Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.
Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.
This week, the top managed care stories included CMS outlining a plan to encourage Medicare accountable care organizations to take on more risk, faster; a study found substantial growth in Medicaid managed care enrollment; an analysis showed nearly 1 in 5 inpatient hospital stays includes a claim from an out-of-network provider.
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CMS Plans to Overhaul MSSP Program to Force More Risk on ACOs
CMS Proposal Is a Start for Making Risk More Appealing to ACOs
Medicaid Managed Care Grew Substantially From 1999 to 2012
Nearly 1 in 5 Inpatient Admissions Includes a Claim From an Out-of-Network Provider
CVS Will Rely on ICER Data as It Seeks to Curb Costs, Implement "Zero-Dollar Drug List"
What We're Reading: Ark. Work Requirements Lawsuit; CVS' Cost Savings Plan; Kavanaugh and Healthcare
Choosing Wisely Clinical Decision Support Adherence and Associated Inpatient Outcomes
Read more about the stories in this podcast:
Sequencing CAR T and Bispecifics for Multiple Myeloma: Tyler Sandahl, PharmD
July 8th 2025Tyler Sandahl, PharmD, a clinical pharmacist at Mayo Clinic, explains that sequencing novel multiple myeloma therapies with CAR T-cell therapy is generally prioritized first for eligible patients, while bispecific antibodies are reserved for later lines or for patients unable to tolerate CAR T.
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Driving Value via Outcomes-Based Pricing and EHR Interoperability: Tyler Sandahl, PharmD
July 7th 2025Tyler Sandahl, PharmD, a clinical pharmacist at Mayo Clinic, discussed the complexities of alternative payment models for chimeric antigen receptor T-cell and bispecific therapies and the need for improved data sharing in cancer care.
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Insurance Gaps Threaten Cancer Treatment Success
July 7th 2025Access to and affordability of immune checkpoint inhibitors, which can be lifesaving if patients receive them on time and under optimal circumstances, continue to top the list of reasons behind outcomes disparities for patients who have private insurance vs those who remain uninsured.
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