Managed Care Cast

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.

Every week, The American Journal of Managed Care® (AJMC®) 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 demonstrating that diabetes drug canagliflozin cuts the risk of renal failure and death; the FDA approving the first targeted therapy for metastatic bladder cancer; approximately half of all cancer deaths are attributable to modifiable risk factors. Read more about the stories in this podcast: CREDENCE: Canagliflozin Cuts Risk of Renal Failure, Death 30% in Patients With Type 2 Diabetes, CKD: https://www.ajmc.com/newsroom/credence-canagliflozin-cuts-risk-of-renal-failure-death-30-in-patients-with-type-2-diabetes-ckd FDA Approves Erdafitinib, First Targeted Therapy for Metastatic Bladder Cancer: https://www.ajmc.com/newsroom/fda-approves-erdafitinib-first-targeted-therapy-for-metastatic-bladder-cancer Nearly Half of Cancer Deaths Attributable to Modifiable Risk Factors: https://www.ajmc.com

Understanding the Impact of Inappropriate Opioid Prescribing Practices by Managed Care Cast

As the prevalence of burnout among healthcare providers has increased over the last few years, it has raised attention to the issue. Burnout includes overwhelming exhaustion, feelings of cynicism and detachment from the job, and a sense of ineffectiveness and a lack of accomplishment. Among physicians, common drivers include excessive workloads, clerical burdens, organizational structures, and leadership culture. Greater attention to the issue, and the impact it can have on patient outcomes, has led to more organizations to implement interventions to address and alleviate burnout in healthcare. Bernadette Melnyk, PhD, RN, APRN-CNP, FAANP, FNAP, FAAN, vice president for health promotion, chief wellness officer and professor and dean of the college of nursing at The Ohio State University, highlighted the need for a chief wellness officer, same as healthcare has chief technology and quality officers, and some interventions being implemented. Learn more about burnout: Making The Case For The Chief Wellness Offi

Every week, The American Journal of Managed Care® (AJMC®) 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 CDC clarifying its opioid guidelines for chronic pain; pharmacy benefit managers testifying before a Senate committee; Sanofi expanding its insulin savings program starting in June. Read more about the stories in this podcast: Oncologists, Hematologists Welcome CDC Clarification on Opioid Therapy for Chronic Pain: https://www.ajmc.com/newsroom/oncologists-hematologists-welcome-cdc-clarification-on-opioid-therapy-for-chronic-pain PBM Executives Tout Value Before Senate Finance Committee: https://www.ajmc.com/newsroom/pbm-executives-tout-value-before-senate-finance-committee Sanofi Offer Sets Monthly Price of $99 for Insulin Supply: https://www.ajmc.com/newsroom/sanofi-offers-set-monthly-price-of-99-for-insulin-supply Doctors More Likely to Overprescribe Antibiotics for Children During Telemedicine

As a former chief operating officer for a national diabetes supply, education, and support company, Tom Milam created programs for people with diabetes that served more than 100,000 members nationwide. His experience also includes a federal appointment providing advisory service to Medicare. His extensive experience and knowledge within the diabetes space allows Tom to offer us an expert view of CMS’ Competitive Bidding Program.

Every week, The American Journal of Managed Care® (AJMC®) 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 courts rejecting multiple health initiatives from the Trump administration; Congress heard more about rising insulin prices; a new agreement seeks standards for reporting social determinants of health. Read more about the stories in this podcast: Federal Judge Strikes Down Medicaid Work Rules in Kentucky, Arkansas: https://www.ajmc.com/newsroom/federal-judge-strikes-down-medicaid-work-rules-in-kentucky-arkansas Judge Rules Trump's DOL Tried to Create "End Run" Around ACA With Association Health Plans: https://www.ajmc.com/newsroom/judge-rules-trumps-dol-tried-to-create-end-run-around-aca-with-association-health-plans Healthcare Availability, Affordability Most Pressing Worry, Gallup Poll Says: https://www.ajmc.com/newsroom/healthcare-availability-affordability-most-pressing-worry-gallup-poll-says

Dr. Elizabeth Mynatt, the executive director of the Institute for People and Technology and a professor in the College of Computing at the Georgia Institute of Technology discusses an app she and her team developed called MyPath that uses artificial intelligence to help guide a patient’s cancer journey.

Every week, The American Journal of Managed Care® (AJMC®) 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 Department of Justice siding with a federal judge in striking down the Affordable Care Act; FDA Commissioner Scott Gottlieb, MD, calling for stricter oversight of electronic health records; and a study finding that healthy eating in Medicare and Medicaid is cost effective. Read more about the stories in this podcast: DOJ Reverses Course, Sides With Judge Striking Down ACA: https://www.ajmc.com/focus-of-the-week/doj-reverses-course-sides-with-judge-striking-down-aca House Democrats Unveil Bill Aimed at Shoring Up ACA Patient Protections, Affordability: https://www.ajmc.com/newsroom/house-democrats-unveil-bill-aimed-at-shoring-up-aca-patient-protections-affordability What We're Reading: EHR Oversight; Medicaid Expansion and CRC; Arkansas Work Requirements: https://www.ajmc.com/newsroom/what-were

In this week’s bonus podcast, we have a conversation from the Association of Community Cancer Centers (ACCC) 45th Annual Meeting & Cancer Center Business Summit, which was held March 21-22 in Washington, DC. The meeting marked the end of Tom Gallo’s year as president and the beginning of the yearlong presidency of Ali McBride, PharmD. At the meeting, Gallo and McBride sat down to discuss how ACCC’s members feel about the state of cancer delivery, as well as recent trends that were highlighted in an annual report and their presidential themes. Related articles: Envisioning the Future of Cancer Care: https://www.ajmc.com/conferences/accc-2019/envisioning-the-future-of-cancer-care Digital Health Lessons From Around the World: https://www.ajmc.com/conferences/accc-2019/digital-health-lessons-from-around-the-world Different Vantage Points, but Similar Goals of High-Value Care, Patient Satisfaction: https://www.ajmc.com/conferences/accc-2019/different-vantage-points-but-similar-goals-of-highvalue-care-patient-sat