Because managed care’s approach includes managing how dollars are spent on healthcare to ensure that patients can achieve a decent quality of life and live happy and healthy, the panelists discuss the importance of incorporating prevention programs into the country’s healthcare system.
Unfortunately, the panelists conclude that the prevalence of cardiometabolic disorders continues to rise. David Calabrese, RPh, MHP, explains that this is true in part because our country’s current healthcare system is not focused on providing for health, wellness, and preventive care for patients at risk for developing cardiometabolic events.
Obesity, now clarified as a disease by the American Association of Clinical Endocrinologists, is an example of a driver of cardiometabolic disease. Unfortunately, explains Yehuda Handelsman, MD, FACP, FACE, FNLA, there currently are no reimbursement programs set up for providers who manage obese patients.
However, Mr. Calabrese and Kenneth L. Schaecher, MD, FACP, CPC, explain how the Affordable Care Act and healthcare reform are beginning to shift payer programs toward preventive care.
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.
Listen
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.
Read More