PODCAST

Managed Care Cast

Podcast by Managed Care Cast

science

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00:18:48

Reflecting on 15 Years of Health IT Evolution and...

Managed Care Cast ·

2026/01/27

The American Journal of Managed Care® (AJMC) kicks off its 2026 author podcast series with Nate C. Apathy, PhD, guest editor of AJMC’s 15th Health Information Technology (IT) special issue. He is an assistant professor of health policy and management at the University of Maryland School of Public Health and an affiliated research scientist at the Regenstrief Institute in Indianapolis, Indiana.To set the stage for this milestone issue, Apathy reflects on the most significant health IT advancements

00:31:27

Transparency in Coverage: Exposing Ghost Rates and...

Managed Care Cast ·

2026/01/20

On this episode of Managed Care Cast, The American Journal of Managed Care® spoke with David Muhlstein, PhD, JD, founder and CEO of Simple Healthcare, about his recent articles highlighting Transparency in Coverage (TIC) files and ghost rates from 119 insurers, including 3 national commercial payers. Aetna, Cigna, and United Healthcare TIC files were more than 90% ghost rates—billing codes for procedures that would never be performed by a specific physician. For example, there were billing codes

00:03:59

Managed Care Cast News Roundup: January 13, 2026

Managed Care Cast ·

2026/01/13

The latest news from The American Journal of Managed Care.

00:16:58

2026 Health Care Predictions: AI, GLP-1s, MAHA, DEI:...

Managed Care Cast ·

2026/01/01

On today’s episode, AJMC® spoke with Dr. Sachin Jain, president and CEO of SCAN Group and Health Plan, about his 10 predictions for the health care industry in 2026. Jain breaks down his predictions and what they could mean in both the short and long term for Americans and how they may shape access, affordability, and accountability across the US health care system.

00:14:51

Switching From MA to TM Increases Mental Health Care...

Managed Care Cast ·

2025/12/24

To wrap up this year's author podcast series, The American Journal of Managed Care® speaks with Angela Liu, PhD, MPH, assistant research professor at the Johns Hopkins Bloomberg School of Public Health, about her December 2025 study, "Mental Health Care Use After Leaving Medicare Advantage for Traditional Medicare." Her research analyzed Medicare beneficiaries with mental health diagnoses who switched from Medicare Advantage (MA) to traditional Medicare (TM), examining their use of mental health

00:20:20

AJMC® Editors Reflect on Milestone Year and Look to 2026

Managed Care Cast ·

2025/12/16

On this episode of Managed Care Cast, we’re talking with the co–editors in chief of The American Journal of Managed Care® (AJMC®), Mark Fendrick, MD, and Michael Chernew, PhD. They look back on the research and news that stood out to them from the past year and discuss what they’re looking forward to in 2026.Check out the dedicated page featuring our efforts to celebrate AJMC’s 30th anniversary: https://www.ajmc.com/anniversary

00:28:39

Bright Lights, Dark Months: Understanding Seasonal...

Managed Care Cast ·

2025/12/09

Have the shorter, darker days of fall and winter ever left you feeling sluggish, down, or simply "blah"? Today, we are discussing seasonal affective disorder with Craig Sawchuk, PhD, LP, a clinical psychologist at Mayo Clinic. He details how the seasonal pattern often presents as "hibernation syndrome"; explores the characteristics that increase vulnerability to SAD; and covers the effective and unique evidence-based treatment for SAD: bright light therapy.

00:23:57

Frameworks for Advancing Health Equity: Dental Health...

Managed Care Cast ·

2025/12/02

Frameworks for Advancing Health Equity: Dental Health Care Access by Managed Care Cast

00:41:00

Managed Care Cast Presents: New Evidence and Economic...

Managed Care Cast ·

2025/11/25

Today we are bringing you a conversation on the evolving landscape for idiopathic pulmonary fibrosis (IPF) and progressive pulmonary fibrosis (PPF) treatment. Ryan Haumschild, PharmD, MS, MBA, vice president of ambulatory pharmacy at Emory Healthcare and Winship Cancer Institute, spoke with Marilyn Glassberg, MD, the John W. Clarke Professor and Chair of medicine at Loyola University Chicago Stritch School of Medicine; Ayodeji Adegunsoye, MD, MSc, PhD, FACP, FCCP, assistant professor at the

00:15:27

Home Health Care Delivery, Outcomes Vary by Payment...

Managed Care Cast ·

2025/11/18

On this episode of Managed Care Cast, Rachel A. Prusynski, DPT, PhD, an assistant professor at the University of Washington's School of Medicine, speaks with The American Journal of Managed Care® about her research published in the November 2025 issue.Her study, "Medicare Advantage Reimbursement Structures Impact Home Health Delivery and Outcomes," explores how home health care delivery and patient outcomes differ between 3 plan types: traditional Medicare, episodic Medicare Advantage, and

00:22:20

Inside the Discovery That Changed CML Treatment...

Managed Care Cast ·

2025/11/11

On this episode of Managed Care Cast, AJMC spoke with lead CML researcher, Jorge Cortes, MD, to discuss the evolution of the groundbreaking treatment Imatinib and its effect on survial in patients with chronic myelogenous lukiemia.

00:29:32

From Niche to Mainstream: Transforming Physical...

Managed Care Cast ·

2025/11/04

Donovan Campbell, CEO, and his organization Medbridge are urging CMS to finalize specific refinements to RTM as part of the Calendar Year 2026 Physician Fee Schedule (CMS-1832-P), recognizing that RTM is critical for supporting physical therapy, patient health, and patient engagement. We will explore how this shift provides a crucial financial incentive for organizations, but more importantly, how the successful adoption of RTM enhances the clinical value proposition by improving population health,

00:15:24

Age-Related Disparities in ADC Treatment Rates in...

Managed Care Cast ·

2025/10/31

On today’s episode, Dr. Tabby Khan, senior director of analytics for Komodo Health, spoke about their newest data analysis measuring age and insurance disparities in antibody-drug conjugate, or ADC, treatment rates in patients with metastatic breast cancer. The analysis was in partnership with the Tigerlily Foundation, a national breast cancer advocacy organization, in celebration of the 40th anniversary of Breast Cancer Awareness Month.

00:29:38

Managed Care Cast Presents: Leveraging Topical...

Managed Care Cast ·

2025/10/30

Today we are bringing you a conversation on how topical therapies can effectively manage atopic dermatitis. Brian Keegan, MD, PhD, FAAD, a dermatologist with Princeton Dermatology, spoke with Alexa Hetzel, MS, PA-C, physician assistant with Schweiger Dermatology Group; Vikash D. Oza, MD, director of pediatric dermatology at NYU Langone; and Amy Spizuoco, DO, FAOCD, dermatologist and dermatopathologist at True Dermatology. In addition to discussing the clinical benefits and impact on patient

00:26:24

Advocacy, Access, and Awareness: Addressing Barriers...

Managed Care Cast ·

2025/10/28

In this episode of Managed Care Cast, we talk with Barbara Kelley, executive director of the Hearing Loss Association of America. In our conversation, we discuss advocating for hearing loss awareness, breaking down care barriers related to stigma, and empowering individuals through legislation and public policy. Kelley also highlights the importance of early intervention, advancements in hearing technology, and the social and financial challenges faced by individuals with hearing loss, advocating

00:16:55

Nishikawa BC Podcast - 10:23:25, 12.23 PM

Managed Care Cast ·

2025/10/23

How is AI transforming breast cancer screening? On this episode of Managed Care Cast, leading radiology expert, Robert NIshikawa, PhD, breaks down the latest advancements in deep-learning models designed to work alongside mammograms—improving accuracy, efficiency, and early detection in breast imaging.

00:14:08

Challenges, Opportunities in Implementing the MDPP:...

Managed Care Cast ·

2025/10/21

On this episode of Managed Care Cast, The American Journal of Managed Care® speaks with Melanie T. Turk, PhD, RN, an associate professor in the School of Nursing at Duquesne University and author of a study published in the October 2025 issue.Despite its potential, her study, "Opportunities and Obstacles Associated With the Medicare Diabetes Prevention Program," examines the challenges of implementing the Medicare Diabetes Prevention Program (MDPP) from the perspective of program suppliers

00:19:31

The Emerging Landscape of GLP-1 RA Therapies: Gen Li,...

Managed Care Cast ·

2025/10/14

On this episode of Managed Care Cast, The American Journal of Managed Care® spoke with Gen Li, PhD, CEO and cofounder of Phesi, a clinical data company that provides AI-driven insights to sponsors and providers to optimize clinical trial efficacy. A recent analysis from Phesi found over 100 diseases currently being studied using GLP-1 RA therapies. The rapid growth of GLP-1 RA therapies being used across multiple, overlapping conditions creates an incentive for efficient and easily accessible

00:17:48

How Medicaid Reforms Could Deepen State Coverage Gaps

Managed Care Cast ·

2025/10/07

On this episode of Managed Care Cast, The American Journal of Managed Care® speaks with Laxmi Patel, chief strategy officer at Savista, about how the proposed federal Budget Reconciliation Act could reshape Medicaid coverage nationwide. Patel explains why states with large immigrant populations, rural hospital dependence, or provider tax funding could face the most immediate disruptions and what payers can do to prepare. Building on AJMC’s prior discussion with Patel on state-level Medicaid

00:15:55

Frequent Routine Primary Care Visits May Lower Costs...

Managed Care Cast ·

2025/09/30

On this episode of Managed Care Cast, The American Journal of Managed Care® (AJMC®) speaks with Tory M. Wolff, MBA, an author of a study published in the September 2025 issue and managing partner of Recon Strategy, a management consulting firm specializing in health care strategy.His study, "Impact of More Primary Care Visits on Commercial Health Care Costs," found that more frequent routine primary care visits among certain higher-risk commercially insured adults are associated with lower net

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Managed Care Cast

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