Managed Care Cast

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, which includes the UPMC for Life Medicare Faith and Wellness Program.

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, UPMC Health Plan, and Markisha Jones, a Pathways to Work/Freedom House 2.0 graduate.

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.

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 potential impact of health policy on the upcoming election.

On this episode of Managed Care Cast, we're talking with the University of Minnesota School of Public Health's Hannah Neprash, PhD; John Mulcahy, a PhD candidate; and Ezra Golberstein, PhD, the authors of a study published in the March 2024 issue of The American Journal of Managed Care®. Their study, "The Extent and Growth of Prior Authorization in Medicare Advantage," discusses how the service-, area-, and carrier-level patterns they identified suggest variation in how Medicare Advantage plans use prior authorization.

On this episode of Managed Care Cast, we're talking with J. Nwando Olayiwola, MD, MPH; Candy Magaña, MPA; and Bereket Kindo, PhD, the lead author, research and project lead, and data scientist of a study published in the February 2024 issue of The American Journal of Managed Care. Their study, "Screening for Health Literacy, Social Determinants, and Discrimination in Health Plans," provides insight on the experiences of patients in a national health plan with 2 structural determinants of health and how those interact with social determinants of health and patient demographics.

In the wake of the 2023 American Society of Hematology Annual Meeting and Exposition, Raymond Thertulien, MD, PhD, of Novant Health, and Joseph Mikhael, MD, MEd, FRCPC, FACP, chief medical officer of the International Myeloma Foundation, discussed health equity research highlights from the meeting and drivers of racial disparities in multiple myeloma outcomes.

The editors in chief of The American Journal of Managed Care® discuss the managed care developments of 2023 and anticipate trends on the horizon.

At the end of 2022, adagrasib received its first FDA approval for the treatment of adults with KRAS G12C-mutated locally advanced or metastatic non–small cell lung cancer. Research is ongoing into adagrasib, a KRAS G12C inhibitor, for other tumors. In today’s episode, we're joined by Jun Gong, MD, associate professor of medicine and the medical director of colorectal cancer in the Division of Medical Oncology at Cedars-Sinai Medical Center. During this interview, he discusses the mechanism of adagrasib, what other diseases it is being studied in, the latest data on adagrasib in colorectal cancer, and the importance of conducting genomic testing.

Justin Bekelman, MD, director of the Penn Center for Cancer Care Innovation, sat with our hosts Emeline Aviki, MD, MBA, and Stephen Schleicher, MD, MBA, for our final episode of 2023 to discuss the importance of collaboration between academic medicine and community oncology and testing innovative cancer care delivery in these settings.

Today, we bring you a podcast featuring insights from Blue Cross and Blue Shield of North Carolina. Sonny Goyal, chief strategy officer at Blue Cross NC, discusses some top priorities, as well as the insurer’s multiple investments in primary care and the workforce to improve value-based care.

Today we are bringing you a conversation between 3 experts on precision medicine in non–small cell lung cancer (NSCLC). Martin Socinski, MD, executive director of the AdventHealth Cancer Institute, spoke with Martin Dietrich, MD, PhD, medical oncologist of Florida Cancer Specialists and Research Institute, and Joshua Sabari, MD, medical oncologist with NYU Langone Health Perlmutter Cancer Center and assistant progessor in the Department of Medicine at NYU Grossman School of Medicine. The topics of conversation for today’s podcast include how precision medicine in NSCLC for patients with driver mutations, current immunotherapies for patients lacking driver mutations, and more.

Today we are bringing you part 2 of a 2-part podcast series on opportunities for biosimilars, specifically adalimumab biosimilars, in dermatology, gastroenterology, and rheumatology. The discussion was moderated by Ryan Haumschild, PharmD, director of Pharmacy Services at Emory Healthcare and Winship Cancer Institute. The topics of conversation for today’s podcast include implementation of biosimilars in patients with no history of reference biologic use, insights on switching patients from the reference to the biosimilar, auto-substitution, impact of biosimilar utilization on payers and pharmacy benefit managers, and more.

Today we are bringing you part 1 of a 2-part podcast series on opportunities for biosimilars, specifically adalimumab biosimilars, in dermatology, gastroenterology, and rheumatology. The discussion was moderated by Ryan Haumschild, PharmD, director of Pharmacy Services at Emory Healthcare and Winship Cancer Institute. The topics of conversation for today’s podcast include the provider and payer considerations for transitioning patients to biosimliars, challenges associated with biosimilars, approaches to prescribing biosimilars over reference products, and more.

On this episode of Managed Care Cast, Emily Goldberg, MS, CGC, genetic counselor at JScreen, breaks down how genetic screening for breast cancer works and why it is so important to increase awareness and education around these screening tools available to patients who may be at risk for cancer.

Lucio Gordan, MD, president and managing physician of Florida Cancer Specialists & Research Institute, discusses recently updated clinical guidelines from the National Comprehensive Cancer Network (NCCN) in multiple myeloma, which specifically discuss disease staging and risk stratification and advise clinicians on how to address 1q abnormalities.

A biomedical engineer by education, Shah spent the first 5 years of his professional career as practice administrator and business manager at Gettysburg Cancer Center, working with his father, a community oncologist. From there, he moved to Flatiron Health and in July of 2017, helped to found OneOncology. Thyme Care was founded in July of 2020, and in August of this year announced a successful $60 million Series B round of investment capital. Also an angel investor, this entrepreneur in oncology care innovation has been guided by a patient-first mentality and the principal goal of positively changing how patients experience the cancer care system.

On this episode of Managed Care Cast, we speak with the senior author of a study published in the September 2023 issue of The American Journal of Managed Care® on the importance of adequate and effective lung cancer risk factor documentation to determine a patient's eligibility for screening. Farhood Farjah, MD, MPH, FACS, is thoracic surgeon at the University of Washington, and a senior investigator of the study, “Factors Associated With Lung Cancer Risk Factor Documentation.”

In part 2 of this 2-part podcast, a panel of experts discusses challenges with biosimilar uptake, interchangeability studies, patient and provider education.

Florida Cancer Specialists & Research Institute's (FCS') Nathan Walcker, chief executive office at FCS, discusses some key strategic practices and initiatives in providing high quality community-based oncology care he has implemented at FCS.