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In this latest episode of Tuning In to the C-Suite podcast, Briana Contreras, an editor with MHE had the pleasure of meeting Loren McCaghy, director of consulting, health and consumer engagement and product insight at Accenture, to discuss the organization's latest report on U.S. consumers switching healthcare providers and insurance payers. One of those surveys were on payer experiences and the other on patient experiences. McCaghy shared that ease of interaction, rather than clinical experience, is a primary reason for switching. He stressed the importance of building trust through positive experiences and meeting patient needs digitally, starting with basic functionalities could help patient turnover.
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In our latest "Meet the Board" podcast episode, Managed Healthcare Executive Editors caught up with board member, Eric Hunter, CEO of Care Oregon, to discuss a number of topics, with one including the merger that never closed with SCAN Health Plan due to local opposition from Oregonians, emphasizing the need for partnerships to meet scaling and capital requirements.
On the other hand, Hunter also praised Oregon's careful Medicaid redetermination, resulting in a smaller enrollment decline than expected.
He also highlighted a new preventive medicine residency program with Oregon Health and Science University to improve healthcare for populations most at need.
Before concluding the conversation with a question on what public official or figure of past or present he'd love to sit down over dinner with, Hunter briefly covered cybersecurity challenges and the potential impact of healthcare issues in the upcoming election. -
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In the latest episode of the Meet the Board podcast series, Managing Editor, Peter Wehrwein, catches up with Chief Clinical Officer at Optum Rx and EAB member, David Calabrese, about his new role alongside his team's progress in improving quality, patient safety and health equity in healthcare. David highlights efforts to address pharmacy deserts and medication shortages; and the two discuss the challenges and future of retail pharmacies, the impact of cell and gene therapies and the rise of GLP-1 weight loss drugs, noting their cost and regulatory scrutiny. David also emphasized the importance of comprehensive patient support programs.
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In this month’s episode of Meet the Board, MHE’s Managing Editor Peter Wehrwein and spoke with a new member of our editorial advisory board, Marci J. Chodroff, MD, FACP, VP of Medical Affairs at Magellan Rx Management, a Prime Therapeutics company. The two discussed Chodroff's career transition from clinical practice to pharmacy benefits management, then crossed over to highlight challenges like Medicare regulations and the growth of specialty pharmacy, focusing on oncology and GLP-1 agonists. The conversation also touched on Magellan's acquisition by Prime Therapeutics and Chodroff's focus which remains on ensuring seamless healthcare access, especially for Medicare beneficiaries, and addressing emerging challenges like cell and gene therapies.
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In this episode, MHE's Peter Wehrwein spoke with Patrick Cooney, president of The Federal Group, discussing Washington's focus on Pharmacy Benefit Managers (PBMs). Cooney highlighted increased federal attention on PBMs, with legislative activity indicating bipartisan interest in reform. Despite recent setbacks in negotiations over PBM-related provisions, both Democrats and Republicans aim for transparency and change. Cooney also predicts eventual PBM legislation in 2024, emphasizing the bipartisan recognition of reform necessity.
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As we bring back our "Meet the Board" Series podcast series, Managed Healthcare Executive welcomes our newest Editorial Advisory Board member Greg Baker, CEO of AffirmedRx. In this conversation, Baker and Peter Wehrwein, MHE managing editor, discussed insights from Baker's career journey. Drawing from his experiences at Walgreens and Premise Health, Baker highlighted the importance of patient-centered care and process orientation. He discussed AffirmedRx's mission to bring transparency to the PBM industry through innovative approaches such as a cloud-based system and clinically-driven formulary. Expressing concerns about opaque pricing practices, he shared the need for industry reform and cautioned against the proliferation of corporate entities within PBMs.
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In this second part of a two-part podcast episode, Managed Healthcare Executive's Managing Editor Peter Wehrwein spoke with Ceci Connolly and Margaret "Meg" Murray about Medicare Advantage utilization and challenges, highlighting proposed CMS payment cuts and prior authorization issues. Murray emphasized MA's growth and benefits, while Connolly introduced MA for Tomorrow proposals. They also tackled drug pricing transparency concerns, Medicaid coverage challenges, and predicted affordability as a key issue in the 2024 elections.
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In this first part of a two-part podcast episode, Managed Healthcare Executive's Managing Editor Peter Wehrwein kicks off our new podcast series "DC Roundtable," with guests Margaret "Meg" Murray, CEO of the Association of Community Affiliated Plans, and member of MHE's Editorial Advisory Board, and CeCi Connolly, president and CEO of the Alliance of Community Health Plans, for a discussion on healthcare policy issues. The trio addressed the impact of Medicaid redetermination, emphasizing ongoing challenges and the need for policy flexibility. While recognizing the ACA's success in expanding access, they highlighted affordability concerns and partisan divides. The conversation also highlighted efforts to advocate for solutions prioritizing access, affordability and quality care.
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In this month’s episode of Tuning In to the C-Suite, Briana Contreras, an editor of Managed Healthcare Executive, got to chatting with Sanjula Jain, Ph.D., chief research officer at Trilliant Health.
In the conversation, Sanjula shared the concerning rise in cancer cases among those in their 30s and 40s, despite declining mortality rates. In this age range, neoplasm-related deaths are notably increasing, which could possibly be linked to pandemic-induced declines in primary care and screenings.
Sanjula added that rising cancer care costs and increased pharmaceutical investments highlight the need for a comprehensive approach in this space. -
In this month’s episode, Briana Contreras, an editor of MHE, chatted with Lynn Carroll, executive of HSBlox, about the difference between predictive and generative AI, yet how each works together in preventive healthcare. In the discussion, Carroll expressed the challenges and opportunities with generative AI in clinical documentation, pharmaceutical research, and medical device manufacturing. Also shared were strategies for aligning primary and specialty care in value-based initiatives, along with emerging use cases, best practices for Generative AI and much more.
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Briana Contreras, an editor of Managed Healthcare Executive, spoke with Fred Turner, CEO of Curative, in this month’s episode. The two talked about the challenges middle-class Americans face in dealing with medical debt, exploring the causes behind it and the impact on overall health. Fred also touched on potential solutions, both from the perspective of organizations like Curative and through collaborative efforts between various stakeholders in the healthcare system. The solutions mentioned in the conversation focus on making healthcare more financially accessible and creating a sustainable and inclusive healthcare system for all Americans.
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Briana Contreras, an editor with Managed Healthcare Executive, spoke with Harsha Rajasimha, MD, founder and executive chairman of IndoUSrare, in this month's episode of Tuning in to the C-Suite podcast. The conversation was about how the disparity in diversity and ethnicity in rare disease clinical trials in the U.S. has led to gaps in understanding diseases and conditions, jeopardizing universal health, and increasing the economic burden of healthcare. Dr. Rajasimha also shared some examples of rare diseases that have been affected most by the lack of diversity in clinical trials, but even some strategies or initiatives that are being implemented to address the diversity gap in rare disease clinical trials.
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Managing Editor of Managed Healthcare Executive, Peter Wehrwein, had a discussion with William Shrank, M.D., a venture partner with Andreessen Horowitz, a venture capital firm in Menlo Park, California, about how artificial intelligence's role is improving healthcare, where we are today with value-based care and the ongoing efforts of reducing waste in the healthcare space for this episode of the "What's on Your Mind" podcast series.
Shrank, a member of MHE's Editorial Advisory Board, also shared what has been "on his mind" as of late with Wehrwein. A topic that has been of focus includes personalized care and how it can result to better outcomes for that patient.
"We spend a lot of time thinking at a high level about how to optimize a health system, how to make sure patients have access to therapies and treatments and providers," Shrank said. "But the critical feature to anyone's health really has to do with 'what motivates them', 'what they get out of bed to focus on', what they want to be able to do that day, that week, that month, that year with their parents, their family, their children."
He added the barriers to health often aren't the issues that the healthcare system are focused on.
"There's a whole host of things that impact one's ability to achieve their best health," Shrank said. "Trying to make sure we have a health system and a way of delivering care that really meets people where they are and understands what their motivations are, what means the most to them, what challenges they face, is the job of a really effective healthcare system." -
Managed Healthcare Executive's Managing Editor Peter Wehrwein, and Editor Briana Contreras, had a discussion in July with Mostafa Kamal, president and CEO of Prime Therapeutics, an organization in which Kamal acquired this position in July 2023. Kamal addressed his newer role, plans for Prime, the company’s more recent acquisitions and previous partnerships and some of his thoughts on the multimillion gene therapies and price transparency from a PBM perspective.
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In this month’s episode, Briana Contreras, an editor of Managed Healthcare Executive, had the pleasure of catching up with MHE Editorial Advisory Board Member, Ateev Mehrotra, who is a professor of healthcare policy at Harvard Medical School and an Associate Professor of Medicine and Hospitalist at Beth Israel Deaconess Medical Center. What’s been on Ateev’s mind or has been a focus, lately, are most things in the digital health and telehealth space, as well as practice licensure in the U.S. Among many topics discussed in the conversation, Ateev shared his thoughts on the push for better virtual visit opportunities and the fact that insurers are now offering virtual first health plans with lower premiums.
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Welcome back to another episode of "Tuning In to the C-Suite," where Briana Contreras, an editor of Managed Healthcare Executive, had the pleasure of chatting with Cindy Gaines, chief clinical transformation officer at Lumeon. In the conversation the two mainly addressed how automation is filling in the gaps electronic health records are not able to meet and how these gaps are affecting staff, increased costs, workflows and more.
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Briana Contreras, an editor of Managed Healthcare Executive, spoke with Brian Adams, President and CEO of Tabula Rasa HealthCare, in this month's episode of Tuning In to the C-Suite podcast. In the episode, Brian and Briana got to chatting about value-based care and why the transition to this type of model has been slower than expected for some practices to adopt. Most of the discussion focused on Brian’s suggestion of simplifying and personalizing value-based care models to improve health outcomes for patients and reduce costs for organizations who’ve adopted these models.
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In this episode, Briana Contreras, an editor with Managed Healthcare Executive, and Peter Wehrwein, managing editor of MHE, got to chatting with the newest editorial advisory board member, Jeffrey Casberg, who is vice president of Clinical Pharmacy at IPD Analytics.
In the discussion, Casberg shared the most pressing or prominent issues on his mind, he explained what the drug life-cycle is at IPD, and what the latest is on drugs in the pipeline. Casberg also shared his predictions for Sarepta Therapeutics’ DMD drug for young children and Mounjaro’s Type 2 Diabetes Drug, and even touched on some common misconceptions he notices about drug approvals, pricing and cost. -
Briana Contreras, an editor of Managed Healthcare Executive, spoke with Leah Dewey, vice president of clinical and consumer engagement operations at Cotiviti, in this month’s podcast episode. In our discussion, Leah talked about what she’s seeing as the process of Medicaid Redetermination is well underway and some of the issues affecting consumers, as many are at risk of losing coverage. Leah also shared best practices for health plans when reaching out to consumers and ways to keep members informed and engaged in the redetermination process.
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