Managed Care Cast

On today’s episode, AJMC® spoke with Dr. Sachin Jain, president and CEO of SCAN Group and Health Plan, about his 10 predictions for the health care industry in 2026. Jain breaks down his predictions and what they could mean in both the short and long term for Americans and how they may shape access, affordability, and accountability across the US health care system.

To wrap up this year's author podcast series, The American Journal of Managed Care® speaks with Angela Liu, PhD, MPH, assistant research professor at the Johns Hopkins Bloomberg School of Public Health, about her December 2025 study, "Mental Health Care Use After Leaving Medicare Advantage for Traditional Medicare." Her research analyzed Medicare beneficiaries with mental health diagnoses who switched from Medicare Advantage (MA) to traditional Medicare (TM), examining their use of mental health services in the year before and after the switch. In this Managed Care Cast episode, Liu discusses what inspired her research, highlights the key findings, and explores ways to improve equitable access to mental health services for Medicare beneficiaries.

On this episode of Managed Care Cast, we’re talking with the co–editors in chief of The American Journal of Managed Care® (AJMC®), Mark Fendrick, MD, and Michael Chernew, PhD. They look back on the research and news that stood out to them from the past year and discuss what they’re looking forward to in 2026. Check out the dedicated page featuring our efforts to celebrate AJMC’s 30th anniversary: https://www.ajmc.com/anniversary

Have the shorter, darker days of fall and winter ever left you feeling sluggish, down, or simply "blah"? Today, we are discussing seasonal affective disorder with Craig Sawchuk, PhD, LP, a clinical psychologist at Mayo Clinic. He details how the seasonal pattern often presents as "hibernation syndrome"; explores the characteristics that increase vulnerability to SAD; and covers the effective and unique evidence-based treatment for SAD: bright light therapy.

Frameworks for Advancing Health Equity: Dental Health Care Access by Managed Care Cast

Today we are bringing you a conversation on the evolving landscape for idiopathic pulmonary fibrosis (IPF) and progressive pulmonary fibrosis (PPF) treatment. Ryan Haumschild, PharmD, MS, MBA, vice president of ambulatory pharmacy at Emory Healthcare and Winship Cancer Institute, spoke with Marilyn Glassberg, MD, the John W. Clarke Professor and Chair of medicine at Loyola University Chicago Stritch School of Medicine; Ayodeji Adegunsoye, MD, MSc, PhD, FACP, FCCP, assistant professor at the University of Chicago; and Janet Pope, MD, MPH, professor of medicine and division member of rheumatology at the University of Western Ontario in Canada. IPF and PPF are increasingly prevalent conditions that pose a growing burden on both patients and health care systems. Despite the availability of FDA-approved antifibrotic therapies, the median survival for patients with IPF and PPF remains less than 5 years after diagnosis—underscoring the critical unmet needs that persist in this field. The panelists discussed the impact these conditions have on patients' lives, evaluated emerging agents, and addressed economic considerations that affect treatment decisions and health care resource allocation.

On this episode of Managed Care Cast, Rachel A. Prusynski, DPT, PhD, an assistant professor at the University of Washington's School of Medicine, speaks with The American Journal of Managed Care® about her research published in the November 2025 issue. Her study, "Medicare Advantage Reimbursement Structures Impact Home Health Delivery and Outcomes," explores how home health care delivery and patient outcomes differ between 3 plan types: traditional Medicare, episodic Medicare Advantage, and per-visit Medicare Advantage. Throughout the conversation, Prusynski discusses what motivated the research, the study's key findings, and the broader implications for improving the quality and accessibility of future home health care.

On this episode of Managed Care Cast, AJMC spoke with lead CML researcher, Jorge Cortes, MD, to discuss the evolution of the groundbreaking treatment Imatinib and its effect on survial in patients with chronic myelogenous lukiemia.

Donovan Campbell, CEO, and his organization Medbridge are urging CMS to finalize specific refinements to RTM as part of the Calendar Year 2026 Physician Fee Schedule (CMS-1832-P), recognizing that RTM is critical for supporting physical therapy, patient health, and patient engagement. We will explore how this shift provides a crucial financial incentive for organizations, but more importantly, how the successful adoption of RTM enhances the clinical value proposition by improving population health, lowering overall costs, and tackling the problem of access barriers to conservative care.

On today’s episode, Dr. Tabby Khan, senior director of analytics for Komodo Health, spoke about their newest data analysis measuring age and insurance disparities in antibody-drug conjugate, or ADC, treatment rates in patients with metastatic breast cancer. The analysis was in partnership with the Tigerlily Foundation, a national breast cancer advocacy organization, in celebration of the 40th anniversary of Breast Cancer Awareness Month.

Today we are bringing you a conversation on how topical therapies can effectively manage atopic dermatitis. Brian Keegan, MD, PhD, FAAD, a dermatologist with Princeton Dermatology, spoke with Alexa Hetzel, MS, PA-C, physician assistant with Schweiger Dermatology Group; Vikash D. Oza, MD, director of pediatric dermatology at NYU Langone; and Amy Spizuoco, DO, FAOCD, dermatologist and dermatopathologist at True Dermatology. In addition to discussing the clinical benefits and impact on patient outcomes of using topical therapies for atopic dermatitis, the panelists explored how health economics research informs treatment decisions by demonstrating the cost-effectiveness and accessibility of topical therapies. The panel also analyzed the potential health care cost savings and resource optimization achieved through strategic use of topical treatments and atopic dermatitis management.

In this episode of Managed Care Cast, we talk with Barbara Kelley, executive director of the Hearing Loss Association of America. In our conversation, we discuss advocating for hearing loss awareness, breaking down care barriers related to stigma, and empowering individuals through legislation and public policy. Kelley also highlights the importance of early intervention, advancements in hearing technology, and the social and financial challenges faced by individuals with hearing loss, advocating for better hearing health integration into overall wellness.

How is AI transforming breast cancer screening? On this episode of Managed Care Cast, leading radiology expert, Robert NIshikawa, PhD, breaks down the latest advancements in deep-learning models designed to work alongside mammograms—improving accuracy, efficiency, and early detection in breast imaging.

On this episode of Managed Care Cast, The American Journal of Managed Care® speaks with Melanie T. Turk, PhD, RN, an associate professor in the School of Nursing at Duquesne University and author of a study published in the October 2025 issue. Despite its potential, her study, "Opportunities and Obstacles Associated With the Medicare Diabetes Prevention Program," examines the challenges of implementing the Medicare Diabetes Prevention Program (MDPP) from the perspective of program suppliers nationwide. In this conversation, Turk discusses the limited adoption of the MDPP and the inspiration behind her study. She also outlines her key findings and shares next steps for implementing and sustaining the program.

On this episode of Managed Care Cast, The American Journal of Managed Care® spoke with Gen Li, PhD, CEO and cofounder of Phesi, a clinical data company that provides AI-driven insights to sponsors and providers to optimize clinical trial efficacy. A recent analysis from Phesi found over 100 diseases currently being studied using GLP-1 RA therapies. The rapid growth of GLP-1 RA therapies being used across multiple, overlapping conditions creates an incentive for efficient and easily accessible clinical trial data to aid sponsors and researchers in establishing control cohorts using Phesi's Trial Accelerator platform and digital patient profiles.

On this episode of Managed Care Cast, The American Journal of Managed Care® speaks with Laxmi Patel, chief strategy officer at Savista, about how the proposed federal Budget Reconciliation Act could reshape Medicaid coverage nationwide. Patel explains why states with large immigrant populations, rural hospital dependence, or provider tax funding could face the most immediate disruptions and what payers can do to prepare. Building on AJMC’s prior discussion with Patel on state-level Medicaid policy changes, this conversation explores how coverage loss, care deserts, and administrative burdens may evolve if these reforms move forward—and what proactive, state-specific strategies can help mitigate the impact.

On this episode of Managed Care Cast, The American Journal of Managed Care® (AJMC®) speaks with Tory M. Wolff, MBA, an author of a study published in the September 2025 issue and managing partner of Recon Strategy, a management consulting firm specializing in health care strategy. His study, "Impact of More Primary Care Visits on Commercial Health Care Costs," found that more frequent routine primary care visits among certain higher-risk commercially insured adults are associated with lower net population-level health care costs. In this conversation, Wolff explores the inspiration behind his research, expands on his findings, and discusses the next steps to better understand the long-term value of routine primary care in commercial populations.

Dr. Anders Kolb on Leading Blood Cancer United Into a New Era by Managed Care Cast

On this episode of Managed Care Cast, expert Mary Catherine Beach, MD, MPH, a professor of medicine at the Johns Hopkins University School of Medicine, discusses the practical implications of bias in electronic health care records.

For National Recovery Month, we are joined by Matthew O. Hurford, MD, vice president, Behavioral Health, UPMC Insurance Services Division, and Michael Lynch, MD, an attending emergency physician and medical toxicologist at UPMC. Among the topics we hit on are the 4 crucial dimensions of recovery; understanding that addiction is a brain disease, not a moral failing; and the challenges and opportunities they encounter in providing behavioral health services to millions of Pennsylvanians.