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Investigating How Care Fragmentation May Affect Primary Care Redesign in Medicare
On this episode of Managed Care Cast, Lori Timmins, PhD, and Eugene Rich, MD, discuss the findings of their interim analysis of data from the first 3 years of the Comprehensive Primary Care Plus Initiative, a large-scale effort of primary care redesign meant to improve care fragmentation among Medicare fee-for-service beneficiaries.
CMS first implemented the Comprehensive Primary Care Plus, or CPC+, Initiative in January 2017. The medical home model is a large-scale redesign effort meant to improve primary care through payer reform and care delivery transformation. However, an interim data analysis of the initiative’s first 3 years among Medicare fee-for-service beneficiaries did not demonstrate improvements in either care continuity or care fragmentation.
On this episode of Managed Care Cast, we speak with Lori Timmins, PhD, senior researcher, and Eugene Rich, MD, senior fellow, both of Mathematica. With their fellow authors, Carol Urato, MA, researcher at Mathematica; Lisa M. Kern, MD, MPH, associate professor of medicine at Weill Cornell Medicine in New York; and Arkadipta Ghosh, PhD, principal researcher at Mathematica, they published their study, “Primary Care Redesign and Care Fragmentation Among Medicare Beneficiaries,” in the March issue of The American Journal of Managed Care®.
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Areas of Unmet Need Continue to Burden Patients With gMG
April 2nd 2025Patient-reported outcomes measures in generalized myasthenia gravis (gMG) are more important than ever, for both those treating and being treated for the chronic autoimmune neuromuscular disorder, to have a more nuanced understanding of experiences and difficulties.
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Navigating Sport-Related Neurospine Injuries, Surgery, and Managed Care
February 25th 2025On this episode of Managed Care Cast, we speak with Arthur L. Jenkins III, MD, FACS, CEO of Jenkins NeuroSpine, to explore the intersection of advanced surgical care for sport-related neurospine injuries and managed care systems.
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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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The IRA’s Unintended Consequences for Drug Pricing and Coverage
April 2nd 2025The Inflation Reduction Act (IRA) may be restricting Medicare Part D formularies, increasing patient costs, and stifling pharmaceutical innovation, experts warned at the Academy of Managed Care Pharmacy 2025 annual meeting.
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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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