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How Payers Can Use 4 Strategies to Ensure Opioid Use Disorder Care
On this episode of Managed Care Cast, we speak with the chief medical officer for Virginia’s Medicaid program about 4 ways payers can make sure that those with opioid use disorder get the treatment they need; the strategies are outlined in the March issue of The American Journal of Managed Care.
The upheaval created by the pandemic over the past year has particularly affected individuals struggling with opioid use disorder (OUD) and other substance use issues in the United States, which set an unfortunate record in the first half of last year. Over 81,000 people died of drug overdoses between June 2019 and May 2020, largely driven by illicit fentanyl, as synthetic opioid overdose deaths increased 38%.
The March issue of The American Journal of Managed Care® includes a commentary about how payers can meet the needs of patients who need care for OUD. Chethan Bachireddy, MD, MSc, the chief medical officer for Virginia’s Medicaid program, and coauthor Mishka Terplan, MD, MPH, outline 4 things that payers can do to make sure that patients can get the treatment they need, and what’s at risk if they don’t.
On this episode of Managed Care Cast, Bachireddy discusses the commentary, “Payer Strategies to Ensure Access to Care for Individuals With Opioid Use Disorder During COVID-19,” as well as how these strategies are being used in Virginia, where he continues to work one day a week as a primary care physician at Virginia Commonwealth University.
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ACOs’ Focus on Rooting Out Fraud Aligns With CMS Vision Under Oz
April 23rd 2025Accountable care organizations (ACOs) are increasingly playing the role of data sleuths as they identify and report trends of anomalous billing in hopes of salvaging their shared savings. This mission dovetails with that of CMS, which under the new administration plans to prioritize rooting out fraud, waste, and abuse.
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New Research Challenges Assumptions About Hospital-Physician Integration, Medicare Patient Mix
April 22nd 2025On this episode of Managed Care Cast, Brady Post, PhD, lead author of a study published in the April 2025 issue of The American Journal of Managed Care®, challenges the claim that hospital-employed physicians serve a more complex patient mix.
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Contributor: For Complex Cases, Continuity in Acute Care Is Necessary
April 23rd 2025For patients with complex needs and social challenges like unstable housing, the hospital has become their de facto medical home—yet each visit is a fragmented restart, without continuity, context, or a clear path forward.
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Personalized Care Key as Tirzepatide Use Expands Rapidly
April 15th 2025Using commercial insurance claims data and the US launch of tirzepatide as their dividing point, John Ostrominski, MD, Harvard Medical School, and his team studied trends in the use of both glucose-lowering and weight-lowering medications, comparing outcomes between adults with and without type 2 diabetes.
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