Managed Care Cast

On this episode of Managed Care Cast, we speak with the lead researcher from a study published in the July 2023 issue of The American Journal of Managed Care® on whether social determinants of health is a predictor for identifying high-cost utilizers among those with commercial health insurance.

On this episode of Managed Care Cast, we’re talking with 2 individuals who were essential in the creation and implementation of the Health Access Initiative for Recovery (Our HAIR), launched by Community Care Behavioral Health Organization of Pittsburgh, PA.

On this episode of Managed Care Cast, we feature several leaders in diversity, equity, and inclusion advancing health equity in their respective organization’s policy and practice initiatives.

In part 2 of this 2-part series on health equity in the treatment of psoriasis, Ryan Haumschild, PharmD, and Bryan Buckley, DrPH, discuss how providers can address disparities in psoriasis care, specifically with race, cultural, and ethnic backgrounds in mind.

On this episode of Managed Care Cast, we speak with Bruce W. Sherman, MD, of Case Western Reserve University School of Medicine, about a recent study on wage-level disparities effecting the utilization of mental health resources, for which he was lead investigator; the study articles appear in the April issue of The American Journal of Managed Care®.

On this episode of Managed Care Cast, we feature several leaders in diversity, equity, and inclusion advancing health equity in their respective organization’s policy and practice initiatives.

Shereef Elnahal, MD, MBA, under secretary for health at the Veterans Health Administration, sat for a conversation with our hosts Emeline Aviki, MD, MBA, and Stephen Schleicher, MD, MBA, that covered the cancer footprint of the VHA, from work within the newly reinvigorated Cancer Moonshot program and screening for vulnerable communities to the Million Veterans Program, the largest genomic database of its kind in the country and of Black Americans, including information on more than 150,000 Black veterans.

National Public Health Week is observed across the United States each year during the first full week of April, and this year will run from April 3-9. Originally conceived and organized by the American Public Health Association, and now in existence for more than 25 years, the theme this year is, “Centering and Celebrating Cultures in Health.” For National Public Health Week this year, we sat down with Kristen Krause, PhD, MPH, instructor in the Department of Urban-Global Public Health and deputy director, Center for Health, Identity, Behavior and Prevention Studies, Rutgers School of Public Health. Our conversation covered not only her current areas of research focus, but the importance of health equity among traditionally marginalized communities, how the early days of the HIV/AIDS epidemic shaped much of the worldview on public health, the influence of culture on many a health outcome, and lessons learned from past public health emergencies.

In part 1 of this 2-part series on health equity in the treatment of psoriasis, Ryan Haumschild, PharmD, and Bryan Buckley, DrPH, discuss how providers can address disparities in care, specifically with race, cultural, and ethnic backgrounds in mind.

On this episode of Managed Care Cast, we speak with Virginia Wang, PhD, and Matthew L. Maciejewski, PhD, who talk about their recent study on racial disparities in home dialysis, and what more needs to be done to increase uptake and reduce disparities in home dialysis for non-White patients.

On this episode of Managed Care Cast, we feature several leaders in diversity, equity, and inclusion advancing health equity in their respective organization’s policy and practice initiatives.

On this episode of Managed Care Cast, we speak with Jennifer Schneider, MD, co-founder and chief executive officer of Homeward, a value-based care provider aiming to improve access to high-quality care in rural communities through tech-enabled clinical services, partnerships with local physicians and health plans, and community-level demographic data.

On this episode of Managed Care Cast, we speak with Elizabeth Cuevas, MD, division chief of Allegheny Health Network’s Center for Inclusion Health, on prevalent health inequities facing marginalized communities in the Western Pennslyvania region and strategies to identify and address these issues.

For patients to receive timely access to care and for providers to deliver that care on a correspondingly timely basis, the correctness of provider contact information is of utmost importance. However, the results of a new study on the accuracy of mental health provider directories and network adequacy, published in the February issue of The American Journal of Managed Care® and online at AJMC.com, paint a less-than-stellar picture of these data, with implications for the ability of consumers to be able to use mental health care services when they need them. On this episode of Managed Care Cast, we speak with Simon F. Haeder, PhD, MPA, professor of public health at the Texas A&M University School of Public Health, 1 of 3 authors of the article, “Provider Directory Inaccuracy and Timely Access for Mental Health Care.” He and his co-investigators looked at the accuracy of directories of psychiatrists and nonphysician mental health providers for all plans regulated by the California Department of Managed Health

Mental health issues and substance use disorder are one of the contributing factors to America’s high maternal mortality rates, in addition to poverty, racism, and lack of access to adequate health care. Last year, the CDC reported that suicide accounts for 9% of the maternal mortality rate 1 year postpartum. Anxiety, perinatal and postpartum depression, and birth-related PTSD are the most common complications of pregnancy and childbirth, affecting 1 in 5 individuals, and for those affect, 75% do not get treatment. Women of color are both more likely to experience these conditions and also also less likely to seek help. On this episode of Managed Care Cast, we speak with Heather Waters, LCSW who leads the maternal health and children’s health services team at Inland Empire Health Plan, a managed care plan serving more than 1.4 million residents on Medi-Cal in California. She tells us about a new maternal mental health program at IEHP aimed at supporting new mothers, both before they give birth and afterward

Wanting to provide the best treatment available, help people live their healthiest lives, and alleviate the health care burden on providers, Intermountain Healthcare, a Utah-based not-for-profit system of 33 hospitals in 7 states, and Story Health, a California-based health technology and services company, have partnered to disseminate specialty care for patients living with heart failure in rural areas. Goals of this new partnership include ensuring patients get the care they need in a sustainable manner, increasing health system efficiency by preventing unnecessary hospitalizations, and getting high-quality care from urban population centers to rural patients while saving costs to the health care system and saving patients and their families time and convenience. On this episode of Managed Care Cast, we speak with Tom Stanis, CEO and co-founder of Story Health, and Phillip Wood, Intermountain Ventures program director on how their partnership came about, how it is going so far, and the future of their col

On this episode of Managed Care Cast, we speak with Reverend Paul Abernathy, chief executive officer of the Neighborhood Resilience Project and board member of UPMC for You, who discusses his experiences in promoting health and resiliency in trauma-affected communities, as well as challenges related to access and accessibility of care and medical mistrust.

To mark the publication of The American Journal of Managed Care®’s 12th annual health IT issue, on this episode of Managed Care Cast, we speak with Christopher M. Whaley, PhD, health care economist at the RAND Corporation, who focuses on health economics issues, including the influence of the COVID-19 pandemic on health care delivery. In particular, he examines how existing technology has pivoted to become a backbone for virtual care delivery while its ongoing evolvement has highlighted inequities in care delivery, making access and lack thereof divisive issues. In their article in the health IT issue, “Differences in Telehealth During COVID-19 Between Commercial and Medicaid Enrollees,” Whaley and his co-authors compare rates of telehealth and in-person evaluation and management visits between individuals with commercial insurance through the California Public Employees’ Retirement System, or CalPERS, and those with publicly funded coverage through the California Medicaid program, with implications for equi

The editors of The American Journal of Managed Care® reflect on the past year and discuss what they’re looking forward to in 2023.

High-deductible health plans (HDHPs) have gained traction in recent years as a means to reduce unnecessary health care spending. The monthly premiums are low, but the high deductibles can lead to higher downstream costs for individuals and families. Potential downsides include the risk of patients deterring or avoiding necessary care. A team headed by Matthew D. Eisenberg, PhD, from the Johns Hopkins Bloomberg School of Public Health, recently investigated the impact of HDHPs through the lens of the ongoing epidemic of substance use disorder, or SUD, in the United States. The article detailing their study’s findings appears in the October issue of The American Journal of Managed Care®. On this episode of Managed Care Cast, we speak with Dr Eisenberg on his team’s findings that these plans may have reduced SUD service use through the shifting of costs to their members, thereby exacerbating this already troubling epidemic that has resulted in declines in life expectancy and increases in drug- and alcohol-rela