- Center on Health Equity & Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
Episode 6 - Recommended Guidelines and Payer Challenges
Treatment guidelines are now recognizing and suggesting immunotherapy for the treatment of several types of cancer.
However, Jeffrey Weber, MD, PhD, explains that the unspoken issue in regard to immunotherapies is that most are investigational. With respect to a payer covering treatment, in different states throughout the country, some will cover research-related costs and some will not.
As the panelists discuss how coverage inconsistencies, or the lack of coverage altogether, challenges providers to offer treatment as suggested by important NCCN guidelines, Daniel J. George, MD, concludes that there is no real way to develop a standard policy without reviewing each case individually.
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
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
NCCN Data Find Racial, Socioeconomic Disparities in Quality of Care for Metastatic Pancreatic Cancer
April 9th 2025New data from the National Comprehensive Cancer Network (NCCN) reveal that socially vulnerable and minority patients with metastatic pancreatic cancer are less likely to receive recommended treatments and achieve longer survival.
Read More
