Managed Care Cast

Most patients with metabolic dysfunction–associated steatotic liver disease (MASLD) go undiagnosed until significant liver damage has already occurred, despite the availability of simple, guideline-supported screening tools that remain notoriously underused in both primary care and weight management settings. That's according to a conversation between Naim Alkhouri, MD, chief medical officer at Summit Clinical Research and director of the Steatotic Liver Disease Program at the Clinical Research Institute of Ohio, and Chika Anekwe, MD, obesity medicine clinical director at the Massachusetts General Hospital Weight Center and an instructor in medicine at Harvard Medical School.

In this episode of Beyond the Silo: Integrated Care Across the CRM Continuum, the third installment in a series examining the cardio-renal-metabolic continuum, Alkhouri and Anekwe discuss why MASLD and its more aggressive form, metabolic dysfunction–associated steatohepatitis (MASH), belong alongside the heart and kidney in conversations about cardiometabolic risk. The pair walk through how Fibrosis-4 Index for Liver Fibrosis calculations can identify high-risk patients before liver damage becomes irreversible, why ownership of screening often falls through the cracks between primary care, obesity medicine, and specialty clinics, and how the recent FDA approvals of resmetirom and semaglutide for MASH have raised the urgency of early detection. The conversation also covers strategies for closing equity gaps in liver disease screening, including the role of telehealth and artificial intelligence in extending care to underserved and rural communities.

In this episode, Bhavana "Tina" Bhatnagar, DO, discusses how the field of acute myeloid leukemia has been fundamentally transformed; what this means for patients in rural, underserved settings; and where hematologic oncology is headed next.

Perry Halkitis, PhD, MS, MPH, dean of the Rutgers School of Public Health, watched epidemics emerge, witnessed governments fail to respond, and seen communities mobilize when institutions would not. From the early days of the AIDS crisis to COVID-19, Ebola, and beyond, he has drawn consistent lessons about what makes public health succeed and what causes it to collapse.

For patients with cancer, diagnosis doesn't just bring a physical battle. It can trigger a trauma response that can linger long after treatment ends, quietly reshaping how people sleep, think, and connect with the world around them.

Early detection of chronic kidney disease (CKD) means little if it does not lead to timely treatment, yet a significant gap persists between when CKD is found and when evidence-based therapies are started. That disconnect is the focus of the second episode of Beyond the Silo: Integrated Care Across the CRM Continuum, a podcast series from The American Journal of Managed Care®, in which Ralph Riello, PharmD, BCPS, leads a conversation with Nihar Desai, MD, MPH, on how to shift CKD care from a reactive, late-stage model to one that is proactive, pathway-driven, and equitable.

The discussion builds on the first episode's focus on urine albumin-to-creatinine ratio underutilization, stipulating that screening has occurred and asking what must happen next. You can listen to the first episode here: https://www.ajmc.com/link/89943