This Week in Managed Care: September 17, 2016

Hello, I’m Justin Gallagher, Associate Publisher of The American Journal of Managed Care. Welcome to This Week in Managed Care from the Managed Markets News Network.

Lavizzo-Mourey to Leave RWJF

Risa Lavizzo-Mourey, MD, MBA, who has served for 14 years as president and CEO of the Robert Wood Johnson Foundation, announced this week she will be stepping down as soon as a successor is named to lead the $10 billion private foundation.

In 2007, Lavizzo-Mourey committed $500 million to combat childhood obesity, which later became the top cause of First Lady Michelle Obama. She also worked to advance the Culture of Health, an initiative to give every American the chance to live a longer, healthier life.

Last year, Lavizzo-Mourey was among the special commentators for the 20th anniversary of The American Journal of Managed Care, and she spoke with AJMC about making the Culture of Health part of daily decision making. Watch the interview.

To read Lavizzo-Mourey’s commentary from our 20th anniversary series, click here.

Obesity on the Rise in the Military

A new report shows that while the problem of obesity is less severe in the armed services than the rest of the country, rates have climbed steadily in recent years. Military Times reported this week that the overall obesity rate for service members was 7.8% in December, up from 1.6% in 2001. Rates were higher among women, minorities, and older service members, according to the report.

There are many possible reasons for rising obesity in the military, including young people who are less active and low quality meals served to those on active duty. Too much obesity presents a problem for readiness, and members who don’t meet fitness standards might miss out on promotions or even be forced out of the service.

Fifteen years ago, only 21 states had obesity rates above 20%, but now every state is above that mark. The average obesity rate in the country is 36.5%, according to the CDC.

CMS Denies Ohio's Medicaid Changes

CMS has denied a request from Ohio to charge new Medicaid fees and impose penalties on beneficiaries who miss payments. Federal officials estimated that the changes would lead to 125,000 people losing coverage.

Ohio’s Governor, John Kasich, who supported Medicaid expansion against the wishes of his legislature had projected the changes would save taxpayers $1 billion.

The decision by CMS would seem to not bode well for a proposal from Kentucky’s new governor, Matt Bevin, who wants to charge small premiums for those who gained coverage under Medicaid expansion and suspend it for those who miss payments.

Nonadherence to Blood Pressure Medication

A report this week from the CDC offered the first county-by-county look at Medicare patients have poor adherence to high blood pressure medication.

Data from Medicare Part D showed that 26% of those over age 65 fail to take medication for high blood pressure at least 80% of the time, raising their risk for heart attacks or strokes. Minorities, the poor, and those in the Deep South had higher-than-average rates of nonadherence.

Out-of-pocket costs for seniors who hit the “donut hole” were definitely a factor, but not the only one. The authors had several recommendations, including:

• Use more combination pills
• Synchronize prescriptions to limit trips to the pharmacy
• Use technology to remind patients about refills

Genetic Counseling

Should payers demand that genetic counselors assist patients who need genetic testing for a hereditary cancer? Or do obstetrician/gynecologists have the right training?

A recent report in Kaiser Health News said there’s great debate in the American Congress of Obstetricians and Gynecologists, since some believe patients might forego testing if forced to see genetic counselor.

The value of genetic counseling has been a topic of several sessions at Patient-Centered Oncology Care, AJMC’s annual multistakeholder meeting in Baltimore, Maryland, which is scheduled for November 17-18 this year.

Joy Larsen Haidle, who is the past president of the National Society of Genetic Counselors, said patients should see a counselor as a resource. Watch her interview.

To register for Patient-Centered Oncology Care, click here.

For all of us at the Managed Markets News Network, I’m Justin Gallagher. Thanks for joining us.