Tuning In to The C-Suite

Perry Cohen, Pharm.D., a longtime member of the Managed Healthcare Executive (MHE) editorial advisory board, is host of the "Conversations with Perry and Friends" podcast. In this episode, Cohen speaks with Jon Bloom, M.D., co-founder and CEO of Podimetrics, about the evolving role of physicians in U.S. healthcare.

Perry Cohen, Pharm.D., a longtime member of the Managed Healthcare Executive editorial advisory board, is host of the Conversations with Perry and Friends podcast. In this episode, his guest is Paul Fronstin, Ph.D., director of health benefits research at the Employee Benefit Research Institute.

Featured in this latest episode of Tuning In to the C-Suite podcast is Paul Fronstin, director of health benefits research at EBRI, who shed light on the evolving landscape of health benefits with editors of Managed Healthcare Executive. Fronstin discussed the challenges employers face in designing health plans that steer employees toward high-value care. He also shared insights on high-deductible health plans (HDHPs), noting that while they initially lead to reduced healthcare usage, they don’t deliver significant long-term savings. Looking ahead, he highlighted the potential of technology, such as AI and mobile apps, to empower employees to better understand their health benefits and make more informed decisions during open enrollment.

In our latest "Meet the Board" podcast episode, Managed Healthcare Executive Editors caught up with board member, Eric Hunter, CEO of Care Oregon, to discuss a number of topics, with one including the merger that never closed with SCAN Health Plan due to local opposition from Oregonians, emphasizing the need for partnerships to meet scaling and capital requirements. On the other hand, Hunter also praised Oregon's careful Medicaid redetermination, resulting in a smaller enrollment decline than expected. He also highlighted a new preventive medicine residency program with Oregon Health and Science University to improve healthcare for populations most at need. Before concluding the conversation with a question on what public official or figure of past or present he'd love to sit down over dinner with, Hunter briefly covered cybersecurity challenges and the potential impact of healthcare issues in the upcoming election.

A limited pharmacy benefit manager (PBM) reform bill may be used as a "pay for" to offset the costs of extending Medicare telehealth flexibilities, shares Kelly, of Capitol Advocacy & Government Affairs.

In this episode, MHE's Peter Wehrwein spoke with Patrick Cooney, president of The Federal Group, discussing Washington's focus on Pharmacy Benefit Managers (PBMs). Cooney highlighted increased federal attention on PBMs, with legislative activity indicating bipartisan interest in reform. Despite recent setbacks in negotiations over PBM-related provisions, both Democrats and Republicans aim for transparency and change. Cooney also predicts eventual PBM legislation in 2024, emphasizing the bipartisan recognition of reform necessity.

In this second part of a two-part podcast episode, Managed Healthcare Executive's Managing Editor Peter Wehrwein spoke with Ceci Connolly and Margaret "Meg" Murray about Medicare Advantage utilization and challenges, highlighting proposed CMS payment cuts and prior authorization issues. Murray emphasized MA's growth and benefits, while Connolly introduced MA for Tomorrow proposals. They also tackled drug pricing transparency concerns, Medicaid coverage challenges, and predicted affordability as a key issue in the 2024 elections.

In this month’s episode of Tuning In to the C-Suite, Briana Contreras, an editor of Managed Healthcare Executive, got to chatting with Sanjula Jain, Ph.D., chief research officer at Trilliant Health. In the conversation, Sanjula shared the concerning rise in cancer cases among those in their 30s and 40s, despite declining mortality rates. In this age range, neoplasm-related deaths are notably increasing, which could possibly be linked to pandemic-induced declines in primary care and screenings. Sanjula added that rising cancer care costs and increased pharmaceutical investments highlight the need for a comprehensive approach in this space.

Briana Contreras, an editor of Managed Healthcare Executive, spoke with Fred Turner, CEO of Curative, in this month’s episode. The two talked about the challenges middle-class Americans face in dealing with medical debt, exploring the causes behind it and the impact on overall health. Fred also touched on potential solutions, both from the perspective of organizations like Curative and through collaborative efforts between various stakeholders in the healthcare system. The solutions mentioned in the conversation focus on making healthcare more financially accessible and creating a sustainable and inclusive healthcare system for all Americans.

Managing Editor of Managed Healthcare Executive, Peter Wehrwein, had a discussion with William Shrank, M.D., a venture partner with Andreessen Horowitz, a venture capital firm in Menlo Park, California, about how artificial intelligence's role is improving healthcare, where we are today with value-based care and the ongoing efforts of reducing waste in the healthcare space for this episode of the "What's on Your Mind" podcast series. Shrank, a member of MHE's Editorial Advisory Board, also shared what has been "on his mind" as of late with Wehrwein. A topic that has been of focus includes personalized care and how it can result to better outcomes for that patient."We spend a lot of time thinking at a high level about how to optimize a health system, how to make sure patients have access to therapies and treatments and providers," Shrank said. "But the critical feature to anyone's health really has to do with 'what motivates them', 'what they get out of bed to focus on', what they want to be able to do that day, that week, that month, that year with their parents, their family, their children." He added the barriers to health often aren't the issues that the healthcare system are focused on. "There's a whole host of things that impact one's ability to achieve their best health," Shrank said. "Trying to make sure we have a health system and a way of delivering care that really meets people where they are and understands what their motivations are, what means the most to them, what challenges they face, is the job of a really effective healthcare system."

In this month’s episode, Briana Contreras, an editor of Managed Healthcare Executive, had the pleasure of catching up with MHE Editorial Advisory Board Member, Ateev Mehrotra, who is a professor of healthcare policy at Harvard Medical School and an Associate Professor of Medicine and Hospitalist at Beth Israel Deaconess Medical Center. What’s been on Ateev’s mind or has been a focus, lately, are most things in the digital health and telehealth space, as well as practice licensure in the U.S. Among many topics discussed in the conversation, Ateev shared his thoughts on the push for better virtual visit opportunities and the fact that insurers are now offering virtual first health plans with lower premiums.

Briana Contreras, an editor of Managed Healthcare Executive, spoke with Brian Adams, President and CEO of Tabula Rasa HealthCare, in this month's episode of Tuning In to the C-Suite podcast. In the episode, Brian and Briana got to chatting about value-based care and why the transition to this type of model has been slower than expected for some practices to adopt. Most of the discussion focused on Brian’s suggestion of simplifying and personalizing value-based care models to improve health outcomes for patients and reduce costs for organizations who’ve adopted these models.