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Examining How Mergers and Acquisitions Are Shaking Up Healthcare
December 19th 2018As we enter an era of megamergers like the one between CVS Health and Aetna, The American Journal of Managed Care® convened its Oncology Stakeholder Summit to discuss the history of mergers and acquisitions, the reasons behind them, and what they mean for different stakeholders.
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Using Cost Variation to Identify Savings Opportunities Under the OCM
December 14th 2018A study published in this month's issue of The American Journal of Managed Care® estimated standardized episode-level spending for patients across subcategories of care for each hospital referral region—defined by the Dartmouth Atlas—in order to identify the greatest opportunities for cost savings under the Oncology Care Model (OCM).
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The Impact of Group Purchasing Organizations on Healthcare Prices
December 13th 2018Who sets the price for medications and other supplies used in hospitals and why are there shortages of some of these items? Martin Makary, MD, MPH, a surgical oncologist and chief of the Johns Hopkins Islet Transplant Center as well as executive director of Choosing Wisely, discussed this issue and its ramifications for healthcare costs.
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Nationwide Children's Pediatrician Alex Kemper Discusses Review of ADHD Therapies
December 5th 2018Alex R. Kemper, MD, MPH, MS, discusses the key findings from a comparative effectiveness review called Attention Deficit Hyperactivity Disorder: Diagnosis and Treatment in Children and Adolescents from the Agency for Healthcare Research and Quality.
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Using Data to Combat the Opioid Epidemic
November 28th 2018As the opioid epidemic continues to claim tens of thousands of lives each years, stakeholders from around the country are launching efforts to enforce appropriate prescribing patterns and identify those most at risk for opioid misuse and abuse.
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Susan Dentzer Discusses Breaking Down Walls and Reinventing Healthcare
November 21st 2018A lot of healthcare is simply exchange of information, but the current healthcare system doesn’t allow for that exchange to happen in a convenient way. The Network for Excellence in Health Innovation (NEHI) has released a new roadmap that reinvents healthcare in the United States through the use of technology.
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Using Community-Based Care Management to Lower Service Use, Spending Among High-Risk Patients
November 16th 2018This month's issue of The American Journal of Managed Care® features a study that examined the effectiveness of a high-intensity, community-based care management program for Medicare patients with complex medical and social needs. We sat down with 2 of the study's researchers—Purvi Sevak, PhD, senior researcher at Mathematica, and Cara Stepanczuk, MPA, researcher in the health unit at Mathematica—to discuss the study findings and their implications.
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CGRP Inhibitors: A Promising New Class of Drugs for Migraine
November 14th 2018This fall, The American Journal of Managed Care® convened a panel of experts on migraine to discuss calcitonin gene-related peptide (CGRP) inhibitors, an emerging therapy for the condition, which affects 39 million people in the United States.
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Heard at Psych Congress: Clinical Impacts of Stigma Surrounding Mental Illness
November 6th 2018During Psych Congress 2018, we sat down with several clinicians to get insight into the prevalence of internal and external stigma in mental illness and how this stigma creates barriers to positive clinical outcomes.
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Dr Barbara McAneny Discusses New Payment Models, Transforming Care, and the AMA
October 30th 2018Recently, Barbara McAneny, MD, the current president of the American Medical Association (AMA), visited The American Journal of Managed Care®’s office for a wide-ranging discussion on new payment models, transforming care, and the work of the AMA.
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Looking Back at CAR T: PROs From a Patient's Perspective
October 23rd 2018A survivor of chronic lymphocytic leukemia who participated in the first chimeric antigen receptor T-cell trial in 2010 looks back at his experience and also discusses his views on how patient-reported outcomes (PROs) should be used, if at all, by CMS.
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Examining Health-Related Challenges Puerto Rico Faces a Year After Hurricane Maria
October 17th 2018It's been a little over a year since Hurrican Maria hit Puerto Rico, devastating the island, its infrastructure, and its health system. While progress has been made, the island still faces challenges in providing high-quality care to its 3 million people.
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Heard at NAACOS: Focus on Proposed MSSP Changes
October 10th 2018CMS’ accountable care organization program, the Medicare Shared Savings Program (MSSP), could potentially be undergoing some big changes. During the recent fall 2018 meeting of the National Association of ACOs (NAACOS), the proposed changes were top of mind. Attendees were most concerned about how the faster timeline to taking on risk would impact participation, but were pleased with changes to the benchmark and risk adjustment.
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Employers Take a Vested Interest in Healthcare
October 3rd 2018Employers may not look forward to purchasing healthcare, but they are in the position to transform the market. More employers are getting more involved in healthcare by championing alternative payment models and other services to their employees.
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