Managed Care Cast

Health-system pharmacy is entering a decade of change, and Future-Proofing Pharmacy is built to keep asking what that future should look like. In this debut episode, host Mark Makhinson, PharmD, senior director of outpatient and specialty pharmacy at Mount Sinai Health System, introduces the podcast's mission: exploring how pharmacy leaders can build organizations that are clinically meaningful, scalable, and ready to adapt, rather than simply reacting to financial pressure, workforce shifts, and drug shortages as they arise.

Makhinson lays out the questions the series will return to throughout its run, including what a health system pharmacy enterprise looks like in 2035, where artificial intelligence can meaningfully help, and where human judgment should remain central.

Episode 1 kicks off with Nilesh Desai, PharmD, chief pharmacy officer at University of Miami Health System, who shares the pharmacy enterprise he would build from scratch in 2035 and the lessons that shaped his thinking during a major pharmacy transformation at Baptist Health, including the development of a consolidated pharmacy service center.

This week's Managed Care Cast episode features a conversation between The American Journal of Managed Care® and August 2026 authors Jeff Romine, PhD, and Kofi Essel, MD, MPH, about their study, "Insurance-Provided Grocery Assistance and Health Care Outcomes Among Patients With Diabetes."

It examined the association between a commercial health plan's grocery assistance benefit and health care use and outcomes among members with type 2 diabetes, offering evidence in a space where prior food-as-medicine research has centered largely on Medicare and Medicaid populations.

The benefit provided members between $1200 and $3000 annually, distributed across pay periods on a card usable at a range of grocery chains. Purchases excluded alcohol, tobacco, and preprepared foods, with an emphasis on fruits, vegetables, and other healthy items. Essel noted the design was a deliberate light touch, requiring no dietitian or health coach support, which he said made it more scalable than medically tailored meal programs that have driven much of the existing food as medicine literature. Romine, an economist by training, added that the appeal of studying a lighter intervention was the chance to observe how members made decisions about food and health without the more rigid structure of prior research.

To evaluate the benefit, the team used a difference-in-differences design, comparing changes in utilization and clinical outcomes over time for members receiving the benefit against a control group of members with type 2 diabetes who were not eligible. Romine highlighted 3 main results: a 3.1% decrease in diabetes complications, no significant change in overall health care utilization, and improved medication adherence. He said the utilization finding was a positive surprise, since it suggested members retained access to needed care even within a narrower network.

Essel pointed to a secondary finding as especially notable: the largest reduction in diabetes complications occurred among members living in lower socioeconomic areas, indicating a potential role for grocery assistance in narrowing health disparities. He emphasized that Elevance Health's approach to food as medicine considers both diet-related chronic conditions and social drivers of health such as food and nutrition insecurity, rather than treating them as separate levers.

Looking ahead, Essel said future iterations of the benefit could be strengthened by tailoring groceries to individual cultural and dietary needs, adding nutrition education such as medical nutrition therapy or culinary counseling, and integrating the benefit more closely with primary care and specialist providers.

"We are incredibly excited to see what we've seen here, and we can continue to build off of these learnings across the board," Essel concluded.

Socially vulnerable Medicare patients see dramatically better outcomes—such as fewer emergency department visits, fewer preventable hospital admissions, and 23.4% to 30% less use of high-risk medications—when their physicians take on full financial risk for their care compared with those in traditional fee-for-service Medicare. That's the core finding of a new study published in the June issue of Population Health, Equity & Outcomes, and the subject of this conversation between Ken Cohen, MD, chief medical officer for Optum Health, and host Sophia Humphreys, PharmD, vice president of health system strategy and innovation at The American Journal of Managed Care.

UPMC and Birth Root Community Doula describe a 4-year partnership addressing food insecurity, housing, and maternal health disparities in Erie, Pennsylvania.

In this episode of Managed Care Cast, Alvin Thomas, PhD, clinical psychologist at the University of Wisconsin-Madison, discusses the mental health challenges facing Black and Latino boys and young men.