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Episode 10 - Drivers of Cost in Cardiometabolic Management
During this segment, the panelists discuss the highest drivers of cost when managing cardiometabolic disease. Michael Weber, MD, explains that adverse events cause costs to rise dramatically and Kenneth L. Schaecher, MD, FACP, CPC, clarifies the fact that from a managed care standpoint, the greatest proportion of dollars are spent on inpatient services.
David Calabrese, RPh, MHP, claims that 70% of the dollars spent today are used to manage factors associated with diabetes, including cardiovascular comorbidities, and explains that the dollars are used to try to prevent other negative sequalae from occurring down the road.
Additionally, the panelists explain that the topic of the costs associated with cardiometabolic management is controversial. Dr Schaecher explains that preventing cardiometabolic events can be more expensive than treating an event on a firsthand basis due to the costs of drugs for the treatment of long-term conditions, or risk factors.
Stuck in Prior Auth Purgatory: The Hidden Costs of Health Care Delays
June 19th 2025Delays, 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.
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From Red Tape to Relief: Rewriting the Rules of Prior Authorization
June 23rd 2025Up to 257 million Americans could benefit from these prior authorization reforms that could have cross-market implications on health care plans administered through commercial insurers, Medicare Advantage, and Medicaid.
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Moving Evidence From Research to Practice: Q&A With Ken Cohen, MD
June 23rd 2025In 2025, each issue of Population Health, Equity & Outcomes will feature a profile of a health system leader transforming care in their area of expertise. This issue spotlights a conversation with Ken Cohen, MD, executive director of translational research at Optum Health.
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