Expert Interviews

While the impact of Medicaid changes on employer-sponsored insurance remains to be seen, competition between providers is a steadfast way to stabilize the system for everyone, according to Christoph Dankert, chief network officer of Carrum Health.

Panelists discuss how their study compared healthcare resource utilization between newly diagnosed patients with type 1 diabetes with and without prior type 2 diabetes misdiagnosis, using a retrospective claims database analysis to examine utilization patterns across different healthcare services.

Sonali Kulkarni, M.D., M.P.H., Medical Director in the Division of HIV and STD Programs at the Los Angeles County Department of Public Health, recently sat down with Managed Healthcare Executive to explain the barriers within the traditional healthcare system for homeless HIV patients and the importance of mobile care clinics.

The financial balancing act between providers, government programs and commercial insurers, according to Christoph Dankert, chief network officer of Carrum Health.

An expert discusses how early diagnosis of vitiligo is primarily important for limiting the area requiring repigmentation, while explaining that genetic predisposition, autoimmune thyroid disease and skin trauma are key risk factors for developing the condition.

An expert discusses how vitiligo involves a complex autoimmune mechanism where the body’s immune system destroys melanocytes, presenting as either segmental vitiligo (rapid, localized to one body area) or nonsegmental vitiligo (slower, scattered patches), with treatment success depending on the presence of pigmented hairs in affected areas.

A panelist discusses how the historical standard of care for metastatic squamous cell anal carcinoma evolved from cisplatin-based regimens to carboplatin and paclitaxel as the established backbone treatment based on the InterAACT trial, which demonstrated superior progression-free survival and overall survival (20 months vs 12 months) with better tolerability, until recent changes with the POD1UM-303 trial shifted the current standard of care.

A panelist discusses how squamous cell cancer of the anal canal has nearly doubled in incidence over 30 years, with human papillomavirus infection being the primary risk factor that is significantly amplified by immunosuppression from conditions like HIV, immunosuppressive medications or organ transplantation, particularly affecting older patients and women at higher rates.

Panelists discuss how type 1 diabetes is diagnosed using autoantibody testing and the challenges clinicians face, including the common misdiagnosis of adults with type 1 diabetes as having type 2 diabetes due to age bias and the misconception that type 1 diabetes only occurs in childhood.

There are a variety of reasons for this, including stigma, substance use disorders and trauma, according to Sonali Kulkarni, medical director in the Division of HIV and STD Programs at the Los Angeles County Department of Public Health.

In a conversation with Managed Healthcare Executive, 10XBeta CEO Marcel Botha suggested that in order to improve rural healthcare at a time when it’s threatened by potential Medicaid cuts, new technology must be designed with help from local communities. He added that federal policies should better support mobile care and telehealth services.

An experienced team of healthcare providers used to working together will likely be more successful when treating a postpartum hemorrhage, according to Abigail Wooldridge, assistant professor of Industrial and Enterprise Systems Engineering at The University of Illinois.

Managed Healthcare Executive spoke with Ohio Rural Health Association leaders Rosanna Scott and Beth Kluding and Marcel Botha, CEO of healthcare technology company 10XBeta, to discuss how proposed Medicaid cuts and federal program changes could affect rural healthcare access, infrastructure and community well-being.

Nancy Hoyt Taff, M.P.H., is the senior product manager of Medicaid at UCare, an independent, nonprofit health plan providing healthcare and administrative services to more than 600,000 members throughout Minnesota and parts of western Wisconsin.

Jeffrey Casberg, M.S., of IPD Analytics and Luke Greenwalt, MBA, of IQVIA, both members of the Managed Healthcare Executive (MHE) editorial advisory board, will provide a midyear assessment of the pharmacy market and the policy and politics affecting it. Topics to be discussed include the possibility of tariffs, the most-favored nation drug pricing executive order, aspect of the reconciliation bill that could affect the pharmaceutical and pharmacy benefit management industries, pressure on the gross-to-net “bubble,” implementation of the Inflation Reduction Act price negotiations, GLP-1s and notable FDA approvals in the second half of 2025. Note that this a menu and some topics may be added or subtracted depending on time and news up to airtime on June 12. Peter Wehrwein, managing editor of MHE is moderating the discussion.

"All kinds of enhancements" have crept into claims from providers, Ronanki said, and health plans have responded. But his company is impartial about the net value and strives to make the claim accurate in the first place, he said.

Amanda M. Shafton, CNM, DNP, FACNM, advocates for more midwives in the U.S. healthcare system, arguing that many other countries already see their value.

Ronanki says the differentiators for Lyric are a subscription-based model; being a platform that allows for technology integration and scale; and transparency.

Ben Scharfe, CPA, shares how his career-changing advice came from an unlikely person.

The United States has twice the postpartum hemorrhage mortality rate of other developed countries, which is why it’s essential to create and maintain safety protocols during obstetric emergencies, according to Abigail Wooldridge, assistant professor of Industrial and Enterprise Systems Engineering at The University of Illinois.

Patrick Roberts, Pharm.D., said his career changed when he listened to a mentor encouraging him to go back to school.

Kate Masino, MBA, says her career path was changed while watching her chronically ill, aging parents try to navigate the U.S. healthcare system.

Justin Jasniewski, MBA, shared a story about his career turning point and how it involved a rejected proposal and a Big Three PBM seven-figure check.

Bonnie Hui-Callahan, Pharm.D., says her career took off after not matching for a pharmacy residency—a setback that taught her resilience and led her to a better fit the second time around.

Cassie Houff, MBA, says the most impactful change for U.S. healthcare would be “an overhaul to the fee-for-service payment system,” arguing that it doesn’t incentivize timely or necessary care.

Matthew Helbling says the turning point in his pharmacy career came when he took on a pilot program for medication therapy management—and discovered the power of connecting more deeply with patients.

The Teal Wand was recently approved by the FDA as the first self-collection device to screen for cervical cancer, a major step forward for accessible women’s health, according to Rahma S. Mkuu, Ph.D., M.P.H., assistant professor in the Department of Health Outcomes & Biomedical Informatics at the University of Florida College of Medicine.