Mary Caffrey is the Executive Editor for The American Journal of Managed Care® (AJMC®). She joined AJMC® in 2013 and is the primary staff editor for Evidence-Based Oncology, the multistakeholder publication that reaches 22,000+ oncology providers, policy makers and formulary decision makers. She is also part of the team that oversees speaker recruitment and panel preparations for AJMC®'s premier annual oncology meeting, Patient-Centered Oncology Care®. For more than a decade, Mary has covered ASCO, ASH, ACC and other leading scientific meetings for AJMC readers.
Mary has a BA in communications and philosophy from Loyola University New Orleans. You can connect with Mary on LinkedIn.
Bringing Care Coordination to the Fight for Recovery From Opioids
February 26th 2018A symposium at Seton Hall Law School examined the role of care coordination and transitions in helping those with substance use disorder find success in treatment. Some experts say that managed care has not supported care coodination despite evidence that it works and ultimately saves money for health systems.
With Approval of CAR T-Cell Therapy Comes the Next Challenge: Payer Coverage
February 22nd 2018CAR T- cell therapies are among the most expensive ever invented. For now, there’s a lot of uncertainty, as both government and commercial insurers, and a handful of the nation’s leading cancer centers, navigate a reimbursement structure that truly has no precedent.
The Clinical Trial and the Patient's Voice: "I'm Extremely Lucky to Be Alive"
February 21st 2018Two stories--of taking part in clinical trials, and of serving as a voice for patients among scientists who run them--highlight how the advances in cancer are built on the trust between those living with the disease and the clinicians on the frontiers of care.
Value-Based Programs Bring Positive Financial Results, Yet Providers Tread Cautiously, Survey Finds
February 20th 2018A survey of healthcare executives finds that ongoing issues with interoperability are holding back the transition to value-based reimbursement mechanisms. Humana's Chief Medical Officer, Roy A. Beveridge, MD, said the healthcare system must demand the same level of seamlessness seen in the banking industry.
Medicare Continues to Fight CGM Coverage in Court, and Told to Pay
February 3rd 2018Despite an official policy since early 2017 that calls for Medicare to cover CGM for certain beneficiaries with diabetes, an attorney who won a landmark case prior to the policy change reports that beneficiaries are still being denied coverage.
Omada Health Diabetes Prevention Trial to Track Healthcare Utilization
January 29th 2018Officials at Omada Health said the PREDICTS trial was planned long before CMS decided not to include virtual providers in this spring's launch of the Medicare Diabetes Prevention Program. But a spokesperson said the company hopes the growing body of evidence in support of virtual programs will "assuage any concerns."
ODYSSEY Outcomes Results for Sanofi's Praluent to Lead Off ACC Meeting
January 25th 2018The annual meeting of the American College of Cardiology (ACC), which runs March 10-12, 2018, in Orlando, Florida, will open with cardiovascular outcomes results for the PCSK9 inhibitor alirocumab (Praluent). The meeting also features updates on anti-inflammatory drugs, the use of SGLT2 inhibitors in heart failure, and how cardiology is shifting to new healthcare delivery models.
Study Finds Prior Authorization Mandates for PCSK9 Drugs Raise Questions of Access
January 20th 2018Researchers were especially concerned about barriers for patients with familial hypercholesterolemia, whose needs would seem clear cut but who nonetheless faced costly hurdles, such as genetic testing.