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Managed Care Cast

Health & Wellness Podcasts

Podcast by Managed Care Cast

Podcast by Managed Care Cast


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Podcast by Managed Care Cast




Spotlighting Pandemic-Related Challenges, Data-Driven Solutions for Payers

On this episode of Managed Care Cast, we speak with Cheryl Mason, director of Content and Informatics for the Health Language solutions team of Wolters Kluwer, who discusses how delays in routine care and other aspects of the pandemic are affecting payer organizations today, and how technology innovations like natural language processing can work to empower key initiatives in population health and beyond.


Assessing Lower-Than-Expected Health Care Utilization Trends in Early 2021

On this episode of Managed Care Cast, we speak with the lead clinician of a study by the Epic Health Research Network and Kaiser Family Foundation, which found that routine medical care and hospital admissions remained below expected levels in the early months of 2021, marking the second consecutive year for such results.


Examining the Current Lack of Trust in Health Care

Trust in health care was eroding even before the COVID-19 pandemic. In a new book, "Re-Engaging in Trust: The Missing Ingredient to Fixing Healthcare," the authors, Jan Berger, MD, MJ, the CEO of Health Intelligence Partners, and Julie Slezak, MSPH, the president of the health care consulting firm, delve into this issue with data from multiple sources and viewed against the backdrop of multiple stakeholders. Trust among stakeholders—providers, patients, health care organizations and systems,...


Key Issues Influencing 2022 Employer Health Care Strategy and Plan Design

With COVID-19 continuing to change the way in which health care is perceived and delivered, large employers have been tasked with managing employee health concerns in real time, while also planning for when the pandemic does subside. In the Business Group on Health’s 2022 Large Employers’ Health Care Strategy and Plan Design Survey, employers discussed their perspectives on trends in health care cost and coverage, and how these aspects will influence their benefits strategies and programs in...


Reckoning With the Repercussions of Worsening Climate Change on Health Systems

The recently released Intergovernmental Panel on Climate Change’s sixth assessment report drove home many of the concerns regarding the detrimental impacts of climate change that many have been warning about for years. But along with renewed calls for governmental action come doubts that the United States’ and other health care systems are equipped to handle such an influx of increasing medical issues wrought by climate change. Health systems and personnel have already been tested with the...


Co-pay Accumulator Rule Could Cost Patients at the Pharmacy Counter

Co-pay accumulator adjustment programs, or CAAPs, can help incentivize use of lower-cost generics by excluding drug manufacturer assistance from counting toward a patient’s out-of-pocket maximum. However, a rule finalized by HHS last year allows CAAPs to be applied even when no generic alternative is available. If patients are not informed about the implications of these programs, they may be forced to abandon their prescriptions in the face of unaffordable co-pays. On this episode of...


Addressing Pay-for-Delay Deals, Anticompetition in the Pharmaceutical Industry

On this episode of Managed Care Cast, we speak with Michael Abrams, managing partner at Numerof & Associates, on persistent barriers to entry for generics entering the pharmaceutical market, the impact of antitrust laws issued by the Biden administration, and further steps that are warranted to address anticompetitive tactics.


Managed Care Cast Presents: MS Stakeholder Summit—New Treatment Landscape in MS, Part 1

Today, we’re bringing you part 1 of a 2-part podcast series discussing multiple sclerosis, or MS. As part of the MS Stakeholder Summit, a panel of experts discusses tailoring treatments to patients with MS, payer considerations, and more.


Exploring 2022 Trends in Health and Hospital Drug Spending With Vizient

Vizient recently released its Summer 2021 Pharmacy Market Outlook, which projects pharmaceutical spending for 2022 based on an analysis of its members' data, and on this episode of Managed Care Cast, we talk about some of their findings. The report, which delves into its members’ purchasing patterns, predicts a 3.1% increase in pharmaceutical spending next year, with oncology drugs accounting for about 25% of the increase. The report also discusses increasing competition from biosimilars,...


Psoriasis as an Inflammatory Disease, and What’s Changed Over Time

August is National Psoriasis Awareness Month, and on this episode of Managed Care Cast, we bring you an excerpt of an interview conducted by Linda Stocum, assistant editor of Dermatology Times, for Medical World News, a new webcast from MJH Life Sciences. In it, Jerry Bagel, MD, MS, Windsor Dermatology, East Windsor, New Jersey, discusses how psoriasis is now understood to be an inflammatory disease that, if left intreated, can have devastating cardiovascular effects, affecting lifespan and...


Huntington Disease Community Regroups After Trial Failures

Huntington disease is an incurable, progressive neurodegenerative condition that is ultimately fatal, and the field of research into this rare disease saw a setback a few months ago with the end of 2 clinical trials for a type of possible therapy from Roche and Wave Life Sciences. On this episode of Managed Care Cast, we bring you an excerpt of an interview, originally conducted by Matt Hoffman, senior editor of NeurologyLive, with Daniel Claassen, MD, MS, director, Huntington’s Disease...


In Most of the US, Self-insured Employers Lack Power at the Bargaining Table With Hospitals

In this episode of Managed Care Cast, the lead author of an article in the July issue of The American Journal of Managed Care® describes the latest research that looks at the power of self-insured employers to negotiate hospital prices and the relationship between employer market power and hospital prices. Matthew Eisenberg, PhD, and coauthors used the US Census Bureau County Business Patterns data from 2010 to 2016 to estimate employer market power in metropolitan statistical areas (MSAs)...


Is Private Health Insurance Really Superior to Public Programs?

In a recent paper published in JAMA Network Open, Charlie Wray, DO, MS, and colleagues examined experiences and opinions of nearly 150,000 Americans representing the 5 major forms of health insurance coverage. Specifically, the researchers used survey data from the 2016-2018 Behavioral Risk Factor Surveillance System and compared access to care, cost of care, and reported satisfaction among those with public or private insurance. Representing the experiences of over 61 million US adults,...


Quelling COVID-19 Also Capped Clostridium difficile—Will It Continue?

Social distancing, vigilant sanitizing, and mask wearing required by COVID-19 did more than combat the pandemic—it cut down on flu cases as well as improved respiratory health for some patients. Some studies indicate that the measures also reduced Clostridium difficile, or C difficile, in hospitals and facilities. A recent set of interviews on Medical World News®, the 24-hour online news program for health care professionals from MJH Life Sciences™, highlighted this development. The...


Managed Care Cast Presents: MS Stakeholder Summit— New Treatment Landscape in MS, Part 2

Today, we’re bringing you part 2 of the MS Stakeholder Summit series. During part 1, which first ran 2 weeks ago, a panel of experts discussed tailoring treatments to patients with multiple sclerosis, payer considerations, and more. In this second part of the series, the same panel of experts continues their talk on MS. They will discuss newer therapies, switching therapies, and more.


Reports Highlight Strengthening Primary Care After the Pandemic

Linda Schwimmer, JD, president and CEO of the New Jersey Health Care Quality Institute, discusses 2 reports on strengthening primary care after the COVID-19 pandemic: one from her own organization and the other from the National Academy of Medicine.


Referrals to Diabetes Self-management Education Lagging Among Patients in Need

Diabetes care guidelines identify critical points in patients’ care when providers should refer them to diabetes self-management education, or DSME. However, it’s not known whether these clinical indicators of need actually increase the likelihood of receiving a referral. On this episode of Managed Care Cast, we’re talking with an author of an Original Research article published in our June 2021 issue. The article, “Patient Need and Provider Referrals to Diabetes Self-management Education,”...


Understanding the Intersection Between COVID-19, Firearm Ownership, and Suicide

Gun violence is one of the most prominent public health issues facing America today, and accounted for over 43,500 deaths in 2020 alone—the highest number in decades. But a major driver of gun-related deaths in this country that often goes unmentioned is suicide. Research shows having access to a firearm significantly increases the risk of suicide via firearm, and during the pandemic, amid an unprecedented surge in firearm purchases, these purchasers appeared far more likely to have...


Pandemic Factors Driving Predictions for 2022 Medical Cost Trends

This month, the PwC Health Research Institute (HRI) released its annual Medical Cost Trend report for 2022. Reflecting the impact of the COVID-19 pandemic, the report predicts a 6.5% medical cost trend in 2022, slightly lower than the 7% medical cost trend in 2021 and slightly higher than it was between 2016 and 2020. On this episode of Managed Care Cast, we speak with Trina Tsouderos, who leads HRI, and discuss some of the drivers behind those numbers, as patients who put off care begin to...


Who's Driving the Growth of Medicare Advantage Plans?

In this episode of Managed Care Cast, we speak with a coauthor of an article in June’s Health Affairs examining the racial and ethnic composition of beneficiaries in Medicare Advantage plans and the potential implications as the program continues to grow.