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Episode 12 - Recognizing the Strengths and Weaknesses of Current Clinical Practice Guidelines
As Patrick F. Fogarty, MD, briefly discusses the improvements in the length of time of which new factor 8 and factor 9 protein products extend treatment for hemophilia patients and stresses why it is important for clinicians to work together to ensure that their patients have access to these longer-acting agents, the panelists consider issues that should be addressed by managed care professionals and clinicians.
From an economic standpoint, Hugh Fatodu, RPh, MBA, explains that longer-acting agents lead to more product waste and states that a large amount of unused product sits inside the patient’s home. However, he believes that specialty pharmacies can help improve the amount of inventory that is provided to patients.
Maria Lopes, MD, MS, and Mr Fatodu explain that to improve the amount of protein product administered to the patient and to reduce the amount of product waste, it is key to determine how much of the drug is necessary to the patient and develop a fair balance plan.
Dr Lopes and Mr Fatodu explain that the end result of practicing fair balance should minimize waste by recommending lower dosage requirements, yet should ensure that patients do not have bleeding episodes.
AI in Health Care: Closing the Revenue Cycle Gap
April 1st 2025This commentary explores the current state, challenges, and potential of artificial intelligence (AI) in health care revenue cycle management, emphasizing collaboration, data standardization, and targeted implementation to enhance adoption.
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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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Managed Care Reflections: A Q&A With Hoangmai H. Pham, MD, MPH
April 1st 2025To mark the 30th anniversary of The American Journal of Managed Care® (AJMC®), each issue in 2025 will include a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The April issue features a conversation with Hoangmai H. Pham, MD, MPH, a member of AJMC’s editorial board and the president and CEO of the Institute for Exceptional Care (IEC).
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Bridging Care Gaps With a Systemwide Value-Based Care Strategy
March 29th 2025Mapping care management needs by defining patient populations and then stratifying them according to risk and their needs can help to spur the transformation of a siloed health care system into an integrated system that is able to better provide holistic, value-based care despite the many transitions that continue among hospital, primary, specialty, and community care environments.
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