Managed Care Cast

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.

For this Managed Care Cast episode, The American Journal of Managed Care® (AJMC®) spoke with Anuraag R. Kansal, PhD, who leads health economics research at GRAIL, about his study, “State Medicaid Budgetary Implications of New Cancers," published in the July 2026 issue; it examined how new cancer diagnoses affected state Medicaid budgets.

He conducted the study with Amanda C. Chen, PhD, of the USC Mann School of Pharmacy and Pharmaceutical Sciences, and David C. Grabowski, PhD, of Harvard Medical School.

Kansal explained to AJMC that despite Medicaid's younger population, cancer remains the third-largest source of program spending. Most existing research had focused on commercial and Medicare populations rather than Medicaid specifically. Consequently, using de-identified CMS claims data, he and his team identified new cancer diagnoses, defined as no prior cancer evidence in the preceding 6 months, and compared spending, hospitalizations, and emergency department use between metastatic and non-metastatic cases.

Kansal highlighted the core finding, which was that metastatic diagnoses were associated with significantly higher spending than non-metastatic diagnoses across most cancer types. Notably, health care utilization patterns were consistent between fee-for-service and capitated Medicaid states, suggesting that cost drivers stemmed from the disease itself, particularly the shift to systemic therapies once cancer spread, rather than from program administration models.

Kansal pointed to the 4 cancer screenings recommended by the US Preventive Services Task Force, namely lung, breast, colorectal, and cervical, as opportunities to reduce late-stage diagnoses and their associated costs while noting that cancers without established screening protocols presented a distinct policy challenge.

On balancing innovative treatment access with cost sustainability, he emphasized that Medicaid's state-by-state administration means that no single policy solution applied universally. Still, Kansal emphasized that earlier detection could offer states greater financial flexibility to support innovative therapies for patients with true clinical need.

“Intervening earlier is one of the opportunities we might have to really make a difference,” he concluded.

Expanding Support Systems for Black Maternal Health by Managed Care Cast

On this episode of Managed Care Cast, The American Journal of Managed Care® (AJMC®) was joined by Erin L. Duffy, PhD, MPH, an author of a study published in the June 2026 issue. She is a health policy researcher at the Schaeffer Center for Health Policy & Economics at the University of Southern California, with a focus on health care affordability, access to care, and how health systems can better serve patients.

Duffy’s study, "Availability of Hospital Financial Assistance Documents in Non-English Languages," found that nonprofit and system-affiliated hospitals have superior language access. During her conversation with AJMC, she discussed what inspired the research, the study's key findings, and ways to improve equitable access to information about financial assistance, regardless of language.

To conclude, Duffy previewed her study to be published in the July 2026 issue of AJMC, which builds on this work by evaluating the readability of financial assistance documents.

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.