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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.
Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
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Impact of Hospital-Physician Integration on Medicare Patient Mix
April 11th 2025This study found no evidence that hospital employment of physicians resulted in physicians treating sicker patients, undercutting claims that hospital-employed physicians serve a higher-acuity patient mix.
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