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.

Predicting High-Cost Utilizers Among the Commercially Insured Population

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.

Not Just a Hair Cut; An Initiative

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.

Health Equity Conversations: Managing Underserved Communities and Value-Based Payment

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.

Bridging the Gap in Health Care Inequities: Considerations in Treatment Selection: Part 2

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®.

Mental Health Disparities Vary by Wage Level, New Analysis Shows

Health Equity Conversations: Barriers to Equitable Care

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.

Oncology Onward: A Conversation With Dr Shereef Elnahal

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.

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.

A Conversation on the Past, Present, and Future of Public Health: NPHW 2023

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.

Bridging the Gap in Health Care Inequities: Considerations in Treatment Selection: Part 1

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.

More Needs to Be Done To Reduce Racial Disparities in Home Dialysis

Managed Care Cast

Mark Fendrick

Current policies being employed to limit spending can have serious consequences for patients. In the April issue of The American Journal of Managed Care, A. Mark Fendrick, MD, co-authored a paper that examined the relationship between consumer cost sharing for branded antidepressants and the initiation of branded therapy among patients who were filling a prescription for a generic medication to treat major depressive disorder.Read the paper:Cost Sharing and Branded Antidepressant Initiation Among Patients Treated With Generics: www.ajmc.com/journals/issue/2018/2018-vol24-n4/cost-sharing-and-branded-antidepressant-initiation-among-patients-treated-with-generics

Current policies being employed to limit spending can have serious consequences for patients. In the April issue of The American Journal of Managed Care, A. Mark Fendrick, MD, co-authored a paper that examined the relationship between consumer cost sharing for branded antidepressants and the initiation of branded therapy among patients who were filling a prescription for a generic medication to treat major depressive disorder. Read the paper: Cost Sharing and Branded Antidepressant Initiation Among Patients Treated With Generics: <a href="http://www.ajmc.com/journals/issue/2018/2018-vol24-n4/cost-sharing-and-branded-antidepressant-initiation-among-patients-treated-with-generics" rel="nofollow" target="_blank">www.ajmc.com/journals/issue/2018/2018-vol24-n4/cost-sharing-and-branded-antidepressant-initiation-among-patients-treated-with-generics</a>

Examining Consumer Cost Sharing and a Precision Benefit Design With Dr Mark Fendrick

Improving Care While Reducing Costs Through ACOs and Other Value-Based Efforts by Managed Care Cast

Improving Care While Reducing Costs Through ACOs and Other Value-Based Efforts

Providing an open channel of communication between pharmacists and patients, medication therapy management (MTM) allows pharmacists to optimize medications for their patients and patients to take an active role in their healthcare. As MTM services help pharmacists better understand how different medications interact with each other, MTM has been recommended as a way to identify and prevent opioid misuse. In an effort to provide greater incentive for Part D sponsors to use MTM programs, the Center for Medicare and Medicaid Innovation launched in January 2017 the 5-year Part D Enhanced Medication Therapy Management (eMTM) Model. The model is assessing whether incentives, such as payment and regulatory flexibilities, will result in enhancements in the MTM program, ultimately leading to improved patient outcomes and reduced costs.In this podcast, we speak with Brian Litten, JD, chief strategic officer, Tabula Rasa HealthCare; and Calvin Knowlton, BScPharm, MDiv, PhD, chief executive officer and founder of Tabula Rasa HealthCare, to get more insight into MTM and the eMTM model.

Providing an open channel of communication between pharmacists and patients, medication therapy management (MTM) allows pharmacists to optimize medications for their patients and patients to take an active role in their healthcare. As MTM services help pharmacists better understand how different medications interact with each other, MTM has been recommended as a way to identify and prevent opioid misuse. In an effort to provide greater incentive for Part D sponsors to use MTM programs, the Center for Medicare and Medicaid Innovation launched in January 2017 the 5-year Part D Enhanced Medication Therapy Management (eMTM) Model. The model is assessing whether incentives, such as payment and regulatory flexibilities, will result in enhancements in the MTM program, ultimately leading to improved patient outcomes and reduced costs. In this podcast, we speak with Brian Litten, JD, chief strategic officer, Tabula Rasa HealthCare; and Calvin Knowlton, BScPharm, MDiv, PhD, chief executive officer and founder of Tabula Rasa HealthCare, to get more insight into MTM and the eMTM model.

Using Medication Therapy Management to Optimize Medication Regimens, Identify Opioid Misuse

Bringing Virtual Tumor Boards, Real-Time Data to the Point of Care by Managed Care Cast

Bringing Virtual Tumor Boards, Real-Time Data to the Point of Care

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 FDA commissioner discussing boosting drug competition; BMS offering details on its acquisition of Celgene; and cancer mortality rates declining for the 25th consecutive year.Read more about the stories in this podcast:FDA's Scott Gottlieb, MD, Highlights Biosimilars Initiatives in J.P. Morgan Keynote Address: https://www.centerforbiosimilars.com/conferences/jp-morgan-2019/fdas-scott-gottlieb-md-highlights-biosimilars-initiatives-in-jp-morgan-keynote-addressBMS, Celgene Discuss $74 Billion Acquisition During JP Morgan Healthcare Conference: https://www.ajmc.com/newsroom/bms-celgene-discuss-74-billion-acquisition-during-jp-morgan-healthcare-conferenceCancer Mortality Rate Drops for the 25th Consecutive Year, but Socioeconomic Gap Widens: https://www.ajmc.com/focus-of-the-week/cancer-mortality-rate-drops-for-the-25th-consecutive-year-but-socioeconomic-gap-widensRise of Marijuana Cries Out for Research, Regulation, Physicians Say: https://www.ajmc.com/focus-of-the-week/rise-of-marijuana-cries-out-for-research-regulation-physicians-sayCVS Health CEO Outlines How Aetna Deal Will Benefit Customers: https://www.ajmc.com/newsroom/cvs-health-ceo-outlines-how-aetna-deal-will-benefit-customers

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 FDA commissioner discussing boosting drug competition; BMS offering details on its acquisition of Celgene; and cancer mortality rates declining for the 25th consecutive year. Read more about the stories in this podcast: FDA's Scott Gottlieb, MD, Highlights Biosimilars Initiatives in J.P. Morgan Keynote Address: <a href="https://www.centerforbiosimilars.com/conferences/jp-morgan-2019/fdas-scott-gottlieb-md-highlights-biosimilars-initiatives-in-jp-morgan-keynote-address" rel="nofollow" target="_blank">https://www.centerforbiosimilars.com/conferences/jp-morgan-2019/fdas-scott-gottlieb-md-highlights-biosimilars-initiatives-in-jp-morgan-keynote-address</a> BMS, Celgene Discuss $74 Billion Acquisition During JP Morgan Healthcare Conference: <a href="https://www.ajmc.com/newsroom/bms-celgene-discuss-74-billion-acquisition-during-jp-morgan-healthcare-conference" rel="nofollow" target="_blank">https://www.ajmc.com/newsroom/bms-celgene-discuss-74-billion-acquisition-during-jp-morgan-healthcare-conference</a> Cancer Mortality Rate Drops for the 25th Consecutive Year, but Socioeconomic Gap Widens: <a href="https://www.ajmc.com/focus-of-the-week/cancer-mortality-rate-drops-for-the-25th-consecutive-year-but-socioeconomic-gap-widens" rel="nofollow" target="_blank">https://www.ajmc.com/focus-of-the-week/cancer-mortality-rate-drops-for-the-25th-consecutive-year-but-socioeconomic-gap-widens</a> Rise of Marijuana Cries Out for Research, Regulation, Physicians Say: <a href="https://www.ajmc.com/focus-of-the-week/rise-of-marijuana-cries-out-for-research-regulation-physicians-say" rel="nofollow" target="_blank">https://www.ajmc.com/focus-of-the-week/rise-of-marijuana-cries-out-for-research-regulation-physicians-say</a> CVS Health CEO Outlines How Aetna Deal Will Benefit Customers: <a href="https://www.ajmc.com/newsroom/cvs-health-ceo-outlines-how-aetna-deal-will-benefit-customers" rel="nofollow" target="_blank">https://www.ajmc.com/newsroom/cvs-health-ceo-outlines-how-aetna-deal-will-benefit-customers</a>

This Week in Managed Care—Coverage From the JP Morgan Healthcare Conference and Other Health News

Michael Chernew

Creators of President Donald Trump’s blueprint to control drug prices, American Patients First, say it represents real reform. Critics see a pulled punch to the pharmaceutical industry.Mary Caffrey, the managing editor of The American Journal of Managed Care’s Evidence-Based series, spoke with Harvard healthcare economist Michael E. Chernew, PhD, who is the co-editor in chief of AJMC, to discuss elements of the Trump administration proposal to control drug prices. Chernew is also a former vice chair of the Medicare Payment Advisory Commission.Read more:Trump Offers Blueprint to Drive Down Prescription Drug Prices; Targets Rebates, "Middlemen": www.ajmc.com/newsroom/-trump-offers-blueprint-to-drive-down-prescription-drug-prices-targets-rebates-middlemenAzar Stumps for Plan to Hold Down Prescription Drug Costs: www.ajmc.com/focus-of-the-week/azar-stumps-for-plan-to-hold-down-prescription-drug-costsTrump Targets Drug Prices, Right-to-Try in State of the Union: www.ajmc.com/newsroom/trump-targets-drug-prices-righttotry-in-state-of-the-union​​​​​​​Will Trump Take Steps to Rein in Drug Prices?: www.ajmc.com/focus-of-the-week/will-trump-take-steps-to-rein-in-drug-prices

Creators of President Donald Trump’s blueprint to control drug prices, American Patients First, say it represents real reform. Critics see a pulled punch to the pharmaceutical industry. Mary Caffrey, the managing editor of The American Journal of Managed Care’s Evidence-Based series, spoke with Harvard healthcare economist Michael E. Chernew, PhD, who is the co-editor in chief of AJMC, to discuss elements of the Trump administration proposal to control drug prices. Chernew is also a former vice chair of the Medicare Payment Advisory Commission. Read more: Trump Offers Blueprint to Drive Down Prescription Drug Prices; Targets Rebates, "Middlemen": <a href="http://www.ajmc.com/newsroom/-trump-offers-blueprint-to-drive-down-prescription-drug-prices-targets-rebates-middlemen" rel="nofollow" target="_blank">www.ajmc.com/newsroom/-trump-offers-blueprint-to-drive-down-prescription-drug-prices-targets-rebates-middlemen</a> Azar Stumps for Plan to Hold Down Prescription Drug Costs: <a href="http://www.ajmc.com/focus-of-the-week/azar-stumps-for-plan-to-hold-down-prescription-drug-costs" rel="nofollow" target="_blank">www.ajmc.com/focus-of-the-week/azar-stumps-for-plan-to-hold-down-prescription-drug-costs</a> Trump Targets Drug Prices, Right-to-Try in State of the Union: <a href="http://www.ajmc.com/newsroom/trump-targets-drug-prices-righttotry-in-state-of-the-union" rel="nofollow" target="_blank">www.ajmc.com/newsroom/trump-targets-drug-prices-righttotry-in-state-of-the-union</a> ​​​​​​​Will Trump Take Steps to Rein in Drug Prices?: <a href="http://www.ajmc.com/focus-of-the-week/will-trump-take-steps-to-rein-in-drug-prices" rel="nofollow" target="_blank">www.ajmc.com/focus-of-the-week/will-trump-take-steps-to-rein-in-drug-prices</a>

What Is and Is Not in Trump’s Drug Pricing Plan: An Interview With Dr Michael Chernew

The widespread nature of the opioid epidemic will require coordination from a variety of stakeholders and all levels of government. In this podcast, experts discuss how the crisis got so out of hand, various tactics being undertaken to reverse the opioid, and the current impact of stigma on getting treatment.

Tackling the Opioid Epidemic With a Public Health Approach

Lowering Costs And Readmission Rates Through a Meal Delivery Program by Managed Care Cast

Lowering Costs And Readmission Rates Through a Meal Delivery Program

This week, the top stories in managed care included new hypertension guidelines lowering the threshold for high blood pressure, Trump nominating a new HHS secretary, and many consumers now have access to less expensive Affordable Care Act plans.High Blood Pressure Starts at 130/80, New Guidelines Say: www.ajmc.com/conferences/aha-2017/80-new-guidelines-sayTrump Nominates Alex Azar, Former Lilly Executive, to Lead HHS: www.ajmc.com/newsroom/trump-nominates-alex-azar-former-lilly-executive-to-lead-hhsKaiser Analysis: For Many, Health Coverage Costs Less Than Individual Mandate Penalty: www.ajmc.com/focus-of-the-week/kaiser-analysis-for-many-health-coverage-costs-less-than-individual-mandate-penaltyPatient-Centered Oncology Care: www.ajmc.com/conferences/pcoc-2017/

This week, the top stories in managed care included new hypertension guidelines lowering the threshold for high blood pressure, Trump nominating a new HHS secretary, and many consumers now have access to less expensive Affordable Care Act plans. High Blood Pressure Starts at 130/80, New Guidelines Say: <a href="http://www.ajmc.com/conferences/aha-2017/80-new-guidelines-say" rel="nofollow" target="_blank">www.ajmc.com/conferences/aha-2017/80-new-guidelines-say</a> Trump Nominates Alex Azar, Former Lilly Executive, to Lead HHS: <a href="http://www.ajmc.com/newsroom/trump-nominates-alex-azar-former-lilly-executive-to-lead-hhs" rel="nofollow" target="_blank">www.ajmc.com/newsroom/trump-nominates-alex-azar-former-lilly-executive-to-lead-hhs</a> Kaiser Analysis: For Many, Health Coverage Costs Less Than Individual Mandate Penalty: <a href="http://www.ajmc.com/focus-of-the-week/kaiser-analysis-for-many-health-coverage-costs-less-than-individual-mandate-penalty" rel="nofollow" target="_blank">www.ajmc.com/focus-of-the-week/kaiser-analysis-for-many-health-coverage-costs-less-than-individual-mandate-penalty</a> Patient-Centered Oncology Care: <a href="http://www.ajmc.com/conferences/pcoc-2017/" rel="nofollow" target="_blank">www.ajmc.com/conferences/pcoc-2017/</a>

This Week in Managed Care—New Hypertension Guidelines, and Other Health News

Addressing the Complexities of Value-Based Payment Models by Managed Care Cast

Addressing the Complexities of Value-Based Payment Models

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.

How a Self-Insured Employer Decreased Costs While Improving Performance

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 stories included a new direction for the Center for Medicare and Medicaid Innovation; a bipartisan group of governors spoke out against the latest effort to repeal the Affordable Care Act; and the World Health Organization warned that antibiotics currently being developed were not enough to fight antibiotic-resistant infections.

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 stories included a new direction for the Center for Medicare and Medicaid Innovation; a bipartisan group of governors spoke out against the latest effort to repeal the Affordable Care Act; and the World Health Organization warned that antibiotics currently being developed were not enough to fight antibiotic-resistant infections.

This Week in Managed Care—New Direction for CMS Innovation Center, and Other Health News

Health literacy in the United States is low to begin with, and health financial literacy is even lower. The changing health insurance system is partly to blame. A few decades ago, health insurance covered everything. Now, patients have a lot more financial responsibility, and they don’t always understand it. In cancer, health financial literacy is particularly important since treatment can be so costly.This episode of Managed Care Cast includes conversations with a few experts in the field: Yousuf Zafar, MD, MHS, of the Duke Cancer Institute; Clara Lambert, BBA, OPN-CG, chair of the Association of Community Cancer Centers Financial Advocacy Network Advisory Committee; Todd Yezefski, MD, senior fellow in the Clinical Research Division at the Fred Hutchinson Cancer Research Center and Division of Medical Oncology at the University of Washington; and Michele McCourt, senior director of the CancerCare Co-Payment Assistance Foundation.Read more:A Descriptive Study of Patients Receiving Foundational Financial Assistance Through Local Specialty Pharmacies: www.ajmc.com/journals/supplement/2018/the-patient-assistance-safety-net-how-many-need-help-how-many-are-helped/a-descriptive-study-of-patients-receiving-foundational-financial-assistance-through-local-specialty-pharmaciesImpact of Trained Oncology Financial Navigators on Patient Out-of-Pocket Spending: www.ajmc.com/journals/supplement/2018/the-patient-assistance-safety-net-how-many-need-help-how-many-are-helped/impact-of-trained-oncology-financial-navigators-on-patient-outofpocket-spendingPolicy Improvement Areas to Reduce Financial Hardship: www.ajmc.com/conferences/pan-2018/policy-improvement-areas-to-reduce-financial-hardshipAddressing Financial Concerns at the Outset to Improve Patient Outcomes: www.ajmc.com/conferences/pan-2018/addressing-financial-concerns-at-the-outset-to-improve-patient-outcomes

Health literacy in the United States is low to begin with, and health financial literacy is even lower. The changing health insurance system is partly to blame. A few decades ago, health insurance covered everything. Now, patients have a lot more financial responsibility, and they don’t always understand it. In cancer, health financial literacy is particularly important since treatment can be so costly. This episode of Managed Care Cast includes conversations with a few experts in the field: Yousuf Zafar, MD, MHS, of the Duke Cancer Institute; Clara Lambert, BBA, OPN-CG, chair of the Association of Community Cancer Centers Financial Advocacy Network Advisory Committee; Todd Yezefski, MD, senior fellow in the Clinical Research Division at the Fred Hutchinson Cancer Research Center and Division of Medical Oncology at the University of Washington; and Michele McCourt, senior director of the CancerCare Co-Payment Assistance Foundation. Read more: A Descriptive Study of Patients Receiving Foundational Financial Assistance Through Local Specialty Pharmacies: <a href="http://www.ajmc.com/journals/supplement/2018/the-patient-assistance-safety-net-how-many-need-help-how-many-are-helped/a-descriptive-study-of-patients-receiving-foundational-financial-assistance-through-local-specialty-pharmacies" rel="nofollow" target="_blank">www.ajmc.com/journals/supplement/2018/the-patient-assistance-safety-net-how-many-need-help-how-many-are-helped/a-descriptive-study-of-patients-receiving-foundational-financial-assistance-through-local-specialty-pharmacies</a> Impact of Trained Oncology Financial Navigators on Patient Out-of-Pocket Spending: <a href="http://www.ajmc.com/journals/supplement/2018/the-patient-assistance-safety-net-how-many-need-help-how-many-are-helped/impact-of-trained-oncology-financial-navigators-on-patient-outofpocket-spending" rel="nofollow" target="_blank">www.ajmc.com/journals/supplement/2018/the-patient-assistance-safety-net-how-many-need-help-how-many-are-helped/impact-of-trained-oncology-financial-navigators-on-patient-outofpocket-spending</a> Policy Improvement Areas to Reduce Financial Hardship: <a href="http://www.ajmc.com/conferences/pan-2018/policy-improvement-areas-to-reduce-financial-hardship" rel="nofollow" target="_blank">www.ajmc.com/conferences/pan-2018/policy-improvement-areas-to-reduce-financial-hardship</a> Addressing Financial Concerns at the Outset to Improve Patient Outcomes: <a href="http://www.ajmc.com/conferences/pan-2018/addressing-financial-concerns-at-the-outset-to-improve-patient-outcomes" rel="nofollow" target="_blank">www.ajmc.com/conferences/pan-2018/addressing-financial-concerns-at-the-outset-to-improve-patient-outcomes</a>

Addressing Financial Toxicity With Navigators and Better Conversations Around Decision Making

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 Institute for Clinical and Economic Review investigating rising drug prices; CMS expanding value-based insurance design; and researchers using a blood test to detect preclinical Alzheimer disease.Read more about the stories in this podcast:What's Driving US Healthcare Costs? Stakeholders Weigh In: https://www.ajmc.com/focus-of-the-week/whats-driving-us-healthcare-costs-stakeholders-weigh-inICER Will Review If Drug Price Hikes Are Supported by New Evidence: https://www.ajmc.com/newsroom/icer-will-review-if-drug-price-hikes-are-supported-by-new-evidenceReport: Increasing Drug Prices, Shortages Causing Hospitals to Cut Staff, Putting Patient Safety at Risk: https://www.ajmc.com/focus-of-the-week/report-increasing-drug-prices-shortages-causing-hospitals-to-cut-staff-putting-patient-safety-at-riskWhat We're Reading: Insulin Costs Double; PhRMA's Record Spending; Causes of Liver Transplants: https://www.ajmc.com/newsroom/what-were-reading-insulin-costs-double-phrmas-record-spending-causes-of-liver-transplantsCMS Expands VBID in Medicare Advantage, Increases Risk Sharing in Part D: https://www.ajmc.com/newsroom/cms-expands-vbid-in-medicare-advantage-increases-risk-sharing-in-part-dResearchers Use Blood Test to Detect Preclinical Alzheimer Disease Signs: https://www.ajmc.com/newsroom/researchers-use-blood-test-to-detect-preclinical-alzheimer-disease-signsImproving Care for Patients With Metastatic Breast Cancer: https://www.ajmc.com/peer-exchange/advances-metastatic-breast-cancer/improving-care-for-patients-with-metastatic-breast-cancer

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 Institute for Clinical and Economic Review investigating rising drug prices; CMS expanding value-based insurance design; and researchers using a blood test to detect preclinical Alzheimer disease. Read more about the stories in this podcast: What's Driving US Healthcare Costs? Stakeholders Weigh In: <a href="https://www.ajmc.com/focus-of-the-week/whats-driving-us-healthcare-costs-stakeholders-weigh-in" rel="nofollow" target="_blank">https://www.ajmc.com/focus-of-the-week/whats-driving-us-healthcare-costs-stakeholders-weigh-in</a> ICER Will Review If Drug Price Hikes Are Supported by New Evidence: <a href="https://www.ajmc.com/newsroom/icer-will-review-if-drug-price-hikes-are-supported-by-new-evidence" rel="nofollow" target="_blank">https://www.ajmc.com/newsroom/icer-will-review-if-drug-price-hikes-are-supported-by-new-evidence</a> Report: Increasing Drug Prices, Shortages Causing Hospitals to Cut Staff, Putting Patient Safety at Risk: <a href="https://www.ajmc.com/focus-of-the-week/report-increasing-drug-prices-shortages-causing-hospitals-to-cut-staff-putting-patient-safety-at-risk" rel="nofollow" target="_blank">https://www.ajmc.com/focus-of-the-week/report-increasing-drug-prices-shortages-causing-hospitals-to-cut-staff-putting-patient-safety-at-risk</a> What We're Reading: Insulin Costs Double; PhRMA's Record Spending; Causes of Liver Transplants: <a href="https://www.ajmc.com/newsroom/what-were-reading-insulin-costs-double-phrmas-record-spending-causes-of-liver-transplants" rel="nofollow" target="_blank">https://www.ajmc.com/newsroom/what-were-reading-insulin-costs-double-phrmas-record-spending-causes-of-liver-transplants</a> CMS Expands VBID in Medicare Advantage, Increases Risk Sharing in Part D: <a href="https://www.ajmc.com/newsroom/cms-expands-vbid-in-medicare-advantage-increases-risk-sharing-in-part-d" rel="nofollow" target="_blank">https://www.ajmc.com/newsroom/cms-expands-vbid-in-medicare-advantage-increases-risk-sharing-in-part-d</a> Researchers Use Blood Test to Detect Preclinical Alzheimer Disease Signs: <a href="https://www.ajmc.com/newsroom/researchers-use-blood-test-to-detect-preclinical-alzheimer-disease-signs" rel="nofollow" target="_blank">https://www.ajmc.com/newsroom/researchers-use-blood-test-to-detect-preclinical-alzheimer-disease-signs</a> Improving Care for Patients With Metastatic Breast Cancer: <a href="https://www.ajmc.com/peer-exchange/advances-metastatic-breast-cancer/improving-care-for-patients-with-metastatic-breast-cancer" rel="nofollow" target="_blank">https://www.ajmc.com/peer-exchange/advances-metastatic-breast-cancer/improving-care-for-patients-with-metastatic-breast-cancer</a>

This Week in Managed Care—Tracking Drug Price Hikes and Other Health News

Healthcare is increasingly trying to use big data and clinical pharmacists are no exception. On today's episode of Managed Care Cast, we talk with an assistant professor at Geisinger’s Center for Pharmacy Innovation and Outcomes about his work with big data.

The Many Uses of Big Data by Clinical Pharmacists

In 2018, the Ochsner Accountable Care Network was able to reduce expected costs of care by more than $12.78 million for its Medicare beneficiaries, and it increased its savings 12% over 2017. This comes amidst research and claims that accountable care organizations may not be successful at reducing costs while improving outcomes.David Carmouche, MD, president of the Ochsner Health Network and executive director of the Ochsner Accountable Care Network, explains how the Ochsner accountable care organization (ACO) was able to find success and how other ACOs can get over the learning curve to achieve savings.Learn more about Ochsnerhttps://www.ajmc.com/partners/ochsner

In 2018, the Ochsner Accountable Care Network was able to reduce expected costs of care by more than $12.78 million for its Medicare beneficiaries, and it increased its savings 12% over 2017. This comes amidst research and claims that accountable care organizations may not be successful at reducing costs while improving outcomes. David Carmouche, MD, president of the Ochsner Health Network and executive director of the Ochsner Accountable Care Network, explains how the Ochsner accountable care organization (ACO) was able to find success and how other ACOs can get over the learning curve to achieve savings. Learn more about Ochsner <a href="https://www.ajmc.com/partners/ochsner" rel="nofollow" target="_blank">https://www.ajmc.com/partners/ochsner</a>

Discussing the ACO Learning Curve and Ochsner's Success With Accountable Care

Surviving cancer doesn't mean the challenges are all in the past. After cancer is treated and cured, many survivors still face financial debt and lingering toxcities that impact their lives. Samantha Eisenstein Watson, MBA, CEO and founder of The Samfund, explains the challenges that young adult cancer survivors, in particular, go through and how her organization tries to help alleviate some of the financial burden. Plus, a look at what the effects of cancer treatment mean for fertility and what challenges this represents for young adults.

Cancer Survivorship: The Challenges That Remain After Treatment

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 Officer In America’s Health Systems: A Call To Action: https://www.healthaffairs.org/do/10.1377/hblog20181025.308059/full/Physicians Are Pessimistic About Future of Healthcare, Highlight Extent of Social Determinants: https://www.ajmc.com/focus-of-the-week/physicians-are-pessimistic-about-future-of-healthcare-highlight-extent-of-social-determinantsPhysician Burnout Associated With Poorer Patient Outcomes: https://www.ajmc.com/focus-of-the-week/physician-burnout-associated-with-poorer-patient-outcomesDr W. Clay Jackson Discusses Identifying, Addressing Clinician Burnout: https://www.ajmc.com/conferences/psychcongress2018/dr-w-clay-jackson-discusses-identifying-addressing-clinician-burnoutWill HHS' Strategy to Address Health IT–Related Physician Burden Provide Relief for Providers? https://www.ajmc.com/focus-of-the-week/will-hhs-strategy-to-address-health-itndashrelated-physician-burden-provide-relief-for-providersAfter Increasing for Several Years, Physician Burnout Shows Modest Decline: https://www.ajmc.com/newsroom/after-increasing-for-several-years-physician-burnout-shows-modest-decline

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 Officer In America’s Health Systems: A Call To Action: <a href="https://www.healthaffairs.org/do/10.1377/hblog20181025.308059/full/" rel="nofollow" target="_blank">https://www.healthaffairs.org/do/10.1377/hblog20181025.308059/full/</a> Physicians Are Pessimistic About Future of Healthcare, Highlight Extent of Social Determinants: <a href="https://www.ajmc.com/focus-of-the-week/physicians-are-pessimistic-about-future-of-healthcare-highlight-extent-of-social-determinants" rel="nofollow" target="_blank">https://www.ajmc.com/focus-of-the-week/physicians-are-pessimistic-about-future-of-healthcare-highlight-extent-of-social-determinants</a> Physician Burnout Associated With Poorer Patient Outcomes: <a href="https://www.ajmc.com/focus-of-the-week/physician-burnout-associated-with-poorer-patient-outcomes" rel="nofollow" target="_blank">https://www.ajmc.com/focus-of-the-week/physician-burnout-associated-with-poorer-patient-outcomes</a> Dr W. Clay Jackson Discusses Identifying, Addressing Clinician Burnout: <a href="https://www.ajmc.com/conferences/psychcongress2018/dr-w-clay-jackson-discusses-identifying-addressing-clinician-burnout" rel="nofollow" target="_blank">https://www.ajmc.com/conferences/psychcongress2018/dr-w-clay-jackson-discusses-identifying-addressing-clinician-burnout</a> Will HHS' Strategy to Address Health IT–Related Physician Burden Provide Relief for Providers? <a href="https://www.ajmc.com/focus-of-the-week/will-hhs-strategy-to-address-health-itndashrelated-physician-burden-provide-relief-for-providers" rel="nofollow" target="_blank">https://www.ajmc.com/focus-of-the-week/will-hhs-strategy-to-address-health-itndashrelated-physician-burden-provide-relief-for-providers</a> After Increasing for Several Years, Physician Burnout Shows Modest Decline: <a href="https://www.ajmc.com/newsroom/after-increasing-for-several-years-physician-burnout-shows-modest-decline" rel="nofollow" target="_blank">https://www.ajmc.com/newsroom/after-increasing-for-several-years-physician-burnout-shows-modest-decline</a>

Healthcare Needs More Chief Wellness Officers to Address Burnout and Its Impact

This week included the much-anticipated report from the Congressional Budget Office releasing rating of the GOP's health plan; the Senate voted to confirm Seema Verma for CMS administrator; and President Donald Trump nominated Scott Gottlieb, MD, to lead the FDA.

This Week in Managed Care—CBO Rates Healthcare Bill, and Other News

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