Listen to their dynamic conversation as they explore groundbreaking treatments and the impact of anti-VEGF therapy in transforming patient outcomes. From clinical trials to real-world applications, this podcast offers a comprehensive look at the advancements and challenges in managing retinal vascular diseases. Tune in now for a journey through the evolving landscape of retinal healthcare. Read Less

Learn about the critical discussions surrounding the escalating challenges and costs associated with managing retinal diseases like age-related macular degeneration and diabetic retinopathy in an aging population. Explore the advancements in treatment, the role of socioeconomic factors, and the complex interplay between healthcare providers and insurance policies in delivering patient care. This podcast offers invaluable insights into the future of ophthalmic care and the importance of preserving vision in an aging society. Read Less

As they delve into the complexities of ROP—a condition that poses a significant threat to the vision of premature infants—the duo sheds light on the critical importance of timely and accurate screening, diagnosis, and intervention. With insightful discussions on the nuances of treatment options, including the pivotal role of anti-VEGF therapy and laser treatments, this episode is a must-listen for healthcare professionals striving to safeguard the vision of our youngest and most vulnerable patients. Read Less

Among other topics their conversation covers the challenges of patient compliance due to treatment frequency, the role of payers in supporting innovative treatments, addressing the socio-economic factors affecting patient care, and the use of telemedicine and AI in improving access to care, especially in underserved areas. Read Less

This episode delves deep into the challenges of diagnosing EoE, the significant impact of delayed diagnosis, and the innovative approaches to collaborative care. Discover the evolving recommendations that are shaping the future of EoE management and how multidisciplinary teams are working to improve outcomes for patients. This insightful discussion offers a comprehensive look at the efforts to enhance the quality of life for those affected by EoE, emphasizing the importance of timely intervention and ongoing monitoring. Read Less

This episode sheds light on the patient journey, the importance of early diagnosis, the multidisciplinary approach to care, and the evolving landscape of treatment options. With insights on benefit design strategies and payer roles in improving outcomes, this discussion is a valuable resource for healthcare professionals seeking to enhance the quality of life for patients with EoE. Tune in to gain a deeper understanding of how collaborative care and informed access strategies are pivotal in the effective management of eosinophilic esophagitis. Read Less

They explore innovative strategies to enhance access to treatment and navigate the complexities of payer benefit management. This episode is crucial for understanding the evolving landscape of AD therapies, including injectables and oral treatments that have emerged as game-changers in patient care. The dialogue examines the challenges of balancing cost-effective care with ensuring patients receive timely and appropriate treatment. Through their expert insights, Dr. Owens and Ms. McCormick shed light on the critical role of utilization management in optimizing healthcare resources while prioritizing patient well-being. Read Less

This session considers the critical aspects of pediatric dermatology, focusing on atopic dermatitis (AD). Dr. Wan shares her extensive experience in treating a diverse range of pediatric patients, from initial diagnosis to managing complex, severe cases. The conversation navigates through the challenges of accessing specialized care, the importance of a detailed patient assessment, and the impact of AD beyond skin symptoms, emphasizing the profound effect on quality of life and mental health. With a growing arsenal of effective treatments transforming patient care, this episode highlights the necessity for managed care professionals to understand the intricacies of AD in children and the importance of facilitating timely and appropriate access to life-changing therapies. Read Less

They explore the intricate world of commercial health plans' coverage decisions for atopic dermatitis treatments in the US. Dr. Chambers provides insights from his extensive research into how various payers are navigating the rapidly evolving treatment landscape for AD, particularly with the advent of specialty therapies like biologics. This conversation sheds light on the significant variability in coverage policies, the evolution of these policies over time, and the impact on patient access to critical treatments. Health plan professionals will gain a deeper understanding of the challenges and considerations in formulating coverage policies for AD treatments, emphasizing the need for evidence-based decision-making and the potential implications for patient care and outcomes. Read Less

They discuss innovative treatment options that have recently become available, the impact of these treatments on patient quality of life, and strategies health plans can implement to enhance patient outcomes. The conversation highlights the challenges in designing benefits to ensure timely access to evidence-based treatments, the lag in clinical guidelines following rapid advancements in therapy options, and the administrative hurdles that can impede patient care. The faculty also discuss the importance of payer-provider collaboration in addressing these issues and the potential for technology to streamline access and reduce administrative burdens. This discussion is essential for health plan professionals looking to navigate the intricacies of providing coverage for atopic dermatitis treatments effectively. Read Less

Ashley shares her personal journey as a mother of a child with atopic dermatitis, providing insights into the patient and caregiver experience. The discussion covers the clinical management of the condition, its economic implications for families, and the broader humanistic impact on patients' lives, emphasizing the need for empathy and understanding in healthcare interactions. The conversation also touches on the importance of effective patient-provider communication, the potential benefits of newer treatment options, and the complexities involved in navigating health insurance systems to access necessary care. Read Less

Dr. Friedman shares insights into the disease's complexities, its impact on quality of life, and the innovative therapies transforming patient care. The conversation delves into the challenges and opportunities health plans face in integrating these new treatments, emphasizing the need for personalized care and equitable access. This episode is an invaluable resource for health plan professionals seeking to enhance their understanding of atopic dermatitis and its evolving treatment landscape. Read Less

Expert panelists, including clinicians and pharmacists from diverse healthcare backgrounds, provide insights on how CGM technology enhances diabetes management by offering real-time glucose data, reducing A1c levels, and improving patient engagement and outcomes. They explore the economic and clinical benefits of CGM within health plans, discussing its impact on reducing complications and healthcare costs. The episode serves as an essential resource for health plan professionals looking to optimize diabetes care and resource allocation. Read Less

They delve into how Kroger Prescription Plans has pioneered open access to CGM, eliminating prior authorizations and streamlining access for both type 1 and type 2 diabetes patients. The dialogue covers the rationale behind this strategic move, the impact on patient and provider satisfaction, and the broader implications for healthcare coverage and wellness programming. This episode is essential for health plan professionals looking to understand the evolving landscape of diabetes management and the benefits of enhanced access to CGM. Read Less

Dr. Jeffrey Dunn (Cooperative Benefits Group) and Dr. Richard Dlott (formerly The Permanente Medical Group (TPMG) / Kaiser Permanente Northern California) look at the findings of a recent study published in JAMA, which observed significant benefits of CGM in both type 1 and type 2 diabetes patients, including notable A1c reductions and decreased emergency room visits for hypoglycemia. They emphasize the importance of patient engagement in diabetes management and explore the implications of new CMS quality measures for 2023 on health plans. The conversation highlights the potential for CGM to transform diabetes care by providing real-time data that can empower patients and inform treatment decisions, underscoring the need for health plans to consider broader access to this technology. Read Less

They discuss the importance of addressing hypoglycemia risks and the integration of continuous glucose monitoring (CGM) to improve patient outcomes. The dialogue sheds light on the challenge of balancing cost-effective treatment with the safety and efficacy of diabetes management, emphasizing the need for health plans to adapt to innovative technologies and education for better patient engagement. They highlight how Zing Health is pioneering in providing CGM devices at no cost to members and the impact of recent CMS coverage changes on diabetes care. The session concludes with insights into tackling technology gaps in elderly patients and addressing disparities in diabetes treatment across different demographics. Read Less

They examine the clinical evidence supporting rtCGM's role in improving patient outcomes, adherence to ADA guidelines, and recent CMS local coverage determination criteria updates facilitating broader rtCGM access. The conversation emphasizes rtCGM's potential in enhancing patient engagement, reducing healthcare costs, and improving quality metrics. A Q&A session with the audience addresses CMS changes, health plan coverage, and identifying rtCGM candidates, underscoring the technology's growing impact on diabetes care. Read Less

Together, they discuss the impact of various MS subtypes, the significance of early and effective treatment, and the challenges of aligning treatment with health plan policies. The session also touches on the use of disease-modifying therapies, considering patient-specific factors such as comorbidities and insurance coverage to personalize care. This educational content is critical for health plan professionals aiming to enhance care strategies within their plans. Read Less

Joined by Dr. Heather Woolery-Lloyd (Johns Hopkins School of Medicine) and Jason Harris (National Psoriasis Foundation), the conversation covers the broad spectrum of psoriasis treatments, from topical therapies to biologics, and highlights the importance of considering patient preferences and comorbidities in treatment planning. They also discuss the challenges of access to care, the impact of psoriasis on mental health, and the evolving landscape of treatment options, emphasizing a multidisciplinary approach to manage this complex condition effectively. Read Less

It emphasizes the significance of recognizing and addressing health disparities, particularly among Black men, who are disproportionately affected by prostate cancer. The conversation covers advancements in treatment options, including the impact of androgen deprivation therapy (ADT) and the potential of combination therapies to enhance outcomes. The speakers also highlight the importance of patient-provider communication, the role of precision medicine, and the need for systemic approaches to improve access and literacy in healthcare. Health plan professionals are encouraged to leverage data and engage in targeted interventions to mitigate disparities within their patient populations. Read Less

The discussion involves experts who examine the regulatory landscape, share insights from real-world evidence, and discuss the clinical implications of biosimilars. Key topics include their efficacy, safety, and interchangeability. The conversation also covers the challenges and strategies for incorporating biosimilars into healthcare systems, emphasizing the need for education, policy adjustments, and practice adaptations. This dialogue aims to enhance health plan professionals' understanding and confidence in biosimilars, underlining their potential to expand patient access to treatments while achieving substantial healthcare savings. Featured faculty include Dr. Raj Duggal (Indiana University Health), Jim Kenney (formerly Harvard Pilgrim), and Dr. Cate Lockhart (Biologics and Biosimilars Collective Intelligence Consortium). Read Less