Meet the Board: David Calabrese of OptumRx Talks Wellbeing, Aduhelm and Biosimilars in the Market
August 11th 2021In this week's episode, editors of Managed Healthcare Executive, Peter Wehrwein and Briana Contreras caught up with MHE Editorial Advisory Board member David Calabrese, market president of Health Plans/PBMs at OptumRx, for another segment of the Meet the Board series. The three discussed Calabrese’s career history, his personal wellbeing lifestyle, and his thoughts on the approval of the Alzheimer’s drug Aduhelm, as well as the Biden Administration's interest in putting more generics and biosimilars in the market.
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Obstructive Sleep Apnea Doubles Sudden Death Risk
August 11th 2021A new meta-analysis summarizes the dangers posed sleep apnea, which include a doubling of the risk of sudden death from cardiac causes. It is still unclear whether continuous positive airway pressure (CPAP), one of the main treatments for obstructive sleep apnea, lowers that risk.
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Medicaid Cost of Incomplete Payment Eats Into Physician Reimbursement
August 9th 2021One-quarter of Medicaid claims result in a denial of payment for at least one service included in the claim compared with just 7.3% of claims submitted to Medicare and 4.8% of claims submitted to commercial insurers
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Summit Health's Jamie Reedy, MD, & Ashish D. Parikh, MD, Discuss How to Manage Value-Based Contracts
August 8th 2021In this final part of a two-part video series, Briana Contreras, associate editor of Managed Healthcare Executive, spoke with Summit Health’s Chief Quality Officer Ashish D. Parikh, MD, and Chief of Population Health Jamie Reedy, MD, about value-based care programs and contracts within Summit Health and what it takes to invest and implement these programs into your healthcare organization.
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In this first part of a two-part video series, Briana Contreras, associate editor of Managed Healthcare Executive, spoke with Summit Health’s Chief Quality Officer Ashish D. Parikh, MD, and Chief of Population Health Jamie Reedy, MD, about value-based care programs and contracts within Summit Health and what it takes to invest and implement these programs into your healthcare organization.
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The Connection Between Telehealth, Pharmacy and How it Affects Self-Funded Employers
August 5th 2021Managed Healthcare Executive had a conversation with Kelly Chillingworth, RPh, director of business development at RxBenefits this week about the unique connection between pharmacy and telemedicine, what impact telemedicine & its pharmacy costs have on self-funded employers and how the right virtual care services a health provider offers to their members can be essential to building a competitive benefit.
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Going Electronic: The Optimization Blueprint for Claim Payments
August 5th 2021By enabling a more efficient, integrated process, electronic payment solutions are optimizing payment processes for payers and providers at a time when reliable, accurate and timely payments are of utmost importance to healthcare organizations.
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How Health Agencies Can Navigate the Newly Proposed ACA Marketplace Rules
August 4th 2021The Centers for Medicare and Medicaid Services and the Treasury Department recently proposed a new rule intending to expand access to health coverage for individuals currently in or interested in entering the Marketplace.
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Updated SITC Immunotherapy Guidelines for Urothelial Cancer
August 3rd 2021The Society for Immunotherapy of Cancer (SITC) released guidelines based on FDA approved immune checkpoint inhibitors (ICIs) for the treatment of urothelial cancer arising from the bladder and other areas of the urinary tract. The guidelines were based around therapies such as the programmed cell death protein 1 (PD-1) inhibitors Opdivo (nivolumab) and Keytruda (pembrolizumab) and the programmed cell death ligand 1 (PD-L1) inhibitors, Tecentriq (atezolizumab), Bavencio (avelumab) and Imfinzi (durvalumab).
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