Navigating Sport-Related Neurospine Injuries, Surgery, and Managed Care
On this episode of Managed Care Cast, we speak with Arthur L. Jenkins III, MD, FACS, CEO of Jenkins NeuroSpine, to explore the intersection of advanced surgical care for sport-related neurospine injuries and managed care systems.
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22:19
Varied Access: The Pharmacogenetic Testing Coverage Divide
On this episode of Managed Care Cast, we are speaking with Jai N. Patel, PharmD, the associate director of shared resources management at Atrium Health Wake Forest Baptist Comprehensive Cancer Center.
His study, "Medical Policy Determinations for Pharmacogenetic Tests Among US Health Plans," uncovered significant differences in coverage decisions for pharmacogenetic tests across major US health insurers and laboratory benefit managers; pharmacogenetic testing examines how an individual's genetic makeup impacts drug response.
In our discussion, Patel shares what motivated this research, key takeaways from his findings, and steps needed to improve consistency in evidence evaluation and pharmacogenetic test coverage.
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12:48
Telemedicine’s Evolution: Expanding Access to Obesity and Specialty Care
On this episode of Managed Care Cast, we speak with George Jones, chief operating officer at UpScript Health, an online pioneer of eprescribing 20 years ago, to learn how telemedicine has progressed from asynchronous conferencing to real-time video consultation, enabling the treatment of complex conditions beyond primary care.
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24:32
Politics vs Science: The Future of US Public Health
On this episode of Managed Care Cast, we speak with Perry N. Halkitis, PhD, MS, MPH, dean of the Rutgers School of Public Health. Our conversation centers on the potential withdrawal of the United States from the World Health Organization, the new directive for the CDC to stop communications with the WHO, and their public health implications. We also touch on the importance of accurate public health information and the role of public health leaders in advocating for science and health.
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28:15
The Evolving Annual Wellness Visit
Today, we're diving deep into a crucial aspect of preventive healthcare: the Annual Wellness Visit. Our guest is Dr. Christopher Wheelock, a clinical transformation physician executive at Highmark Health, responsible for developing payer and provider collaborations to move toward value-based care. In the past, he was heavily involved with developing the workflow, patient scripting and templating for the Annual Wellness Visit when CMS first established it in 2011 as part of the Affordable Care Act.
In today’s episode, Dr. Wheelock sheds light on the various elements of the Annual Wellness Visit, including self-assessments of psychosocial issues and screenings for conditions like dementia and incontinence. He also explains the expansion of services in 2025 for Medicare beneficiaries.
We also explore the intricacies of coding and billing for these visits, especially if they go beyond the scope of the Annual Wellness Visit; the value they bring to patients, providers, and payers; and the critical role of effective communication and preparation to maximize the benefit of the Annual Wellness Visit.
Brasil