Managed Care Cast

On this episode of Managed Care Cast, a research scholar at the Marron Institute of Urban Management at New York University discusses the latest findings in the Health of the Air report, which was presented at the recent American Thoracic Society (ATS) 2021 International Conference.

The COVID-19 pandemic has led to an unprecedented boom in telehealth use, especially when it comes to services provided for mental health. With the combined toll of a global pandemic, economic hardships, and protracted grief, Americans’ mental health has jumped to the forefront of the national conversation. A recent analysis, published by Blue Cross Blue Shield of Massachusetts, illustrates this seismic shift in care delivery and demand for mental health services. Researchers compiled claims data from March through December of 2019 and compared it with the same time frame in 2020. To learn more about the report’s findings and to understand the challenges of providing these services to patients during a pandemic, we spoke with Gregory Harris, MD, MPH, DFAPA, the senior medical director for behavioral health at Blue Cross Blue Shield of Massachusetts. On this episode of Managed Care Cast, Harris describes his experience as a psychiatrist and offers some solutions to meet the growing demand for this field in

An author of a study in the May 2021 issue of The American Journal of Managed Care® describes how the COVID-19 pandemic, the aging of America, and already-existing workforce shortages will further threaten the dual-eligible population unless policy makers reform scope-of-practice laws.

Vaccine hesitancy may be one of the contributing factors if the United States does not reach herd immunity to the virus that causes COVID-19. Such hesitancy presents itself in different ways and forms, ranging from outright refusal in conservative rural areas to fears in communities of color, to skepticism of science elsewhere. On this episode of Managed Care Cast, Patricia Salber, MD, MBA, of The Doctor Weighs In, has a conversation with Abner Mason, the founder and CEO of ConsejoSano, a patient engagement firm working with diverse, multicultural, multilingual populations through at-risk providers, health plans, government programs, employers, and other partners. The two discuss the importance of relationship building and trust building and understanding where people are coming from when they have the opinions and beliefs that they hold. They also discuss the role of health plans in COVID-19 vaccinations and how payers and partners can work on upstream issues to address other care gaps.

This podcast is brought to you by Insulet. Today we are bringing you part 2 of a 2-part, sponsored podcast series discussing insulin delivery for patients with diabetes. In part 1, Mary Caffrey, associate editorial director of The American Journal of Managed Care, spoke with Greg Forlenza, MD, a pediatric endocrinologist at the Barbara Davis Center at the University of Colorado, about prepivotal data. In this segment, they conclude the conversation.

With unprecedented pauses in air pollution emissions seen around the world in the spring of 2020 and virus mitigation behaviors being implemented for over a year, the COVID-19 pandemic has presented a unique opportunity to better understand the impact of poor air quality on human health. In particular, exposure reduction due to mask-wearing and stay-at-home orders has contributed to anecdotal reports of reduced exacerbations among patients with chronic obstructive pulmonary disease (COPD), asthma, allergies and other respiratory conditions. To learn more about how the pandemic has altered care and disease management among these patients, we spoke with Courtney Blair, MD, an allergist and immunologist in Virginia. On this episode of Managed Care Cast, Blair who also serves as the president of the Greater Washington Allergy, Asthma, and Immunology Society, discusses factors that may have contributed to improvements in her patients’ respiratory health over the past 15 months.

This podcast is brought to you by Insulet. Today, we are bringing you part 1 of a 2-part sponsored podcast series discussing insulin delivery for patients with diabetes. In part 1, Mary Caffrey, associate editorial director of The American Journal of Managed Care, speaks to Greg Forlenza, MD, a pediatric endocrinologist, about the evolution of diabetes care technology and standards for automated insulin delivery.

This week, the top managed care news included COVID-19 vaccine eligibility opens to all adults nationwide; a spotlight on payment models and value-based care; barriers to mental health care for children and teenagers.

The United States is now 5 months into its national vaccine rollout. Although hundreds of millions of doses have been successfully administered, the process has hit several snags along the way, including, but not limited to, disparities in administration and a failure to collect racial data on nearly half of those vaccinated at the national level. But to achieve this feat, health systems have had to adjust to shifting vaccine eligibility requirements, ensure outreach efforts are successful, and combat misinformation within their communities, all the while scheduling appointments and making sure shots get into arms. In an effort to meet some of the logistical challenges of the rollout, Kyruus works alongside health care organizations and provides search, scheduling, and data management solutions to help connect patients with the right care. On this episode of Managed Care Cast, we speak with Chris Gervais, the chief technology and security officer at Kyruus, and Erin Jospe, MD, chief medical officer at K

The authors of a study in the April 2021 issue of The American Journal of Managed Care® discuss the possible reasons behind the link between care fragmentation and hospitalizations in veterans with diabetes, as well as potential opportunities to address disjointed care in the context of the widespread telehealth uptake seen during the COVID-19 pandemic.

On this episode of Managed Care Cast, we speak with the chief strategy officer for Well Being Trust, one of the authors of a recent report about how well health insurers and state Medicaid programs are covering mental health care for children and compliance with federal law. We discuss the unique challenges that youth face, the health disparities, racism, and community trauma that has been experienced in the past year, and some creative ways that organizations and communities can consider increase access to mental health supports.

This week, the top managed care news included a pause in distribution of J&J’s COVID-19 vaccine; FDA clears first AI device to find possible cancerous hot spots during colonoscopies; lessons from years of public health budgetary neglect.

Neglecting public health in state budgets for more than 10 years created an environment that was ill-suited to deal with the challenges of COVID-19 as well as other issues. On this episode of Managed Care Cast, we speak with one of the authors of a recent paper that examined state funding trends from 2008 to 2018 and discuss what could be done in the future to avoid past mistakes. In an article published this month in Health Affairs, researchers from the Johns Hopkins Bloomberg School of Public Health, the University of Minnesota School of Public Health, and the College of Health Solutions from Arizona State University, took a close look at state spending in 8 categories of public health spending during an 11-year period to understand the extent to which funding has not kept up with pressing and emerging issues. The stagnation in public health spending occurred during a time of rising mortality in the United States and funding, which was cut during the Great Recession, was not restored. On this episode of

This week, the top managed care news included a European safety committee finding very rare blood clot links with AstraZeneca’s COVID-19 vaccine; new report predicts shifts in the cancer landscape by 2040; the connected nature of type 1 diabetes with other autoimmune diseases.

The Centre for Sexual Health and HIV/AIDS Research Zimbabwe, or CeSHHAR, was founded in 2012 and is headquartered in Harare (hurrahree), Zimbabwe. CeSHHAR conducts evidence-based research related to HIV/AIDS, its prevention, and policy making, along with providing and implementing sexual and reproductive health education and interventions among several at-risk populations. On this episode of Managed Care Cast, we speak with the executive director of CeSHHAR, Frances Cowan, MD, MSc, MRCP, MBBS, professor of global health at the Liverpool School of Tropical Medicine, about CeSHHAR’s history, its programs, and continuing to make inroads against this 4-decades-old pandemic.

This activity is supported by an educational grant from Boehringer Ingelheim. Today, we are bringing you part 2 of a 2-part podcast series discussing chronic obstructive pulmonary disease (COPD). In part 2, moderator Neil Minkoff, MD, chief medical officer of Coeus Healthcare, leads a discussion with a panel of experts about personalized approaches to COPD management and treatment efficacy.

This week, the top news in managed care included COVID-19 cases surging as vaccine eligibility expands nationwide; Senate bill seeks to limit use of step therapy in employer health plans; a look into local and global awareness of the ongoing HIV/AIDS epidemic.

Early on in the pandemic, having the ability to predict where outbreaks were going to take place was something to be desired. Cotiviti developed a COVID-19 tracker map using big data models and artificial intelligence (AI) technologies, which can accurately predict where in the United States new COVID-19 outbreaks would occur and show the relative risk of infection for people with underlying health conditions. On this episode of Managed Care Cast, we speak with Nicole Neumarker, the executive vice president of development and innovation at Cotiviti. Nicole shared Cotiviti’s results with their tracker map at the 2021 AcademyHealth National Health Policy Conference and provided us some insight into what impact this technology could have in the future.

This week, the top managed care news included efficacy data on AstraZeneca’s COVID-19 vaccine questioned; coverage from the NCCN 2021 Virtual Annual Conference; COVID-19 poses risks to children with poorly controlled type 1 diabetes.

Addressing vaccine hesitancy, which may take the form of refusing a vaccine or putting oneself in the “wait and see” camp while thinking it over, has never been more urgent as health authorities race to try and vaccinate as much of the population as possible against the virus that causes COVID-19 in 2021. On this episode of Managed Care Cast, Pat Salber, MD, MBA, of the Doctor Weighs In, discusses education for patients on the topic of vaccine hesitancy and COVID-19. Her guest is Eve Gaus, who directs the development of interactive, people-centered, multimedia programs for Wolters Kluwer Health. The programs are used by health care systems to address questions raised by patients about the vaccines, how they were approved, how they work, and more.