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Jared is a freelance writer for The American Journal of Managed Care® (AJMC®), and previously worked as a senior editor for HCPLive® at MJH Life Sciences®.

He has an MA from University of Sioux Falls. You can connect with Jared on 

Articles

Chimeric antigen receptor T-cell therapies, along with bispecific antibodies, have changed the treatment paradigm for patients with relapsed or refractory mantle cell lymphoma.

CAR T-Cell Therapies, Bispecific Antibodies Usher in New Era in R/R MCL

A new analysis based on two prospective trials helps clarify the roles of chemotherapy and radiotherapy.

Trial Data Yield Risk-Based NRSTS Treatment Strategies

Chronic kidney disease now affects more than 788 million adults globally, with rising prevalence, increasing mortality, and substantial contributions to cardiovascular deaths

Global CKD Burden Nearly Doubles Since 1990, Reaching 788 Million Adults Worldwide

A study identified 32 dysregulated cytokines and 5 key signaling hubs in idiopathic pulmonary fibrosis (IPF), mapping a complex network of profibrotic pathways that may serve as future therapeutic targets.

New Proteomic Analysis Maps Cytokine Signatures Driving IPF

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1rem

Topic

On this episode of Managed Care Cast, we dive into 

, or RTM, a topic of great interest in the physical rehabilitation industry. We are joined by Donovan Campbell, CEO of Medbridge, a leading provider of physical therapy education, currently serving approximately 360,000 clinicians and supporting 15 million patients annually.

 as part of the Calendar Year 2026 Physician Fee Schedule (CMS-1832-P), recognizing that RTM is critical for supporting physical therapy, patient health, and patient engagement. At its core, RTM is the fusion of in-person care with convenient, digitally provided care—a core component of what is known as hybrid care.

With CMS proposing new codes that materially 

—including the potential shift to allowing billing after just 2 days of data transmission—RTM has the opportunity to move from a niche category to a mainstream model of care delivery.

We will explore how this shift provides a crucial financial incentive for organizations, but more importantly, how the successful adoption of RTM enhances the clinical value proposition by improving population health, lowering overall costs, and tackling the problem of access barriers to conservative care.

Listen above or on one of these podcast services:

Medbridge is working to refine remote therapeutic monitoring, or RTM, to transform physical therapy and enhance patient care.

From Niche to Mainstream: Transforming Physical Therapy by Refining Remote Therapeutic Monitoring

 talks with Barbara Kelley, executive director of the Hearing Loss 

Association of America. In the conversation, we discuss her organization's role in advocating for hearing loss awareness, breaking down 

, and empowering individuals through legislation and public 

. Kelley also highlights the importance of early intervention, advancements in hearing technology, and the social and 

 faced by individuals with hearing loss, advocating for better hearing health integration into overall wellness.

To learn more about integrating audiological care, psychological support, and mental health resources alongside hearing loss awareness, please click to read 

Discover how the Hearing Loss Association of America advocates for hearing loss awareness and hearing health integration through a dialogue with Barbara Kelley, executive director.

Advocacy, Access, and Awareness: Addressing Barriers in Hearing Health

) speaks with Laxmi Patel, chief strategy officer at Savista, about how the proposed federal Budget Reconciliation Act could 

, rural hospital dependence, or provider tax funding could face the most immediate disruptions and what payers can do to prepare.

, this conversation explores how coverage loss, 

, and administrative burdens may evolve if these reforms move forward—and what proactive, 

Laxmi Patel of Savista discusses how the Budget Reconciliation Act could widen Medicaid coverage gaps and strain hospitals across states.

How Medicaid Reforms Could Deepen State Coverage Gaps

This podcast originally premiered on The Center for Biosimilars

. This version is the audio-only version.

In this insightful podcast episode, host Giuseppe Randazzo, senior vice president of sciences and regulatory affairs at the Association for Accessible Medicines (AAM), welcomes former Sandoz executive and biosimilar expert Hillel Cohen, PhD, to discuss the evolving world of biosimilars. The conversation covers the scientific and regulatory landscape, touching on the progress in streamlining biosimilar development, the importance of following scientific advancements, and the potential for harmonization in global health regulations.

This special vodcast series provided by The Center for Biosimilars was developed in partnership with the AAM and Biosimilars Council. Check out 

 of the series featuring a discussion between Giuseppe Randazzo and Craig Burton, former executive director of the Biosimilars Council and current senior vice president of government affairs and policy at Fresenius Kabi.



Jeremias S. The Biosimilar Void: 90% of Biologics Coming Off Patent Will Lack Biosimilars. February 5, 2025. Accessed May 3, 2025. 

https://www.centerforbiosimilars.com/view/the-biosimilar-void-90-of-biologics-coming-off-patent-will-lack-biosimilars

Follow the Science: Bridging the Biosimilar Gap With Dr Hillel Cohen

Precision medicine has long shaped cancer care by tailoring treatment to the molecular profile of a patient’s tumor. But Sadie Dobrozsi, MD, medical director for genetic testing and oncology imaging at Evolent, says predictive genomics goes deeper, integrating a patient’s genetic makeup, family history, environment, and overall health to guide both risk reduction and treatment decisions.

Dobrozsi explains how predictive genomics 

 individuals with inherited mutations, such as 

, that increase cancer risk. This enables personalized risk-reduction strategies, ranging from enhanced screening, like breast MRI, to preventive surgery. While payer coverage for germline testing and screening has improved, coverage for more invasive interventions still varies.

Predictive genomics also shapes treatment planning, not only identifying which therapies may work but also who might avoid unnecessary toxicity. Genomic signatures in tumors can determine the need for chemotherapy in early-stage breast cancer or guide the use of targeted agents like PARP inhibitors in 

An emerging area, pharmacogenomics, may further refine treatment by revealing how individuals metabolize drugs, helping avoid ineffective dosing or severe adverse effects. However, Dobrozsi explains the field faces barriers, including data overload, ancestry bias in genetic databases, and inconsistent insurance reimbursement, especially for newer tools like circulating tumor DNA tests.

Evolent plays a key role by aligning clinical evidence with payer policy. Dobrozsi says her team evaluates test quality and relevance, helping health plans streamline access to the most clinically meaningful diagnostics.

As predictive genomics evolves, the goal is clear: “right-sizing” cancer therapy for each individual, using evidence to improve outcomes while minimizing harm.

Sadie Dobrozsi, MD, of Evolent, discusses how predictive genomics is pushing cancer care into a new era of personalization

Navigating Risk, Treatment, and Reimbursement in Precision Oncology: Sadie Dobrozsi, MD 

RFK Jr Sued by Medical Societies Over Unlawful COVID-19 Vaccine Rollbacks

Six major medical organizations and a pregnant physician have filed a lawsuit against HHS Secretary Robert F. Kennedy Jr, alleging that his removal of COVID-19 vaccine recommendations for pregnant individuals and children was unlawful, unscientific, and dangerous. Filed on July 7, 2025, in the U.S. District Court for Massachusetts, the suit argues Kennedy bypassed standard federal procedures and undermined expert guidance by dissolving the CDC’s vaccine advisory committee and replacing members with vaccine skeptics. The plaintiffs, including the American Academy of Pediatrics, American College of Physicians, and Society for Maternal-Fetal Medicine, warn that Kennedy’s actions are eroding public trust, spreading misinformation, and jeopardizing maternal and child health. They are seeking injunctions to halt the changes and restore science-based policy, emphasizing that Kennedy’s unilateral moves threaten decades of established vaccine infrastructure and the physician-patient relationship.

How AI Can Address the Troubled Business Model in Oncology

Over the past 15 years, oncology has experienced a technological revolution, from the adoption of electronic health records under the Affordable Care Act to today's emerging use of artificial intelligence (AI) to address mounting clinical and operational challenges. While groundbreaking therapies like CAR T-cell treatment and supportive services like navigation and palliative care have advanced care, community oncology practices now face a crisis: growing staff shortages, declining Medicare reimbursement, and increasing burnout. At a June 2025 meeting hosted by Tennessee Oncology, leaders highlighted how AI is no longer a future concept but a practical solution, helping streamline operations, support clinical decisions, and ease documentation burdens. Tools like Flatiron Assist, OncoSmart, and DeepScribe are enabling practices to deliver high-quality care more efficiently despite fewer resources. As costs rise and workforce gaps widen, AI may be the key to sustaining and expanding the gains of the past decade.

Insurance Gaps Threaten Cancer Treatment Success

A new cross-sectional study reveals that while immune checkpoint inhibitors (ICIs) have improved survival for patients with stage IV melanoma, non–small cell lung cancer (NSCLC), and renal cell carcinoma (RCC), the benefits are not evenly distributed across insurance types. Patients with private insurance experienced greater survival gains compared with those on Medicaid or uninsured, highlighting widening disparities despite widespread ICI adoption. The study analyzed data from over 183,000 patients between 2002 and 2019 and found that while survival rates improved across all groups after ICI approval, gaps persisted—and in some cases widened—especially for the uninsured. The findings suggest that expanding Medicaid coverage and offering financial assistance and patient navigation programs may help close these gaps. However, limitations such as a lack of data on cancer-specific mortality and insurance changes during treatment highlight the need for further research to understand and address the inequities in access and outcomes.

Without IRA Fix, COA Warns Community Oncology Practices Will Shut Down

The Community Oncology Alliance (COA) has issued a warning that provisions of the Inflation Reduction Act (IRA) could severely undermine community oncology practices unless Congress or CMS intervenes. In a detailed letter to CMS, COA criticized the upcoming shift in Medicare Part B drug reimbursement—from the current average sales price (ASP) plus 6% model to a lower "Maximum Fair Price" (MFP) plus 6%—as financially devastating, particularly for practices administering high-cost cancer therapies. COA also raised concerns about the operational burden of managing separate drug inventories and the increased costs tied to manufacturer rebate options. Combined with recent cuts to physician payments, fallout from the Change Healthcare cyberattack, and longstanding challenges like prior authorization and competition from 340B hospitals, COA argues the system is nearing a breaking point. The group is advocating for a legislative “carve out” to protect providers or, failing that, for CMS to use its authority to mitigate harm. COA leaders stressed the urgency of action ahead of 2028, when the IRA’s Part B price negotiation rules take effect, warning that smaller oncology practices may not survive without meaningful reform.

Practical Considerations for AI in Community Oncology

At a recent “Tech Innovations in Community Oncology” event, experts debated whether artificial intelligence (AI) can meaningfully improve daily oncology practice, amid skepticism rooted in past disappointments with electronic health records. Panelists highlighted how modern AI can now proactively analyze vast data sets, identify care gaps, and personalize treatment decisions, potentially easing physician workloads and improving patient outcomes. However, challenges remain, including data standardization, equitable access, funding, and ensuring clinical accuracy. Speakers emphasized that AI must remain a supportive tool, not a decision-maker, with validation and oversight shared across the health care ecosystem. While AI holds promise for transforming oncology care and reducing inefficiencies, success will depend on responsible adoption, robust infrastructure, and collaboration among providers, payers, and technology developers.

Medical societies challenge HHS Secretary Robert F. Kennedy Jr's COVID-19 vaccine rollbacks, and more news updates from the week. 

Managed Care Cast News Roundup: July 8, 2025

A recent national analysis commissioned by the Path Forward coalition reveals promising but disparate progress in expanding access to the Collaborative Care Model (CoCM). Anna Bobb, MPH, executive director of the Path Forward coalition, which unites health care stakeholders around actionable solutions to expand equitable access to 

 care, discusses how the proven, team-based approach that integrates mental health screening, treatment, and psychiatric consultation directly into primary care can help address the current mental health crisis.

, conducted by an independent global data firm for the Meadows Mental Health Policy Institute, examined 5 years of claims data for 219 million Americans, representing nearly two-thirds of the US population. It found a 10-fold increase in the use of the CoCM among commercially insured individuals from 2018 to 2023. Despite this growth, access remains limited: only an estimated 100,000 people with commercial insurance received care through the CoCM last year, representing less than 1% of the nearly 60 million adults and children with mild to moderate mental health conditions who could benefit.

The CoCM is available in all 50 states and has been shown to reduce depression recovery times 7-fold and improve patient outcomes through a collaborative team led by primary care providers and supported by behavioral health care managers and psychiatric consultants. More than 90 randomized controlled trials have demonstrated its effectiveness, yet start-up costs and uneven reimbursement remain major barriers to widespread adoption.

Path Forward, in partnership with the Meadows Institute and the American Psychiatric Association, released supporting materials, including 

 of coverage, and urged lawmakers to pass the bipartisan COMPLETE Care Act. This 

 would boost Medicare reimbursement for the CoCM, helping overcome initial implementation costs.

Explore how the Collaborative Care Model enhances mental health access in this episode featuring Anna Bobb, MPH, executive director of the Path Forward coalition. 

Why Collaborative Care Is the Path Forward for Mental Health Care: Anna Bobb, MPH

Today, we’re diving into the frustrating world of prior authorizations. Delays, denials, and endless paperwork—this process isn’t just a headache for providers; it’s a barrier for patients who need timely care.

Joining us is Colin Banas, MD, MHA, chief medical officer at DrFirst, who willl unpack why this system is broken and how we can fix it. From shocking patient delays to the surprising role of fax machines in 2025, we’ll explore why prior auths are driving burnout, potentially harming outcomes, and what’s being done to streamline the process.

Whether you’re a provider, patient, or just curious about health care’s hidden hurdles—stick around. This is one episode you won’t want to miss.

Delays, denials, and endless paperwork—prior authorization isn’t just a headache for providers; it’s a barrier for patients who need timely care, explains Colin Banas, MD, MHA, chief medical officer with DrFirst.

Stuck in Prior Auth Purgatory: The Hidden Costs of Health Care Delays

Is the Employer Health Care Tax Exclusion Safe? Kerris Willis Shares Insight From American Benefits Council

2025 Greater Philadelphia Business Coalition on Health

 Annual Conference, Kerri Willis of the American Benefits Council outlined a shifting federal health policy landscape that presents both risks and opportunities for employer-sponsored health plans. With a Republican-led Congress and White House pursuing reconciliation legislation to advance tax and spending priorities, Willis highlighted that proposed changes—such as limiting the tax exclusion for employer-sponsored insurance—could have far-reaching economic consequences. Although the current House bill spares this exclusion, employers remain on alert for potential Senate revisions. Other updates include codifying individual coverage Health Reimbursement Arrangements (HRAs), easing Health Savings Account (HSA) restrictions, and adjusting agency enforcement amid staff cuts.

Supreme Court to Rule Whether Pro-Life Pregnancy Center Can Avoid Subpoena

The US Supreme Court has agreed to hear a case involving First Choice Women’s Resource Centers, a faith-based pregnancy center in New Jersey, which is challenging a subpoena from state Attorney General Matthew Platkin seeking information on its operations, including donors and marketing practices. The investigation, based on New Jersey’s Consumer Fraud Act, centers on whether the center misled the public about offering abortion referrals. While the legal question before the Court is procedural—whether the center sued prematurely—First Choice argues the subpoena violates its First Amendment rights. The case comes amid heightened national debate over abortion access following the overturning of 

Disparities, Worsening Inequality of Growing RA Burden, Reveals AI-Driven Study

 finds that rheumatoid arthritis (RA) has significantly increased worldwide since 1980, with a 13.2% rise in incidence from 1990 to 2021, and the burden is expected to grow through 2040, especially in aging and underserved populations. Using AI to analyze data from nearly 1000 locations, researchers identified widening disparities in RA incidence and disability, particularly in high- and high-middle income countries, with notable "hotspots" in parts of North America, Western Europe, and mountainous regions of Latin America. While the standardized death rate from RA has declined, the disability burden has risen, with younger adults increasingly affected. Japan stands out as an exception, showing declines in disability due to early detection, biologics access, and anti-inflammatory diets. Researchers call for precision public health strategies, including screening, biologic access, smoking cessation, and targeted local interventions, to curb rising RA-related inequalities and improve outcomes globally.

Vaccine Skeptics Among CDC Vaccine Panel Replacements Named by RFK Jr

HHS Secretary Robert F. Kennedy Jr has replaced all 17 members of the CDC’s Advisory Committee on Immunization Practices (ACIP) with 8 new appointees, several of whom have expressed antivaccine views, sparking concern among public health experts. Kennedy claims the move aims to restore public trust and eliminate conflicts of interest, though critics argue it signals a shift toward vaccine skepticism. Notable appointees include Robert Malone and Martin Kulldorff, both known for spreading misinformation about COVID-19 vaccines, along with others linked to controversial claims or organizations that question vaccine safety. Experts warn the new committee lacks sufficient expertise in immunization and may undermine public health guidance. The new ACIP is set to meet for the first time on June 25.

Outcomes for Hospitals Participating in More- and Less-Mature ACOs

A new study evaluated whether hospitals participating in CMS Accountable Care Organizations (ACOs) improve inpatient performance as their ACO maturity increases. Researchers found that hospitals with no ACO maturity had significantly worse outcomes, specifically higher acute myocardial infarction mortality and perioperative pulmonary embolism or deep vein thrombosis rates, compared with nonparticipants, but these differences diminished with increasing ACO maturity. More mature ACOs were associated with reduced accidental punctures or lacerations, though improvements in other inpatient outcomes and cost reductions were limited or statistically insignificant. The study suggests that early ACO efforts focused more on outpatient care coordination than on inpatient transformation, and that meaningful improvements in hospital performance may take longer than two years to materialize. While ACO maturity showed some promise, limitations such as short follow-up, outdated data, and the narrow focus of quality metrics highlight the need for further research. 

A quick roundup episode of major news and health policy developments from The American Journal of Managed Care. 

Managed Care Cast News Roundup: June 17, 2025

CDC Pulls COVID-19 Vaccine Recommendation for Pregnant Women, Healthy Children

HHS Secretary Robert F. Kennedy, Jr, announced that the CDC will no longer recommend routine COVID-19 vaccines for healthy children and pregnant women, a move supported by leaders of the FDA and National Institutes of Health (NIH). However, the CDC’s website still lists COVID-19 vaccination as recommended for these groups, citing studies that show vaccination during pregnancy can protect both mother and infant from severe illness.

The announcement coincides with the emergence of a new COVID-19 variant, NB.1.8.1, spreading in the US, and follows a recent proposal from FDA officials to require randomized controlled trials for COVID-19 vaccines in healthy individuals under 65 years before broader approvals are granted. Notably, the CDC’s Advisory Committee did not vote on the reported schedule change.

ACP Experts Say FDA, CDC Moves May Undermine COVID-19 Vaccine Coverage for Millions

A new commentary published yesterday by leaders of the American College of Physicians (ACP) warns against the increasing politicization of science and public health, calling for humility, transparency, and inclusivity in future crisis responses. Reflecting on the COVID-19 pandemic, the authors highlight how political influence and misinformation eroded public trust, particularly around vaccination. They criticize recent federal decisions that complicate access to COVID-19 vaccines, as the Affordable Care Act (ACA) requires insurers to cover all Advisory Committee on Immunization Practices (ACIP)–recommended vaccines. The FDA's recent limit on COVID-19 booster vaccines and the CDC's lack of recommendations for young children and pregnant women complicate ACIP's ability to approve off-label vaccine use.

Stressing that public health should prioritize both scientific rigor and real-world context, the authors advocate for a risk-based approach that considers social and caregiving factors, not just clinical ones, and affirm the need to safeguard individual autonomy in health care decision-making.

RFK Jr Suggests Creating “In-House” Publications for Government Scientists

Kennedy is reportedly planning to ban government scientists from publishing in leading medical journals such as

, claiming they are corrupted by pharmaceutical interests. Instead, Kennedy proposes creating new, in-house, government-run journals for federally funded research, arguing NIH funding alone proves scientific legitimacy.

Critics, including public health experts, warn this move could undermine scientific credibility, limit peer review, and politicize medical research. The proposal follows significant research funding cuts under the Trump administration, heightening concerns about government overreach in shaping science.

Contributor: Beyond the Sloganeering—A Data-Driven Analysis of Recent 340B Growth

The 340B Drug Discount Program has grown rapidly, reaching $148 billion in 2024, despite a shrinking vulnerable patient population. Critics, including insurers and employers, argue that hospitals are driving growth through profit-driven strategies, especially with high-cost specialty drugs. Although 340B advocates blame drug price inflation, a comprehensive analysis found that from 2018 to 2024, the overwhelming majority of the program’s growth—over 79% at list price and over 100% at discounted prices—was due to increased utilization, not price hikes. Even among top-selling drugs and those with high price increases, utilization remained the primary driver.

A quick roundup episode of major health policy developments, from shifting COVID-19 vaccine guidance and scientific publishing controversies to rising cancer care costs and the impact of oncology biosimilars.

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