices and health systems are transforming care to limit exposure to those who may be at greater risk of severe complications. At Ochsner Health, the largest non-profit academic healthcare system in Louisiana, providers are leveraging the system’s Connected Maternity Online Monitoring (MOM) digital medicine program to minimize expectant mothers’ risks of contracting COVID-19. To learn more about this program, we spoke with Joseph Biggio Jr. MD, MS, the system co-chair of Women’s Services and system chair for Maternal-Fetal Medicine at Ochsner Health. Dr. Biggio, an obstetrician gynecologist, specializes in provision of high-risk pregnancy care and has been involved with provision of care related to women with medical complications, obstetric complications, and fetal complications in pregnancy. On this episode of Managed Care Cast, Dr. Biggio explains how the Connected MOM program functions and lays out the challenges

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 identification of insomnia as a risk factor for type 2 diabetes; a look at the growth of telehealth during coronavirus disease 2019; an overview of the speakers who will appear at Patient-Centered Oncology Care 2020. Read more about the stories in this podcast: Study Finds Insomnia as New Risk Factor for Type 2 Diabetes: https://www.ajmc.com/view/study-finds-insomnia-as-new-risk-factor-for-type-2-diabetes The Growth of Telehealth During COVID-19 and Its Future After: Dr Patricia Salber Interviews Dr Joseph Kvedar: https://www.ajmc.com/view/the-growth-of-telehealth-during-covid-19-and-its-future-after-dr-patricia-salber-interviews-dr PCOC 2020: Cancer Care Transformation Continues During COVID-19: https://www.ajmc.com/view/pcoc-2020-cancer-care-transformation-continues-during-covid-19 Equity in Care Delivery Still at Top of PCOC 2020 Agenda, Amid “Undue Burden”: ht

Telehealth has been around for years in the United States, but it was not until the coronavirus disease 2019 (COVID-19) pandemic that it became regularly used. The growth of telehealth was fueled by the inability to see patients in person at the beginning of the pandemic and a move by the government to temporarily relax regulations. Joseph Kvedar, MD, president of the American Telemedicine Association, professor of Dermatology at Harvard Medical School, co-chair of the American Medical Association's Digital Medicine Payment Advisory Group, and editor-in-chief of npj Digital Medicine, explained that some of those relaxations might continue on after the pandemic passes, but some may get rolled back. In conversation with Patricia Salber, MD, MBA, of The Doctor Weighs In, Kvedar also discussed how breakthroughs in technology have helped make virtual visits possible, the future of telehealth, and more. Learn more: Contributor: Telehealth Claim Lines Increased 4132% Nationally From June 2019 to June 2020: https:

In this episode of Managed Care Cast, we talk with Michael N. Abrams, a cofounder and managing partner of Numerof & Associates, about the fifth annual report on the state of population health.

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 HHS defending a CDC change limiting coronavirus disease 2019 (COVID-19) testing for asymptomatic people; an inside look at the Facing Metastatic Breast Cancer Together campaign; a conversation with Kashyap Patel, MD, on his new book. Read more about the stories in this podcast: Amid Controversy, HHS Defends Change in COVID-19 Testing Guidance: https://www.ajmc.com/view/amid-controversy-hhs-defends-change-in-covid-19-testing-guidance Being Each Other’s Hero: Facing MBC Together: https://www.ajmc.com/view/being-each-others-hero-facing-mbc-together When the Topic Is Dying: A Conversation With Kashyap Patel, MD: https://www.ajmc.com/view/when-the-topic-is-dying-a-conversation-with-kashyap-patel-md How Virtual Care, Back-to-School Support, Health Inequities Are Influencing Employer Action: https://www.ajmc.com/view/how-virtual-care-back-to-school-support-health-inequities-

If there is any issue that has encapsulated the gravity of social determinants of health (SDOH) better than the coronavirus disease 2019 (COVID-19) pandemic, you'd probably be hard pressed to find a public health official able to name one. On this episode of Managed Care Cast, we share a little bit of our interview with the head of the American Public Health Association, which will appear in the September issue of The American Journal of Managed Care®. As schoolchildren, teachers, essential workers and others try to adjust to the changes wrought by this novel infectious disease this year, Georges C. Benjamin, MD, speaks about the "need to have a new societal compact for health."

Every week, The American Journal of Managed Care® recaps the top managed care news of the week. This week in managed care, the top news includes survival improves among wait-listed heart transplant candidates, the Trump administration offers a progress report on its kidney care initiative, and panelists say choice is vital to the biosimilar savings picture. Read more about the stories in this podcast: Survival Improves Among Wait-listed Heart Transplant Candidates: https://www.ajmc.com/view/survival-improves-among-wait-listed-heart-transplant-candidates Administration Offers Progress Report on Kidney Care Initiative: https://www.ajmc.com/view/administration-offers-progress-report-on-kidney-care-initiative Choice Is Vital to Biosimilar Savings Picture, Panelists Say: https://www.ajmc.com/view/choice-is-vital-to-biosimilar-savings-picture-panelists-say Do ICD-10 Codes Accurately Reflect COVID-19 Symptoms? https://www.ajmc.com/view/do-icd-10-codes-accurately-reflect-covid-19-symptoms For Short Bouts of Acute P

The coronavirus disease 2019 (COVID-19)pandemic has created one of the most rapidly changing environments to ever hit health care. The pandemic has put a strain on hospitals and staff, but people are also worried about the impact COVID-19 is having on preventive care and the management of chronic illness. Scott Hayworth, MD, president and CEO of New York-based CareMount Medical, discussed how his medical group handled the pandemic in what had been the epicenter of the US outbreak back in the spring, as well as what changes the group has made that will permanently alter the way it delivers care, during a conversation with Patricia Salber, MD, MBA, of The Doctor Weighs In. Learn more: Continuation of Routine Screenings, Care Is Crucial During COVID-19 Pandemic: https://www.ajmc.com/view/continuation-of-routine-screenings-care-is-crucial-during-covid19-pandemic Cancer Care in the Age of COVID-19: Dr Patricia Salber Interviews Dr Bobby Reddy: https://www.ajmc.com/view/cancer-care-in-the-age-of-covid-19-dr-patri

Every week, The American Journal of Managed Care® recaps the top managed care news of the week. This week in managed care, the top news included all-cause mortality disparities among Black and White men in rural areas; vaping as a risk factor for COVID-19 in young adults; how the pandemic presents an opportunity for value-based care delivery. Read more about the stories in this podcast: All-Cause Mortality Disparities Persist Among Black, White Men Living in Rural US: https://www.ajmc.com/view/all-cause-mortality-disparities-persist-among-black-white-men-living-in-rural-us Vaping a Risk Factor for COVID-19 in Teens, Young Adults: https://www.ajmc.com/view/vaping-a-risk-factor-for-covid-19-in-teens-young-adults How Can the COVID-19 Pandemic Enhance Value-Based Health Care Delivery? https://www.ajmc.com/view/how-can-the-covid-19-pandemic-enhance-value-based-health-care-delivery FDA Clears clonoSEQ to Detect MRD in Chronic Lymphocytic Leukemia: https://www.ajmc.com/view/fda-clears-cloneseq-to-detect-mrd-in-

In the world of drug development, it is typically the outcomes of phase 3 clinical trials that get the most attention. With the possibility of game-changing treatments for a myriad of diseases, they garner the most headlines, especially as the world waits on vaccines and effective treatment for the coronavirus disease 2019 pandemic. But what happens during the early phase of testing? On today’s episode of Managed Care Cast, we speak with Jill A. Fisher, PhD, author of a new book, Adverse Events: Race, Inequality, and the Testing of New Pharmaceuticals. Her research took her inside clinical testing sites for phase 1 drug studies, a veiled world where healthy participants agree to spend days or weeks in a locked facility receiving an active ingredient or placebo. She interviewed participants, research staff, and others, and delves into the societal and economic forces that compel people—typically Black men in their 20s, 30s and 40s—to enroll repeatedly in phase 1 studies.

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 CMS updates on telehealth and more; COVID-19 vaccine developments and remaining challenges; a study examines the impact of state policies on life expectancy. Read more about the stories in this podcast: CMS Releases E&M Updates, Expands Telehealth, Makes ACO Changes: https://www.ajmc.com/view/cms-releases-e-and-m-updates-expands-telehealth-makes-aco-changes Experts Highlight COVID-19 Vaccine Developments and Remaining Challenges: https://www.ajmc.com/view/experts-highlight-covid-19-vaccine-developments-and-remaining-challenges How Do State Policies Impact Life Expectancy? https://www.ajmc.com/view/how-do-state-policies-impact-life-expectancy Tafasitamab Combination Approved for Adults With R/R DLBCL: https://www.ajmc.com/view/tafasitamab-combination-approved-for-adults-with-r-r-dlbcl The Correlation of Family Physician Work With Submitted Codes and Fees: https://www.a

On this episode of Managed Care Cast, we speak with Krisda H. Chaiyachati, MD, MPH, MSHP, about the study he co-wrote entitled “Economic Outcomes of Insurer-Led Care Management for High-Cost Medicaid Patients.” In the study, Chaiyachati and co-authors aim to evaluate the impact of the Community-Based Care Management program on total costs of care and utilization among adult high-need, high-cost patients enrolled in a Medicaid managed care organization. The program included teams of community health care workers and nurses who coordinated care for this cohort. Dr. Chaiyachati is an assistant professor of medicine at the University of Pennsylvania Perelman School of Medicine and a clinical innovation manager at Penn Medicine’s Center for Healthcare Innovation The study was published in the July edition of The American Journal of Manage Care ®.

While there remain a lot of unknowns about coronavirus disease 2019 (COVID-19) and the risk of infection patients with cancer face, it is known that when they do contract the virus, they are at a higher risk of mortality, explained Sandeep “Bobby” Reddy, MD, an oncologist at Harbor-UCLA Medical Center and chief medical officer of NantHealth, during an interview with Patricia Salber, MD, MBA, of The Doctor Weighs In. Reddy discussed the clinical care of cancer patients in the age of COVID-19, including how care has changed as a result of the pandemic; best practices at treatment centers to protect patients and staff; recommendations for patients, whether they are in the middle of treatment, haven’t yet started treatment, or have discovered something worrisome but haven’t yet been diagnosed; and more. Read about related stories: Diagnostic Delays From COVID-19 May Increase Cancer-Related Deaths, UK Studies Say: https://www.ajmc.com/view/diagnostic-delays-from-covid19-may-increase-cancerrelated-deaths-uk-studi