Podcast by Managed Care Cast
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Five Years Later: Ongoing COVID-19 Challenges, Next Steps
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March 11, 2025, will mark 5 years since the World Health Organization (WHO) declared COVID-19 a pandemic. Between January 22, 2020, and March 10, 2023, Johns Hopkins University recorded over 676 million confirmed COVID-19 cases worldwide and more than 6.8 million related deaths. In the US alone, it reported over 103 million cases and more than 1 mi…
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Frameworks for Advancing Health Equity: Pharmacy Support for Non-Hodgkin Lymphoma
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Rachael Drake, pharmacy technician coordinator, University of Kansas Health System, explains how her team collaborates with insurance companies and providers to support patients with non-Hodgkin lymphoma access treatment.Oleh Managed Care Cast
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Managed Care Cast Presents: Navigating Burdens and Treatment Challenges of IPF
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Today we are bringing you insights from 3 separate interviews with experts about the treatment, management, and burdens of idiopathic pulmonary fibrosis (IPF).In this podcast, you’ll hear insight from the following individuals: Toby Maher, MD, PhD, professor of clinical medicine, Keck School of Medicine, USC; Martin Kolb, MD, PhD, professor of medi…
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Advancing Women's Health: CVS Health Leader on Access, Technology, and Breaking Stigmas
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On this episode of Managed Care Cast, we're talking with Joanne Armstrong, MD, MPH, the vice president and chief medical officer for women's health and genomics at CVS Health.We explored the progress and persistent challenges in women's health, highlighting topics like care access, the role of technology, maternal health outcomes, and efforts to br…
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Operationalizing Bispecifics in Multiple Myeloma
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In this special episode of Managed Care Cast, the executive editor of The American Journal of Managed Care, Mary Caffrey, speaks with Tyler Sandahl, PharmD, of Cleveland Clinic, and Michael Byrne, DO, of Tennessee Oncology, about the use of bispecific antibodies to treat patients with multiple myeloma, the importance of caregivers for this regimen,…
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Expert Insights on How Utilization Management Drives Physician Burnout
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On this episode of Managed Care Cast, we're talking with Josie Cooper, BA, executive director of the Alliance for Patient Access.Her study, "Utilization Management and Physician Burnout," involved a survey that assessed physician experiences with utilization management and burnout, investigating the potential link between the 2.…
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Frameworks for Advancing Health Equity: Wellness Way
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Dr Elizabeth Warner, chief medical officer at CDPHP, discusses how Wellness Way's focus on patient experience, community partnerships, and integration of physical and mental health care services sets it apart from traditional hospital-based care.Oleh Managed Care Cast
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Breaking the Cycle: The Importance of Early Intervention in Hidradenitis Suppurativa
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Prompt care supports mental well-being, as hidradenitis suppurativa is often associated with depression and anxiety due to its physical and social challenges.Oleh Managed Care Cast
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Exploring Racial, Ethnic Disparities in Cancer Care Prior Authorization Decisions
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On this episode of Managed Care Cast, we're talking with Benjamin Ukert, PhD, of Elevance Health's Public Policy Institute. His study, "Racial and Ethnic Disparities in Prior Authorizations for Patients With Cancer," evaluated prior authorization decisions in cancer care by race and ethnicity for commercially insured patients.…
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Engage, Educate, Empower: Transforming Kidney Care
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In our conversation with Jeff Giullian, MD, MBA, chief medical officer with DaVita Kidney Care, we dive into 4 important aspects of kidney care: prevention, social support, integrated care, and patient supportOleh Managed Care Cast
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Dr Rick Chapman Discusses Key Insights From the Center’s Rare Disease Project
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On this episode of Managed Care Cast, we're talking with Rick Chapman, PhD, chief science officer of the Center for Innovation & Value Research, formerly known as the Innovation and Value Initiative (IVI).We discussed the Center's Rare Disease project, including the primary goals, key discoveries from Phase 1, and what to expect moving forward.…
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Sustaining Compassionate Trauma Care Across Communities
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To help celebrate and recognize National Recovery Month, we have brought you another limited-edition month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. In this final episode, we speak with Lyndra Bills, MD, senior medical director, and Shari Hutchison, MS, director of program evaluation and outcomes, both with Communit…
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Frameworks for Advancing Health Equity: Community Wellness Centers
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Delia Orosco, MS, director of Community Wellness Centers at Inland Empire Health Plan (IEHP), shares insight into innovative initiatives like the mobile mammogram clinics.Oleh Managed Care Cast
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To recognize National Recovery Month, we are bringing you another limited-edition month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. In episode 4, Amy Herschell, PhD, associate vice president, Program Implementation and Evaluation, Community Care Behavioral Health Organization, and Jessica Meyers, MSEd, senior advisor …
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Exploring Consumer Perspectives on Network Adequacy Definitions
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On this episode of Managed Care Cast, we're talking with Simon F. Haeder, PhD, MPA, associate professor of public health at Texas A&M University.His study, "When is a Network Adequate? Consumer Perspectives on Network Adequacy Definitions," explored the factors that consumers consider essential for an adequate provider network, including travel tim…
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Frameworks for Advancing Health Equity: Youth Behavioral Health Program
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Chris Barton, senior director of Integrated Systems of Care & Network Innovation at Horizon Blue Cross Blue Shield of New Jersey, discusses how the Youth Behavioral Health Strategy program focuses on addressing the specific needs of youth with mental health and substance use issues through a comprehensive approach…
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Healing Wounds Through Peer Support
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To recognize National Recovery Month, we are bringing you another limited-edition month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. In episode 3, we speak with Kim MacDonald-Wilson, ScD, CPRP, senior director, Recovery and Wellness Transformation, and Tracy Carney, CPS, CPRP, senior recovery specialist, both at Commun…
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Providing Patients a Voice in Their Recovery
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To recognize National Recovery Month, we are bringing you another limited-edition month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. In episode 2, we speak with Rebekah Sedlock, DSW, LCSW, Community Care Behavioral Health Organization, part of the UPMC Insurance Services Division, and Mandy Fauble, PhD, LCSW, UPMC West…
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Combatting the Opioid Epidemic: Insights From the Front Lines
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To recognize National Recovery Month, we are bringing you another limited-edition month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. In episode 1, we speak with Michael Lynch, MD, associate professor of emergency medicine at the University of Pittsburgh and an attending emergency physician and medical toxicologist at t…
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Obesity Uncovered: Dr Eden Miller on US Obesity Epidemic, Insurance Shortcomings
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On this episode of Managed Care Cast, we're talking with Eden Miller, DO, founder of the Diabetes and Obesity Care clinic in Bend, Oregon, which provides high-level obesity intervention and diabetes treatment and prevention.Her study, "Inadequate Insurance Coverage for Overweight/Obesity Management," reviews the US obesity epidemic and discusses in…
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Effective Strategies to Enhance Medicare Advantage Star Ratings
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On this episode of Managed Care Cast, we're talking with Marge Ciancetta, the product manager of Cotiviti's Star Intelligence solution, which helps health plans and providers improve their Medicare Advantage Star Ratings.We discussed all things Star Ratings, including their importance, how they are calculated, and their impact on plans in 2024. Loo…
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Building Trust, Breaking Barriers: Health Care Leaders Tackle Primary Care Challenges
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On this episode of Managed Care Cast, we're talking with Sreekanth Chaguturu, MD, chief medical officer of CVS Health; Cathy Moffitt, MD, FAAP, CHIE, chief medical officer of Aetna; and Joneigh Khaldun, MD, MPH, FACEP, chief health equity officer of CVS Health.We discuss various topics, including the current challenges in primary and preventive car…
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Bridging the Vaccination Gap: Insights on Global Immunization Challenges
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On this episode of Managed Care Cast we speak with Jeffery A. Goad, PharmD, MPH, 2024-2025 president of the National Foundation for Infectious Diseases, on the recent report from the World Health Organization and UNICEF on public immunization rates, with national and global health implications.Oleh Managed Care Cast
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Dr Jason Spangler on Enhancing Equity in Health Technology Assessment
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On this episode of Managed Care Cast, we're talking with Jason Spangler, MD, MPH, the CEO of the Center for Innovation and Value Research, formerly known as the Innovation and Value Initiative (IVI). We discuss the strengths and limitations of health technology assessment (HTA), one major limitation being its lack of equity. We also touch on IVI's …
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Frameworks for Advancing Health Equity: Health Equity by Design
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Melissa Clarke, MD, CMQ, the chief health equity officer at Elevance Health, explains "Health Equity by Design" and how Elevance Health is committed to ensuring a personalized and intentional approach for all its members, regardless of race or ethnicity, sexual orientation, gender identity, disability, and geographic or financial access.…
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Insurance Insights: Dr Jason Shafrin Estimates DMD Insurance Value
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On this episode of Managed Care Cast, we're talking with Jason Shafrin, PhD, the senior managing director of FTI Consulting's Center for Healthcare Economics and Policy and an adjunct professor in the University of Southern California's Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences.His study, "Quantifying the Insurance Value for Rar…
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Managed Care Cast Presents: Challenges of Diagnosing and Managing PNH
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Today we are bringing you a conversation between 3 experts on paroxysmal nocturnal hemoglobinuria (PNH). Ryan Haumschild, PharmD, MS, MBA, vice president of Pharmacy at Emory Healthcare and Winship Cancer Institute, spoke with Jamie Koprivnikar, MD, of John Theurer Cancer Center; David Dingli, MD, PhD, of Mayo Clinic; and Brian P. Mulherin, MD, of …
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Exploring Pharmaceutical Innovations, Trust, and Access With CVS Health's CMO
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On this episode of Managed Care Cast, we're talking with Sreekanth Chaguturu, MD, the chief medical officer of CVS Health. We discuss the impact of recent pharmaceutical innovations, namely glucagon-like peptide-1 (GLP-1) receptor agonists and biosimilars, on patient health outcomes. Also, we explore the role of trust between patients and providers…
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Frameworks for Advancing Health Equity: LGBTQIA+ Affirming Provider Designation
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Kim Zynn, vice president of UPMC Health Plan's provider network and development relations team, shares how physicians can become LGBTQIA+ affirming providers, which is designated within the health plan.Oleh Managed Care Cast
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Maternal Health Inequities: Improving Access to Postpartum Depression Treatment
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Douglas Weber, MD, explains how zuranolone has changed the landscape for postpartum depression treatment, addressing a gap in care within the specialty.Oleh Managed Care Cast
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Frameworks for Advancing Health Equity: Trans and Gender Diverse Health Care
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Charlie Borowicz, manager of trans and gender diverse health at Allegheny Health Network, shares how the program offers comprehensive patient-first care to those in the LGBTQ and gender diverse community.Oleh Managed Care Cast
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Double Trouble: High-Deductible Plans Raise Maternity Care Costs Across 2 Calendar Years
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On this episode of Managed Care Cast, we're talking with the University of Southern California's Erin Duffy, PhD, MPH, an author of a study published in the June 2024 issue of The American Journal of Managed Care®.Her study, "Deductible Double Jeopardy: Patients May Pay More Out of Pocket When Pregnancy Crosses 2 Years" discusses how annual high-de…
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Cultivating Equality in the Garden State
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In this fifth, and final, special bonus episode of our Pride Month series, we speak with Lauren Albrecht, director of advocacy and organizing, and Layla Orlando, director of health equity and wellness, at Garden State Equality, the largest LGBTQ+ advocacy organization in New Jersey.Oleh Managed Care Cast
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Shining the Spotlight on Queer Joy and Resilience in LGBTQ+ Youth
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In our fourth Pride Month podcast episode, we are speaking with Domenico Ruggerio, executive director of We Are Family, in Charleston, South Carolina, the state's oldest nonprofit, which provides life-affirming and life-saving programs for LGBTQ+ youth.Oleh Managed Care Cast
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Elevating Equitable Health Care for the LGBTQ+ Community
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For June, we are bringing you a limited-edition podcast series to celebrate Pride Month. In our third episode, we speak with Patrick McGovern, CEO of Callen-Lorde since August of 2023 and an outspoken advocate for HIV, LGBTQ+, and community health.Oleh Managed Care Cast
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Frameworks for Advancing Health Equity: Immigrant Health
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In this interview, we discuss immigrant health with Kheir Mugwaneza, the lead project manager of the Immigrant and Refugee Health Program at Allegheny Health Network.Oleh Managed Care Cast
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Unveiling the AI Equity Gap: A Wake-Up Call for Health Care Systems
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On this episode of Managed Care Cast, we're talking with Dr Paige Nong, the author of a study published in the Health IT bonus issue. Her study, "Equity and AI Governance at Academic Medical Centers," found that academic medical centers show minimal consideration for equity when developing governance for AI technologies; this highlights the need fo…
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Fighting for the Future of LGBTQ Pride at Rutgers
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For June, we are bringing you a limited-edition podcast series to celebrate Pride Month. In our second episode, we speak with Perry Halkitis, PhD, MS, MPH, dean and Hunterdon Professor of Public Health & Health Equity at the Rutgers School of Public Health and founder and director of the Center for Health, Identity, Behavior & Prevention Studies at…
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Exploring the Importance of Biomarker Testing to Identify Genetic Variants, Correct Treatments
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On this episode of Managed Care Cast, we're talking with Kristine Ashcraft, the president and founder of YouScript, a tool that helps to predict adverse drug events and personalize patient care.We discuss the lack of awareness of genetic variants among patients and the recent adoption of biomarker testing legislation in some states. This legislatio…
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Celebrating Pride Month With Lancaster Pride
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For June, we are bringing you a limited-edition podcast series to celebrate Pride Month. In this, our first episode, we speak with Tiffany Shirley, president of Lancaster Pride.Oleh Managed Care Cast
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From Polypharmacy to Personalized Care: Dr Nihar Desai Discusses Holistic Cardiovascular Care
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In this episode of Managed Care Cast, Nihar Desai, MD, MPH, cardiologist and vice chief of Cardiology at the Yale School of Medicine, discusses therapies for cardiovascular conditions as they relate to patient adherence, polypharmacy, and health access.Oleh Managed Care Cast
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Cancer Care Crisis: Experts Discuss CMS Restrictions Impacting Rural Patients With Cancer
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On this episode of Managed Care Cast, we're talking with Illinois CancerCare's Pankaj Kumar, MD, and Stephanie Parker, PharmD, 2 authors of a commentary published in the May 2024 issue of The American Journal of Managed Care.Their commentary, "Access Denied: CMS’ Action Hurts Patients With Cancer in Rural America," discusses how recent CMS rules re…
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Frameworks for Advancing Health Equity: Urban Health Outreach
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In the series debut episode of Frameworks for Advancing Health Equity, Mary Sligh, CRNP, and Chelsea Chappars, of Allegheny Health Network, explain how the Urban Health Outreach program aims to improve health equity for individuals experiencing homelessness.Oleh Managed Care Cast
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CMS Medicare Final Rule: Advancing Benefits, Competition, and Consumer Protection
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On this episode of Managed Care Cast, we're talking with Karen Iapoce, senior director of government products and programs at ZeOmega. We discussed CMS's recent Medicare Part D and Medicare Advantage final rule and how it affects enrollees and health plans.Oleh Managed Care Cast
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Tackling Health Inequality: The Power of Education and Experience
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To help celebrate and recognize National Minority Health Month, we are bringing you a special month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. Welcome to our final episode of this limited series and our conversation with Janine Jelks-Seale, MSPPM, director of health equity at UPMC Health Plan.…
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Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
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On this episode of Managed Care Cast, we're talking with the University of Pennsylvania's Ravi Parikh, MD, MPP, and Aaron Schwartz, MD, PhD, 2 authors of a study published in the April 2024 issue of The American Journal of Managed Care®.Their study, "Trends in Low-Value Cancer Care During the COVID-19 Pandemic," discusses how rates of low-value can…
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Empowering Community Health Through Wellness and Faith
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To help celebrate and recognize National Minority Health Month, we are bringing you a special month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. Welcome to our third episode and our conversation with Camille Clarke-Smith, EdD, MS, CHES, CPT, program director of quality improvement/Medicare/SNP STARs at UPMC Health Plan…
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Overcoming Employment Barriers for Lasting Social Impact: Freedom House 2.0 and Pathways to Work
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To help celebrate and recognize National Minority Health Month, we are bringing you a special month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. Welcome to our second episode in which we learn all about Freedom House 2.0 and the Pathways to Work Program from its very own Dan LaVallee, senior director, Social Impact, UP…
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Making Giant Strides in Maternity Health Through Baby Steps
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To help celebrate and recognize National Minority Health Month, we are kicking off a special month-long podcast series with our Strategic Alliance Partner, UPMC Health Plan. Welcome to our first episode, which is all about the Baby Steps Maternity Program and its mission to support women throughout every step of their pregnancy journey.…
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Navigating Health Policy in an Election Year: Insights From Dr Dennis Scanlon
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On this episode of Managed Care Cast, we're talking with Dennis Scanlon, PhD, the editor in chief of the American Journal of Accountable Care® and a health policy professor at Penn State University. Topics we are discussing include President Biden's recent prescription drug proposals, prior authorization practices, price transparency, and the poten…
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