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/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F1fb0458d4007f177c86e1a37a8c9d4ba60b1f084-303x160.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1080&q=75 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F1fb0458d4007f177c86e1a37a8c9d4ba60b1f084-303x160.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1200&q=75 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F1fb0458d4007f177c86e1a37a8c9d4ba60b1f084-303x160.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1920&q=75 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F1fb0458d4007f177c86e1a37a8c9d4ba60b1f084-303x160.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=2048&q=75 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F1fb0458d4007f177c86e1a37a8c9d4ba60b1f084-303x160.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F1fb0458d4007f177c86e1a37a8c9d4ba60b1f084-303x160.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75" decoding="async" data-nimg="responsive" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/health-equity-access-weekly-roundup-november-16-2024">Health Equity & Access Weekly Roundup: November 16, 2024</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/giuliana-grossi">Giuliana Grossi</a></div><a href="/view/health-equity-access-weekly-roundup-november-16-2024"><span class="text-sm text-gray-500 pl-4">November 16th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">The Center on Health Equity & Access showcases the latest news and expert perspectives on research, social determinants of health, and health policy.</p><div class="pl-4"></div></a><a class="flex items-center justify-center w-24 h-8 mt-4 ml-4 bg-primary border border-primary text-white hover:text-primary hover:bg-white hover:border-primary" href="/view/health-equity-access-weekly-roundup-november-16-2024"><p class="font-bold text-[.75rem]">Read More</p></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/financial-psychological-burden-of-abortion-care-in-us-raises-calls-for-expanded-insurance"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:66.66666666666666%"></span><img alt="Traveling concept. Young woman in casual wear standing in international airport terminal. - luengo_ua - stock.aobe.com" title="Traveling concept. Young woman in casual wear standing in international airport terminal. - luengo_ua - stock.aobe.com" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="Traveling concept. Young woman in casual wear standing in international airport terminal. - luengo_ua - stock.aobe.com" title="Traveling concept. Young woman in casual wear standing in international airport terminal. - luengo_ua - stock.aobe.com" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F365ac81bc7474605401ce01f9cb99e7140fa3012-6000x4000.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F365ac81bc7474605401ce01f9cb99e7140fa3012-6000x4000.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=750&q=75 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F365ac81bc7474605401ce01f9cb99e7140fa3012-6000x4000.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=828&q=75 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F365ac81bc7474605401ce01f9cb99e7140fa3012-6000x4000.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1080&q=75 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F365ac81bc7474605401ce01f9cb99e7140fa3012-6000x4000.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1200&q=75 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F365ac81bc7474605401ce01f9cb99e7140fa3012-6000x4000.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1920&q=75 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F365ac81bc7474605401ce01f9cb99e7140fa3012-6000x4000.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=2048&q=75 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F365ac81bc7474605401ce01f9cb99e7140fa3012-6000x4000.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F365ac81bc7474605401ce01f9cb99e7140fa3012-6000x4000.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75" decoding="async" data-nimg="responsive" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/financial-psychological-burden-of-abortion-care-in-us-raises-calls-for-expanded-insurance">Financial, Psychological Burden of Abortion Care in US Raises Calls for Expanded Insurance</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/giuliana-grossi">Giuliana Grossi</a></div><a href="/view/financial-psychological-burden-of-abortion-care-in-us-raises-calls-for-expanded-insurance"><span class="text-sm text-gray-500 pl-4">November 13th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">There are significant financial and psychological burdens of abortion care in the US, especially for those traveling out of state due to local restrictions in the increasingly restrictive post-Dobbs landscape.</p><div class="pl-4"></div></a><a class="flex items-center justify-center w-24 h-8 mt-4 ml-4 bg-primary border border-primary text-white hover:text-primary hover:bg-white hover:border-primary" href="/view/financial-psychological-burden-of-abortion-care-in-us-raises-calls-for-expanded-insurance"><p class="font-bold text-[.75rem]">Read More</p></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="flex md:hidden justify-center items-center"></div><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/veterans-medicare-advantage-enrollments-drive-cost-duplication"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:61.5%"></span><img alt="Veteran spending | Image Credit: © mehaniq41-stock.adboe.com" title="Veteran spending | Image Credit: © mehaniq41-stock.adboe.com" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="Veteran spending | Image Credit: © mehaniq41-stock.adboe.com" title="Veteran spending | Image Credit: © mehaniq41-stock.adboe.com" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F387bccfa91b92d4a0329f03b74b80aaba0a3a3dd-1200x738.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F387bccfa91b92d4a0329f03b74b80aaba0a3a3dd-1200x738.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=750&q=75 750w, 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/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F387bccfa91b92d4a0329f03b74b80aaba0a3a3dd-1200x738.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F387bccfa91b92d4a0329f03b74b80aaba0a3a3dd-1200x738.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75" decoding="async" data-nimg="responsive" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/veterans-medicare-advantage-enrollments-drive-cost-duplication">Veterans’ Medicare Advantage Enrollments Drive Cost Duplication</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/maggie-l-shaw">Maggie L. Shaw</a></div><a href="/view/veterans-medicare-advantage-enrollments-drive-cost-duplication"><span class="text-sm text-gray-500 pl-4">November 11th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">This research is not the first to uncover duplicative and wasteful spending on health care for veterans who receive care primarily through the Veterans Health Administration as they are also enrolled in Medicare Advantage plans. </p><div class="pl-4"></div></a><a class="flex items-center justify-center w-24 h-8 mt-4 ml-4 bg-primary border border-primary text-white hover:text-primary hover:bg-white hover:border-primary" href="/view/veterans-medicare-advantage-enrollments-drive-cost-duplication"><p class="font-bold text-[.75rem]">Read More</p></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/fixed-duration-1l-cll-treatment-reduces-long-term-costs-in-the-real-world"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:66.66666666666666%"></span><img alt="Health care costs and fees | Image Credit: © everythingpossible - stock.adobe.com" title="Health care costs and fees | Image Credit: © everythingpossible - stock.adobe.com" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="Health care costs and fees | Image Credit: © everythingpossible - stock.adobe.com" title="Health care costs and fees | Image Credit: © everythingpossible - stock.adobe.com" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F386a8d9de05e073b8c8e281bd8b54ba21d2c0fc4-6000x4000.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=75 640w, 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ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/fixed-duration-1l-cll-treatment-reduces-long-term-costs-in-the-real-world">Fixed-Duration 1L CLL Treatment Reduces Long-Term Costs in the Real World </a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/ajmc-contributor">AJMC Contributor</a></div><a href="/view/fixed-duration-1l-cll-treatment-reduces-long-term-costs-in-the-real-world"><span class="text-sm text-gray-500 pl-4">November 9th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">The venetoclax-based regimen was associated with an approximate $8000 decrease in costs compared with the continuous Bruton tyrosine kinase inhibitor treatment 6 months after the fixed-duration period.</p><div class="pl-4"></div></a><a class="flex items-center justify-center w-24 h-8 mt-4 ml-4 bg-primary border border-primary text-white hover:text-primary hover:bg-white hover:border-primary" href="/view/fixed-duration-1l-cll-treatment-reduces-long-term-costs-in-the-real-world"><p class="font-bold text-[.75rem]">Read More</p></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/health-equity-access-weekly-roundup-november-9-2024"><div class=""><span 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srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F1fb0458d4007f177c86e1a37a8c9d4ba60b1f084-303x160.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F1fb0458d4007f177c86e1a37a8c9d4ba60b1f084-303x160.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=750&q=75 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F1fb0458d4007f177c86e1a37a8c9d4ba60b1f084-303x160.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=828&q=75 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F1fb0458d4007f177c86e1a37a8c9d4ba60b1f084-303x160.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1080&q=75 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F1fb0458d4007f177c86e1a37a8c9d4ba60b1f084-303x160.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1200&q=75 1200w, 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style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/health-equity-access-weekly-roundup-november-9-2024">Health Equity & Access Weekly Roundup: November 9, 2024</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/giuliana-grossi">Giuliana Grossi</a></div><a href="/view/health-equity-access-weekly-roundup-november-9-2024"><span class="text-sm text-gray-500 pl-4">November 9th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">The health policy implications and ballot measures in the wake of the presidential election, new trends in physician compensation, lessons from the Medicaid unwinding, disparities in cancer mortality, and privately negotiated hospital fees. </p><div class="pl-4"></div></a><a class="flex items-center justify-center w-24 h-8 mt-4 ml-4 bg-primary border border-primary text-white hover:text-primary hover:bg-white hover:border-primary" href="/view/health-equity-access-weekly-roundup-november-9-2024"><p class="font-bold text-[.75rem]">Read More</p></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " 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href="/view/lessons-learned-from-medicaid-unwinding-as-states-tackle-eligibility-checks">Lessons Learned From Medicaid Unwinding as States Tackle Eligibility Checks</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/giuliana-grossi">Giuliana Grossi</a></div><a href="/view/lessons-learned-from-medicaid-unwinding-as-states-tackle-eligibility-checks"><span class="text-sm text-gray-500 pl-4">November 7th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">Medicaid and CHIP enrollment surged from 71 million in February 2020 to 94 million by April 2023. However, with the pandemic emergency ending in May 2023, states resumed eligibility reviews, initiating a process termed “unwinding.” </p><div class="pl-4"></div></a><a class="flex items-center justify-center w-24 h-8 mt-4 ml-4 bg-primary border border-primary text-white hover:text-primary hover:bg-white hover:border-primary" href="/view/lessons-learned-from-medicaid-unwinding-as-states-tackle-eligibility-checks"><p class="font-bold text-[.75rem]">Read More</p></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " 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src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F387daa801d9b788641f0f7e56d273a800da3008c-4968x2230.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75" decoding="async" data-nimg="responsive" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/physician-compensation-changing-in-new-medical-landscape">Physician Compensation Changing in New Medical Landscape</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/julia-bonavitacola">Julia Bonavitacola</a></div><a href="/view/physician-compensation-changing-in-new-medical-landscape"><span class="text-sm text-gray-500 pl-4">November 7th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">Physician reimbursement stands to be affected by the consolidation of medical systems and changes in Medicare enrollment affecting their pay, which may lead to shifts in medical training and hiring.</p><div class="pl-4"></div></a><a class="flex items-center justify-center w-24 h-8 mt-4 ml-4 bg-primary border border-primary text-white hover:text-primary hover:bg-white hover:border-primary" href="/view/physician-compensation-changing-in-new-medical-landscape"><p class="font-bold text-[.75rem]">Read More</p></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/semaglutide-linked-to-reduced-health-care-expenses-for-patients-with-obesity-hf-ascvd"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:56.25%"></span><img alt="Semaglutide Ozempic injection blood sugar obesity - myskin - stock.adobe.com.jpeg" title="Semaglutide Ozempic injection blood sugar obesity - myskin - stock.adobe.com.jpeg" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="Semaglutide Ozempic injection blood sugar obesity - myskin - stock.adobe.com.jpeg" title="Semaglutide Ozempic injection blood sugar obesity - myskin - stock.adobe.com.jpeg" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F00f67465444e616888dc9d36909fface4fd0ebff-1200x675.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=75 640w, 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flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/semaglutide-linked-to-reduced-health-care-expenses-for-patients-with-obesity-hf-ascvd">Semaglutide Linked to Reduced Health Care Expenses for Patients With Obesity, HF, ASCVD</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/giuliana-grossi">Giuliana Grossi</a></div><a href="/view/semaglutide-linked-to-reduced-health-care-expenses-for-patients-with-obesity-hf-ascvd"><span class="text-sm text-gray-500 pl-4">November 6th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">Results demonstrated the mean total medical costs per patient per year decreased significantly after patients began semaglutide treatment. </p><div class="pl-4"></div></a><a class="flex items-center justify-center w-24 h-8 mt-4 ml-4 bg-primary border border-primary text-white hover:text-primary hover:bg-white hover:border-primary" href="/view/semaglutide-linked-to-reduced-health-care-expenses-for-patients-with-obesity-hf-ascvd"><p class="font-bold text-[.75rem]">Read More</p></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="flex md:hidden justify-center items-center"></div><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/economic-burden-in-late-stage-amd-high-in-patients-and-caregivers-in-us"><div class=""><span 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RFBSIP - stock.adobe.com" title="Woman with AMD test | Image credit: RFBSIP - stock.adobe.com" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F43af789ce76f7e13dd4dbd704fb4bff3a8519779-5616x3744.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F43af789ce76f7e13dd4dbd704fb4bff3a8519779-5616x3744.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=750&q=75 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F43af789ce76f7e13dd4dbd704fb4bff3a8519779-5616x3744.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=828&q=75 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F43af789ce76f7e13dd4dbd704fb4bff3a8519779-5616x3744.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1080&q=75 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F43af789ce76f7e13dd4dbd704fb4bff3a8519779-5616x3744.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1200&q=75 1200w, 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style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/economic-burden-in-late-stage-amd-high-in-patients-and-caregivers-in-us">Economic Burden in Late-Stage AMD High in Patients and Caregivers in US</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/julia-bonavitacola">Julia Bonavitacola</a></div><a href="/view/economic-burden-in-late-stage-amd-high-in-patients-and-caregivers-in-us"><span class="text-sm text-gray-500 pl-4">November 6th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">Reduced well-being and loss of productivity were contributors to the high economic burden in patients with late-stage age-related macular degeneration (AMD) living in the US, Germany, and Bulgaria.</p><div class="pl-4"></div></a><a class="flex items-center justify-center w-24 h-8 mt-4 ml-4 bg-primary border border-primary text-white hover:text-primary hover:bg-white hover:border-primary" href="/view/economic-burden-in-late-stage-amd-high-in-patients-and-caregivers-in-us"><p class="font-bold text-[.75rem]">Read More</p></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/cigna-humana-resume-megamerger-talks-impact-on-stakeholders-health-outcomes-and-cost"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:56.266666666666666%"></span><img alt="Business deal | Image credit: sebra - stock.adobe.com" title="Business deal | Image credit: sebra - stock.adobe.com" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="Business deal | Image credit: sebra - stock.adobe.com" title="Business deal | Image credit: sebra - stock.adobe.com" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F9fdaabe729269f7e033d2d76014c5903b1541576-6000x3376.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F9fdaabe729269f7e033d2d76014c5903b1541576-6000x3376.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=750&q=75 750w, 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href="/view/cigna-humana-resume-megamerger-talks-impact-on-stakeholders-health-outcomes-and-cost">Cigna-Humana Resume Megamerger Talks: Impact on Stakeholders, Health Outcomes, and Cost</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/pearl-steinzor">Pearl Steinzor</a></div><a href="/view/cigna-humana-resume-megamerger-talks-impact-on-stakeholders-health-outcomes-and-cost"><span class="text-sm text-gray-500 pl-4">November 6th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">As Cigna and Humana pick back up on the potential for a megamerger, executives will be keeping a close eye on the outcomes of the presidential election. </p><div class="pl-4"></div></a><a class="flex items-center justify-center w-24 h-8 mt-4 ml-4 bg-primary border border-primary text-white hover:text-primary hover:bg-white hover:border-primary" href="/view/cigna-humana-resume-megamerger-talks-impact-on-stakeholders-health-outcomes-and-cost"><p class="font-bold text-[.75rem]">Read More</p></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/privately-negotiated-facility-fees-at-ambulatory-surgery-centers-and-hospitals"><div class=""><span 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srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F5421358c8f117ee86126333e135f08cf1e61ded6-778x382.png%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F5421358c8f117ee86126333e135f08cf1e61ded6-778x382.png%3Ffit%3Dcrop%26auto%3Dformat&w=750&q=75 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F5421358c8f117ee86126333e135f08cf1e61ded6-778x382.png%3Ffit%3Dcrop%26auto%3Dformat&w=828&q=75 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F5421358c8f117ee86126333e135f08cf1e61ded6-778x382.png%3Ffit%3Dcrop%26auto%3Dformat&w=1080&q=75 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F5421358c8f117ee86126333e135f08cf1e61ded6-778x382.png%3Ffit%3Dcrop%26auto%3Dformat&w=1200&q=75 1200w, 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style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/privately-negotiated-facility-fees-at-ambulatory-surgery-centers-and-hospitals">Privately Negotiated Facility Fees at Ambulatory Surgery Centers and Hospitals</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/daphne-t-hao">Daphne T. Hao</a><span class="mr-1 ml-[1px]">;</span><a class="text-sm text-sky-800" href="/authors/vinay-k-rathi-md-mba">Vinay K. Rathi, MD, MBA</a><span class="mr-1 ml-[1px]">;</span><a class="text-sm text-sky-800" href="/authors/joseph-s-ross-md-mhs">Joseph S. Ross, MD, MHS</a><span class="mr-1 ml-[1px]">;</span><a class="text-sm text-sky-800" href="/authors/rosh-k-v-sethi-md-mph">Rosh K. V. Sethi, MD, MPH</a><span class="mr-1 ml-[1px]">;</span><a class="text-sm text-sky-800" href="/authors/roy-xiao-md-ms">Roy Xiao, MD, MS</a></div><a href="/view/privately-negotiated-facility-fees-at-ambulatory-surgery-centers-and-hospitals"><span class="text-sm text-gray-500 pl-4">November 5th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">Private negotiated facility fees at hospitals are on average double the ambulatory surgery center facility fees for common outpatient procedures.</p><div class="pl-4"></div></a><a class="flex items-center justify-center w-24 h-8 mt-4 ml-4 bg-primary border border-primary text-white hover:text-primary hover:bg-white hover:border-primary" href="/view/privately-negotiated-facility-fees-at-ambulatory-surgery-centers-and-hospitals"><p class="font-bold text-[.75rem]">Read More</p></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/mapping-health-care-s-hidden-financial-burdens"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:50%"></span><img alt="The Center Logo | Image Credit: © Center for Innovation & Value Research" title="The Center Logo 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style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/medicaid-aiming-to-improve-patient-access-to-high-cost-therapies">Medicaid Aiming to Improve Patient Access to High-Cost Therapies</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/laura-joszt">Laura Joszt, MA</a></div><a href="/view/medicaid-aiming-to-improve-patient-access-to-high-cost-therapies"><span class="text-sm text-gray-500 pl-4">November 2nd 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">New legislation would clarify rules around value-based contracts in Medicaid, and a new model is expanding access to gene therapies, explained Adam Colborn, JD, of AMCP.</p><div class="pl-4"></div></a><a class="flex items-center justify-center w-24 h-8 mt-4 ml-4 bg-primary border border-primary text-white hover:text-primary hover:bg-white hover:border-primary" href="/view/medicaid-aiming-to-improve-patient-access-to-high-cost-therapies"><p class="font-bold text-[.75rem]">Read More</p></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/health-equity-access-weekly-roundup-november-2-2024"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:52.8052805280528%"></span><img alt="Center on Health Equity and Access" title="Center on Health Equity and Access" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" 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src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F1fb0458d4007f177c86e1a37a8c9d4ba60b1f084-303x160.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75" decoding="async" data-nimg="responsive" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/health-equity-access-weekly-roundup-november-2-2024">Health Equity & Access Weekly Roundup: November 2, 2024</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/giuliana-grossi">Giuliana Grossi</a></div><a href="/view/health-equity-access-weekly-roundup-november-2-2024"><span class="text-sm text-gray-500 pl-4">November 2nd 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">This week’s Center on Health Equity & Access highlights emphasize the role of social determinants of health in policy-making and underscore the importance of addressing rising costs and challenges employers face. </p><div class="pl-4"></div></a><a class="flex items-center justify-center w-24 h-8 mt-4 ml-4 bg-primary border border-primary text-white hover:text-primary hover:bg-white hover:border-primary" href="/view/health-equity-access-weekly-roundup-november-2-2024"><p class="font-bold text-[.75rem]">Read More</p></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/employers-shift-to-equity-focused-strategies-as-health-costs-outpace-wages"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:66.66666666666666%"></span><img alt="Healthcare costs and fees concept.Hand of smart doctor used a calculator for medical costs in modern hospital - everythingpossible - stock.adobe.com" title="Healthcare costs and fees 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style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/employers-shift-to-equity-focused-strategies-as-health-costs-outpace-wages">Employers Shift to Equity-Focused Strategies as Health Costs Outpace Wages</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/giuliana-grossi">Giuliana Grossi</a></div><a href="/view/employers-shift-to-equity-focused-strategies-as-health-costs-outpace-wages"><span class="text-sm text-gray-500 pl-4">October 31st 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">As health care costs escalate, a new survey reveals that 74% of employers are grappling with the impact on employee wages and benefits, with many anticipating further cost-shifting to their workforce. </p><div class="pl-4"></div></a><a class="flex items-center justify-center w-24 h-8 mt-4 ml-4 bg-primary border border-primary text-white hover:text-primary hover:bg-white hover:border-primary" href="/view/employers-shift-to-equity-focused-strategies-as-health-costs-outpace-wages"><p class="font-bold text-[.75rem]">Read More</p></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="flex md:hidden justify-center items-center"></div><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex 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/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F3a34c18fb30e230ed3e5665d823c6b2bda7cb8b7-1200x798.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F3a34c18fb30e230ed3e5665d823c6b2bda7cb8b7-1200x798.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75" decoding="async" data-nimg="responsive" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/contributor-vulnerable-seniors-are-at-risk-with-looming-medicare-advantage-cuts-income-based-programs-can-minimize-the-damage">Contributor: Vulnerable Seniors Are at Risk With Looming Medicare Advantage Cuts—Income-Based Programs Can Minimize the Damage </a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/andrey-ostrovsky-md">Andrey Ostrovsky, MD</a><span class="mr-1 ml-[1px]">;</span><a class="text-sm text-sky-800" href="/authors/anna-de-paula-hanika">Anna de Paula Hanika</a></div><a href="/view/contributor-vulnerable-seniors-are-at-risk-with-looming-medicare-advantage-cuts-income-based-programs-can-minimize-the-damage"><span class="text-sm text-gray-500 pl-4">October 31st 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">In the wake of the Inflation Reduction Act and other regulatory changes, Medicare Advantage plans have braced for significant cuts that are forcing them to take a hard look at their product offering. </p><div class="pl-4"></div></a><a class="flex items-center justify-center w-24 h-8 mt-4 ml-4 bg-primary border border-primary text-white hover:text-primary hover:bg-white hover:border-primary" href="/view/contributor-vulnerable-seniors-are-at-risk-with-looming-medicare-advantage-cuts-income-based-programs-can-minimize-the-damage"><p class="font-bold text-[.75rem]">Read More</p></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none 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href="/view/aca-enrollees-share-mixed-opinions-ahead-of-open-enrollment-upcoming-election">ACA Enrollees Share Mixed Opinions Ahead of Open Enrollment, Upcoming Election</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/pearl-steinzor">Pearl Steinzor</a></div><a href="/view/aca-enrollees-share-mixed-opinions-ahead-of-open-enrollment-upcoming-election"><span class="text-sm text-gray-500 pl-4">October 30th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">Report reveals growing divide between subsidized and unsubsidized enrollees. </p><div class="pl-4"></div></a><a class="flex items-center justify-center w-24 h-8 mt-4 ml-4 bg-primary border border-primary text-white hover:text-primary hover:bg-white hover:border-primary" href="/view/aca-enrollees-share-mixed-opinions-ahead-of-open-enrollment-upcoming-election"><p class="font-bold text-[.75rem]">Read More</p></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/medicare-shared-savings-program-continues-to-deliver-savings-quality-care"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span 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flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">Program yields largest savings in its history of more than $2.1 billion in 2023. </p><div class="pl-4"></div></a><a class="flex items-center justify-center w-24 h-8 mt-4 ml-4 bg-primary border border-primary text-white hover:text-primary hover:bg-white hover:border-primary" href="/view/medicare-shared-savings-program-continues-to-deliver-savings-quality-care"><p class="font-bold text-[.75rem]">Read More</p></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " 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style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/the-need-for-regulation-to-positively-impact-drug-formulary-decisions-to-ensure-appropriate-patient-access-a-little-discussed-topic-in-pharmaceutical-policy-and-pricing-debate">The Need for Regulation to Positively Impact Drug Formulary Decisions to Ensure Appropriate Patient Access: A Little-Discussed Topic in Pharmaceutical Policy and Pricing Debate</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/jan-e-berger-md-mj">Jan E. Berger, MD, MJ</a></div><a href="/view/the-need-for-regulation-to-positively-impact-drug-formulary-decisions-to-ensure-appropriate-patient-access-a-little-discussed-topic-in-pharmaceutical-policy-and-pricing-debate"><span class="text-sm text-gray-500 pl-4">October 30th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">As health care moves toward a value-based payment model, the pharmacy benefit is going in the opposite direction, one that places unit cost over clinical appropriateness. </p><div class="pl-4"></div></a><a class="flex items-center justify-center w-24 h-8 mt-4 ml-4 bg-primary border border-primary text-white hover:text-primary hover:bg-white hover:border-primary" href="/view/the-need-for-regulation-to-positively-impact-drug-formulary-decisions-to-ensure-appropriate-patient-access-a-little-discussed-topic-in-pharmaceutical-policy-and-pricing-debate"><p class="font-bold text-[.75rem]">Read More</p></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/medicare-costs-push-financial-limits-of-many-older-adults"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:61.5%"></span><img alt="Retired woman counting coins | Image Credit: © manassanant-stock.adobe.com" title="Retired woman counting coins | Image Credit: © manassanant-stock.adobe.com" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="Retired woman counting coins | Image Credit: © manassanant-stock.adobe.com" title="Retired woman counting coins | Image Credit: © manassanant-stock.adobe.com" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F6407f1981693d9f8e62cd9b5c6fead1998a7c1d2-1200x738.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F6407f1981693d9f8e62cd9b5c6fead1998a7c1d2-1200x738.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=750&q=75 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F6407f1981693d9f8e62cd9b5c6fead1998a7c1d2-1200x738.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=828&q=75 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F6407f1981693d9f8e62cd9b5c6fead1998a7c1d2-1200x738.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1080&q=75 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F6407f1981693d9f8e62cd9b5c6fead1998a7c1d2-1200x738.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1200&q=75 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F6407f1981693d9f8e62cd9b5c6fead1998a7c1d2-1200x738.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1920&q=75 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F6407f1981693d9f8e62cd9b5c6fead1998a7c1d2-1200x738.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=2048&q=75 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F6407f1981693d9f8e62cd9b5c6fead1998a7c1d2-1200x738.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F6407f1981693d9f8e62cd9b5c6fead1998a7c1d2-1200x738.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75" decoding="async" data-nimg="responsive" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/medicare-costs-push-financial-limits-of-many-older-adults">Medicare Costs Push Financial Limits of Many Older Adults</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/maggie-l-shaw">Maggie L. Shaw</a></div><a href="/view/medicare-costs-push-financial-limits-of-many-older-adults"><span class="text-sm text-gray-500 pl-4">October 28th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">Patients with Medicare coverage and whose incomes fall between 100% and 400% or less of the federal poverty level may find themselves in a tricky financial situation concerning their ability to pay the Medicare Part A hospital deductible. </p><div class="pl-4"></div></a><a class="flex items-center justify-center w-24 h-8 mt-4 ml-4 bg-primary border border-primary text-white hover:text-primary hover:bg-white hover:border-primary" href="/view/medicare-costs-push-financial-limits-of-many-older-adults"><p class="font-bold text-[.75rem]">Read More</p></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/insurers-ai-denials-of-postacute-care-face-senate-scrutiny"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:61.5%"></span><img alt="Insurance eligibility | Image Credit: © Dmitry-stock.adobe.com" title="Insurance eligibility | Image Credit: © Dmitry-stock.adobe.com" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="Insurance eligibility | Image Credit: © Dmitry-stock.adobe.com" title="Insurance eligibility | Image Credit: © Dmitry-stock.adobe.com" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2Faec3fa7e0e48d7d2a3a47ad6e2485ba561e227dd-1200x738.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2Faec3fa7e0e48d7d2a3a47ad6e2485ba561e227dd-1200x738.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=750&q=75 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2Faec3fa7e0e48d7d2a3a47ad6e2485ba561e227dd-1200x738.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=828&q=75 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2Faec3fa7e0e48d7d2a3a47ad6e2485ba561e227dd-1200x738.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1080&q=75 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2Faec3fa7e0e48d7d2a3a47ad6e2485ba561e227dd-1200x738.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1200&q=75 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2Faec3fa7e0e48d7d2a3a47ad6e2485ba561e227dd-1200x738.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1920&q=75 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2Faec3fa7e0e48d7d2a3a47ad6e2485ba561e227dd-1200x738.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=2048&q=75 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2Faec3fa7e0e48d7d2a3a47ad6e2485ba561e227dd-1200x738.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2Faec3fa7e0e48d7d2a3a47ad6e2485ba561e227dd-1200x738.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75" decoding="async" data-nimg="responsive" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/insurers-ai-denials-of-postacute-care-face-senate-scrutiny">Insurers’ AI Denials of Postacute Care Face Senate Scrutiny</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/maggie-l-shaw">Maggie L. Shaw</a></div><a href="/view/insurers-ai-denials-of-postacute-care-face-senate-scrutiny"><span class="text-sm text-gray-500 pl-4">October 28th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">Prior authorizations (PA) have been the subject of much scrutiny as of late through research demonstrating subsequent limited access to care in the aftermath of PA denials from use of artificial intelligence (AI) technologies.</p><div class="pl-4"></div></a><a class="flex items-center justify-center w-24 h-8 mt-4 ml-4 bg-primary border border-primary text-white hover:text-primary hover:bg-white hover:border-primary" href="/view/insurers-ai-denials-of-postacute-care-face-senate-scrutiny"><p class="font-bold text-[.75rem]">Read More</p></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/hssp-pharmacists-demonstrate-substantial-cost-avoidance-in-specialty-medication-use"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:60.333333333333336%"></span><img alt="Specialty Pharmacy graphic-leowolfert-stock.adobe.comåç.jpeg" title="Specialty Pharmacy graphic-leowolfert-stock.adobe.comåç.jpeg" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="Specialty Pharmacy graphic-leowolfert-stock.adobe.comåç.jpeg" title="Specialty Pharmacy graphic-leowolfert-stock.adobe.comåç.jpeg" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F8324b16a5a8b82cf28791fc1ac0256029556ddb8-1200x724.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F8324b16a5a8b82cf28791fc1ac0256029556ddb8-1200x724.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=750&q=75 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F8324b16a5a8b82cf28791fc1ac0256029556ddb8-1200x724.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=828&q=75 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F8324b16a5a8b82cf28791fc1ac0256029556ddb8-1200x724.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1080&q=75 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F8324b16a5a8b82cf28791fc1ac0256029556ddb8-1200x724.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1200&q=75 1200w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F8324b16a5a8b82cf28791fc1ac0256029556ddb8-1200x724.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1920&q=75 1920w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F8324b16a5a8b82cf28791fc1ac0256029556ddb8-1200x724.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=2048&q=75 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F8324b16a5a8b82cf28791fc1ac0256029556ddb8-1200x724.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F8324b16a5a8b82cf28791fc1ac0256029556ddb8-1200x724.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75" decoding="async" data-nimg="responsive" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/hssp-pharmacists-demonstrate-substantial-cost-avoidance-in-specialty-medication-use">HSSP Pharmacists Demonstrate Substantial Cost Avoidance in Specialty Medication Use</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/giuliana-grossi">Giuliana Grossi</a></div><a href="/view/hssp-pharmacists-demonstrate-substantial-cost-avoidance-in-specialty-medication-use"><span class="text-sm text-gray-500 pl-4">October 28th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">Cost avoidance varied by clinical setting, with the largest savings occurring in hematology clinics ($73,773), followed by rheumatology ($45,330) and pediatric gastrointestinal/irritable bowel syndrome ($16,519).</p><div class="pl-4"></div></a><a class="flex items-center justify-center w-24 h-8 mt-4 ml-4 bg-primary border border-primary text-white hover:text-primary hover:bg-white hover:border-primary" href="/view/hssp-pharmacists-demonstrate-substantial-cost-avoidance-in-specialty-medication-use"><p class="font-bold text-[.75rem]">Read More</p></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/the-challenge-of-addressing-drug-spend-to-drive-down-total-cost-of-care-in-eom"><div class=""><span 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with Stuart Staggs" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F4b65910add9689cf295d4e615085a9082400eac6-1280x720.png%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=75 640w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F4b65910add9689cf295d4e615085a9082400eac6-1280x720.png%3Ffit%3Dcrop%26auto%3Dformat&w=750&q=75 750w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F4b65910add9689cf295d4e615085a9082400eac6-1280x720.png%3Ffit%3Dcrop%26auto%3Dformat&w=828&q=75 828w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F4b65910add9689cf295d4e615085a9082400eac6-1280x720.png%3Ffit%3Dcrop%26auto%3Dformat&w=1080&q=75 1080w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F4b65910add9689cf295d4e615085a9082400eac6-1280x720.png%3Ffit%3Dcrop%26auto%3Dformat&w=1200&q=75 1200w, 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style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/the-challenge-of-addressing-drug-spend-to-drive-down-total-cost-of-care-in-eom">The Challenge of Addressing Drug Spend to Drive Down Total Cost of Care in EOM</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/laura-joszt">Laura Joszt, MA</a></div><a href="/view/the-challenge-of-addressing-drug-spend-to-drive-down-total-cost-of-care-in-eom"><span class="text-sm text-gray-500 pl-4">October 27th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">Stuart Staggs, vice president of transformation and shared services at McKesson, explained that oncology practices in the Enhancing Oncology Model (EOM) have a tough job driving down costs when drug costs make up a larger portion of the total cost of care.</p><div class="pl-4"></div></a><a class="flex items-center justify-center w-24 h-8 mt-4 ml-4 bg-primary border border-primary text-white hover:text-primary hover:bg-white hover:border-primary" href="/view/the-challenge-of-addressing-drug-spend-to-drive-down-total-cost-of-care-in-eom"><p class="font-bold text-[.75rem]">Read More</p></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="flex md:hidden justify-center items-center"></div><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/health-equity-access-weekly-roundup-october-26-2024"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:52.8052805280528%"></span><img alt="Center on Health Equity and Access" title="Center on Health Equity and Access" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" 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src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F1fb0458d4007f177c86e1a37a8c9d4ba60b1f084-303x160.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75" decoding="async" data-nimg="responsive" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/health-equity-access-weekly-roundup-october-26-2024">Health Equity & Access Weekly Roundup: October 26, 2024</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/giuliana-grossi">Giuliana Grossi</a></div><a href="/view/health-equity-access-weekly-roundup-october-26-2024"><span class="text-sm text-gray-500 pl-4">October 26th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">The Center on Health Equity & Access focuses on addressing disparities in health care access, exploring innovative solutions, policies, and research to improve health equity across diverse populations.</p><div class="pl-4"></div></a><a class="flex items-center justify-center w-24 h-8 mt-4 ml-4 bg-primary border border-primary text-white hover:text-primary hover:bg-white hover:border-primary" href="/view/health-equity-access-weekly-roundup-october-26-2024"><p class="font-bold text-[.75rem]">Read More</p></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto 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individuals' chances of developing breast cancer | image credit: Exuberation - stock.adobe.com" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="Preventative mastectomies can significantly reduce high-risk individuals' chances of developing breast cancer | image credit: Exuberation - stock.adobe.com" title="Preventative mastectomies can significantly reduce high-risk individuals' chances of developing breast cancer | image credit: Exuberation - stock.adobe.com" sizes="100vw" 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style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/5-things-to-know-about-preventive-mastectomies">5 Things to Know About Preventive Mastectomies</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/kyle-munz">Kyle Munz</a></div><a href="/view/5-things-to-know-about-preventive-mastectomies"><span class="text-sm text-gray-500 pl-4">October 25th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">As National Breast Cancer Awareness Month comes to a close, here are 5 things to note about the prospect of preventive mastectomies for individuals with a high-risk of developing breast cancer. </p><div class="pl-4"></div></a><a class="flex items-center justify-center w-24 h-8 mt-4 ml-4 bg-primary border border-primary text-white hover:text-primary hover:bg-white hover:border-primary" href="/view/5-things-to-know-about-preventive-mastectomies"><p class="font-bold text-[.75rem]">Read More</p></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " 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href="/view/medicaid-budget-survey-highlights-postpandemic-challenges-and-priorities">Medicaid Budget Survey Highlights Postpandemic Challenges and Priorities</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/cameron-santoro">Cameron Santoro</a></div><a href="/view/medicaid-budget-survey-highlights-postpandemic-challenges-and-priorities"><span class="text-sm text-gray-500 pl-4">October 24th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">The Medicaid budget survey for fiscal years 2024 and 2025 revealed state predictions are expecting a decline in Medicaid enrollment and an increase in spending next year due to the end of pandemic-era policies and federal funding.</p><div class="pl-4"></div></a><a class="flex items-center justify-center w-24 h-8 mt-4 ml-4 bg-primary border border-primary text-white hover:text-primary hover:bg-white hover:border-primary" href="/view/medicaid-budget-survey-highlights-postpandemic-challenges-and-priorities"><p class="font-bold text-[.75rem]">Read More</p></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/sarcoma-care-biomarker-advancements-shape-the-future"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:56.25%"></span><img alt="Vinayak Venkataraman, MD" title="Vinayak Venkataraman, MD" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="Vinayak Venkataraman, MD" title="Vinayak Venkataraman, MD" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F56291615341a19a49bc1c32812b1cab95325255a-1200x675.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=75 640w, 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/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F56291615341a19a49bc1c32812b1cab95325255a-1200x675.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=2048&q=75 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F56291615341a19a49bc1c32812b1cab95325255a-1200x675.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F56291615341a19a49bc1c32812b1cab95325255a-1200x675.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75" decoding="async" data-nimg="responsive" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/sarcoma-care-biomarker-advancements-shape-the-future">Sarcoma Care: Biomarker Advancements Shape the Future</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/maggie-l-shaw">Maggie L. Shaw</a></div><a href="/view/sarcoma-care-biomarker-advancements-shape-the-future"><span class="text-sm text-gray-500 pl-4">October 24th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">At the regional Institute for Value-Based Medicine® event in Boston, Vinayak Venkataraman, MD, medical oncologist at Dana-Farber Cancer Institute and Harvard Medical School, was a panelist for the discussion, “Recent Advancements in Identifying Predictive Biomarkers for Sarcomas."</p><div class="pl-4"></div></a><a class="flex items-center justify-center w-24 h-8 mt-4 ml-4 bg-primary border border-primary text-white hover:text-primary hover:bg-white hover:border-primary" href="/view/sarcoma-care-biomarker-advancements-shape-the-future"><p class="font-bold text-[.75rem]">Read More</p></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/cost-barriers-continue-to-limit-access-to-fertility-care"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:61.5%"></span><img alt="Reproductive health repped by a uterus | Image Credit: © Toowongsa-stock.adobe.com" title="Reproductive health repped by a uterus | Image Credit: © Toowongsa-stock.adobe.com" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="Reproductive health repped by a uterus | Image Credit: © Toowongsa-stock.adobe.com" title="Reproductive health repped by a uterus | Image Credit: © Toowongsa-stock.adobe.com" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F684944646c97968c025ecf2e0669129f46c00717-1200x738.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=75 640w, 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/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F684944646c97968c025ecf2e0669129f46c00717-1200x738.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=2048&q=75 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F684944646c97968c025ecf2e0669129f46c00717-1200x738.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F684944646c97968c025ecf2e0669129f46c00717-1200x738.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75" decoding="async" data-nimg="responsive" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/cost-barriers-continue-to-limit-access-to-fertility-care">Cost Barriers Continue to Limit Access to Fertility Care</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/maggie-l-shaw">Maggie L. Shaw</a></div><a href="/view/cost-barriers-continue-to-limit-access-to-fertility-care"><span class="text-sm text-gray-500 pl-4">October 24th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">Of the 10% of women contacted for this survey who said that they or their partner had ever sought fertility assistance, only 7% were able to get the necessary care; cost was cited as the top reason for not being able to access fertility services.</p><div class="pl-4"></div></a><a class="flex items-center justify-center w-24 h-8 mt-4 ml-4 bg-primary border border-primary text-white hover:text-primary hover:bg-white hover:border-primary" href="/view/cost-barriers-continue-to-limit-access-to-fertility-care"><p class="font-bold text-[.75rem]">Read More</p></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div><div class="w-full h-full"><hr class="mt-1 w-full " style="border-top-width:1px;border-top-color:#F3F4F6"/><div class="w-full h-full"><div class="w-full md:w-auto md:flex md:flex-col md:items-center lg:items-start lg:flex-row mb-4 mt-3 "><div class="flex flex-1 md:col-span-2 " style="background-color:transparent;border-color:#F3F4F6;border-width:0;border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem"><a class=" md:flex-none w-full md:w-48 mt-2" href="/view/breast-cancer-outcomes-improved-in-states-with-medicaid-expansion"><div class=""><span style="box-sizing:border-box;display:block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;padding-top:66.66666666666666%"></span><img alt="Medicare Expansion | Image Credit: wladimir1804- stock.adobe.com" title="Medicare Expansion | Image Credit: wladimir1804- stock.adobe.com" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="responsive" class="shrink-0" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%"/><noscript><img alt="Medicare Expansion | Image Credit: wladimir1804- stock.adobe.com" title="Medicare Expansion | Image Credit: wladimir1804- stock.adobe.com" sizes="100vw" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F48f2cf9bb4aa09a495d57461328e4b728e975001-6000x4000.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=640&q=75 640w, 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/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F48f2cf9bb4aa09a495d57461328e4b728e975001-6000x4000.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=2048&q=75 2048w, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F48f2cf9bb4aa09a495d57461328e4b728e975001-6000x4000.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75 3840w" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fajmc%2F48f2cf9bb4aa09a495d57461328e4b728e975001-6000x4000.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75" decoding="async" data-nimg="responsive" style="border-top-left-radius:0rem;border-top-right-radius:0rem;border-bottom-left-radius:0rem;border-bottom-right-radius:0rem;position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%" class="shrink-0" loading="lazy"/></noscript></span></div></a><div class="flex-auto w-[200%] md:w-auto ml-2 flex-1"><p class="font-bold text-[1rem] pl-4 text-undefined" style="font-size:1rem"><a href="/view/breast-cancer-outcomes-improved-in-states-with-medicaid-expansion">Breast Cancer Outcomes Improved in States With Medicaid Expansion</a></p><div class=" pl-4"><a class="text-sm text-sky-800" href="/authors/cameron-santoro">Cameron Santoro</a></div><a href="/view/breast-cancer-outcomes-improved-in-states-with-medicaid-expansion"><span class="text-sm text-gray-500 pl-4">October 24th 2024</span><div class="mt-2 ml-4"></div><div class="flex flex-row gap-2"></div><p class=" mt-4 text-gray-800 pl-4">Medicaid expansion is associated with improved care and increased survival rates for patients with certain breast cancers, but future studies should focus on whether Medicaid expansion mitigates the disparities between Black and non-White patients.</p><div class="pl-4"></div></a><a class="flex items-center justify-center w-24 h-8 mt-4 ml-4 bg-primary border border-primary text-white hover:text-primary hover:bg-white hover:border-primary" href="/view/breast-cancer-outcomes-improved-in-states-with-medicaid-expansion"><p class="font-bold text-[.75rem]">Read More</p></a><div class="flex flex-col sm:flex-row pl-2 mt-4"></div></div></div></div></div></div></div><div class="w-full text-center flex justify-center pb-24"><a class="px-4 py-2 border-y border-r bg-primary text-white" href="/topic/healthcare-cost?page=1">1</a><a class="px-4 py-2 border-y border-r " href="/topic/healthcare-cost?page=2">2</a><a class="px-4 py-2 border-y border-r " href="/topic/healthcare-cost?page=3">3</a><a class="px-4 py-2 border-y border-r " href="/topic/healthcare-cost?page=4">4</a><a class="px-4 py-2 border-y border-r " href="/topic/healthcare-cost?page=5">5</a><a class="px-4 py-2 border-y border-r " href="/topic/healthcare-cost?page=6">6</a><a class="px-4 py-2 border-y border-r " href="/topic/healthcare-cost?page=7">7</a><a class="px-4 py-2 border-y border-r " 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","published":"2024-11-09T13:00:00.000Z","updatedOn":null,"contentCategory":{"_createdAt":"2020-04-03T20:03:53Z","_rev":"Q2ZL7ihdIB33NiMMcGccmh","_type":"contentCategory","name":"Articles","_id":"3f4b3ced-7c9d-4fc4-967f-fe993087cce2","_updatedAt":"2023-09-29T14:32:27Z"},"authors":[{"displayName":"Giuliana Grossi","url":"giuliana-grossi"}],"title":"Health Equity \u0026 Access Weekly Roundup: November 9, 2024","factCheckAuthors":null,"_id":"27c8411e-9511-4863-922f-ba520dd6ecdf"},{"authors":[{"displayName":"Giuliana Grossi","url":"giuliana-grossi"}],"summary":"Medicaid and CHIP enrollment surged from 71 million in February 2020 to 94 million by April 2023. 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","contentCategory":{"_createdAt":"2020-04-03T20:03:53Z","_rev":"Q2ZL7ihdIB33NiMMcGccmh","_type":"contentCategory","name":"Articles","_id":"3f4b3ced-7c9d-4fc4-967f-fe993087cce2","_updatedAt":"2023-09-29T14:32:27Z"},"factCheckAuthors":null},{"published":"2024-11-06T16:10:00.000Z","updatedOn":null,"_id":"af330767-630e-44b3-854b-79655ecfe0c5","thumbnail":{"_type":"mainImage","alt":"Woman with AMD test | Image credit: RFBSIP - stock.adobe.com","caption":"Woman with AMD test | Image credit: RFBSIP - stock.adobe.com","asset":{"_ref":"image-43af789ce76f7e13dd4dbd704fb4bff3a8519779-5616x3744-jpg","_type":"reference"}},"summary":"Reduced well-being and loss of productivity were contributors to the high economic burden in patients with late-stage age-related macular degeneration (AMD) living in the US, Germany, and Bulgaria.","contentCategory":{"_createdAt":"2020-04-03T20:03:53Z","_rev":"Q2ZL7ihdIB33NiMMcGccmh","_type":"contentCategory","name":"Articles","_id":"3f4b3ced-7c9d-4fc4-967f-fe993087cce2","_updatedAt":"2023-09-29T14:32:27Z"},"authors":[{"displayName":"Julia Bonavitacola","url":"julia-bonavitacola"}],"factCheckAuthors":null,"title":"Economic Burden in Late-Stage AMD High in Patients and Caregivers in US","url":"economic-burden-in-late-stage-amd-high-in-patients-and-caregivers-in-us"},{"contentCategory":{"_type":"contentCategory","name":"Articles","_id":"3f4b3ced-7c9d-4fc4-967f-fe993087cce2","_updatedAt":"2023-09-29T14:32:27Z","_createdAt":"2020-04-03T20:03:53Z","_rev":"Q2ZL7ihdIB33NiMMcGccmh"},"authors":[{"displayName":"Pearl Steinzor","url":"pearl-steinzor"}],"factCheckAuthors":null,"_id":"1649444c-9d37-47bb-81e2-88598fffb96c","summary":"As Cigna and Humana pick back up on the potential for a megamerger, executives will be keeping a close eye on the outcomes of the presidential election. 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","published":"2024-10-31T14:19:13.451Z","updatedOn":null,"factCheckAuthors":null,"url":"employers-shift-to-equity-focused-strategies-as-health-costs-outpace-wages","contentCategory":{"_type":"contentCategory","name":"Articles","_id":"3f4b3ced-7c9d-4fc4-967f-fe993087cce2","_updatedAt":"2023-09-29T14:32:27Z","_createdAt":"2020-04-03T20:03:53Z","_rev":"Q2ZL7ihdIB33NiMMcGccmh"},"authors":[{"displayName":"Giuliana Grossi","url":"giuliana-grossi"}]},{"updatedOn":null,"contentCategory":{"name":"Articles","_id":"3f4b3ced-7c9d-4fc4-967f-fe993087cce2","_updatedAt":"2023-09-29T14:32:27Z","_createdAt":"2020-04-03T20:03:53Z","_rev":"Q2ZL7ihdIB33NiMMcGccmh","_type":"contentCategory"},"authors":[{"displayName":"Andrey Ostrovsky, MD","url":"andrey-ostrovsky-md"},{"displayName":"Anna de Paula Hanika","url":"anna-de-paula-hanika"}],"factCheckAuthors":null,"_id":"d0702e3f-00b8-4bc3-8417-58929d0ae9d5","url":"contributor-vulnerable-seniors-are-at-risk-with-looming-medicare-advantage-cuts-income-based-programs-can-minimize-the-damage","thumbnail":{"asset":{"_ref":"image-3a34c18fb30e230ed3e5665d823c6b2bda7cb8b7-1200x798-jpg","_type":"reference"},"_type":"mainImage","alt":"Medicare | Image Credit: © zimmytws - stock.adobe.com"},"summary":"In the wake of the Inflation Reduction Act and other regulatory changes, Medicare Advantage plans have braced for significant cuts that are forcing them to take a hard look at their product offering. ","title":"Contributor: Vulnerable Seniors Are at Risk With Looming Medicare Advantage Cuts—Income-Based Programs Can Minimize the Damage ","published":"2024-10-31T13:00:00.000Z"},{"_id":"724c0602-0ad3-414f-bc1d-277e29eb4c80","title":"ACA Enrollees Share Mixed Opinions Ahead of Open Enrollment, Upcoming Election","published":"2024-10-30T20:53:33.631Z","updatedOn":null,"authors":[{"displayName":"Pearl Steinzor","url":"pearl-steinzor"}],"factCheckAuthors":null,"url":"aca-enrollees-share-mixed-opinions-ahead-of-open-enrollment-upcoming-election","thumbnail":{"_type":"mainImage","alt":"Affordable Care Act | Image credit: Vitalii Vodolazskyi - stock.adobe.com","asset":{"_type":"reference","_ref":"image-0d6af7e5d45014ceb3f0bfb55fa7b8e384b6e35c-5500x3667-jpg"}},"summary":"Report reveals growing divide between subsidized and unsubsidized enrollees.\n\n","contentCategory":{"_updatedAt":"2023-09-29T14:32:27Z","_createdAt":"2020-04-03T20:03:53Z","_rev":"Q2ZL7ihdIB33NiMMcGccmh","_type":"contentCategory","name":"Articles","_id":"3f4b3ced-7c9d-4fc4-967f-fe993087cce2"}},{"title":"Medicare Shared Savings Program Continues to Deliver Savings, Quality Care","url":"medicare-shared-savings-program-continues-to-deliver-savings-quality-care","summary":"Program yields largest savings in its history of more than $2.1 billion in 2023.\n\n","published":"2024-10-30T14:08:55.219Z","updatedOn":null,"contentCategory":{"name":"Articles","_id":"3f4b3ced-7c9d-4fc4-967f-fe993087cce2","_updatedAt":"2023-09-29T14:32:27Z","_createdAt":"2020-04-03T20:03:53Z","_rev":"Q2ZL7ihdIB33NiMMcGccmh","_type":"contentCategory"},"_id":"fc7799b1-763f-4b37-9ecb-19e2c6dd2cef","authors":[{"displayName":"Pearl Steinzor","url":"pearl-steinzor"}],"factCheckAuthors":null,"thumbnail":{"default":false,"_type":"mainImage","alt":"The homepage of CMS.gov is seen on a smartphone | Tada Images - stock.adobe.com","asset":{"_ref":"image-e06646ca3ca64862748b1a07985b752837b45189-6000x4000-jpg","_type":"reference"}}},{"title":"The Need for Regulation to Positively Impact Drug Formulary Decisions to Ensure Appropriate Patient Access: A Little-Discussed Topic in Pharmaceutical Policy and Pricing Debate","published":"2024-10-30T13:00:00.000Z","contentCategory":{"_updatedAt":"2023-09-29T14:32:27Z","_createdAt":"2020-04-03T20:03:53Z","_rev":"Q2ZL7ihdIB33NiMMcGccmh","_type":"contentCategory","name":"Articles","_id":"3f4b3ced-7c9d-4fc4-967f-fe993087cce2"},"authors":[{"displayName":"Jan E. 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We’ve had more discovery in the past decade, and a lot of those drugs have made a huge difference in people’s lives. We should appreciate that and support that. In many instances, there’s a medical offset, and in some instances there’s not. But in any event, those are very important.","_key":"kvJgdpAm"}]},{"children":[],"_type":"block","style":"normal","_key":"ujMM46RY","markDefs":[]},{"_type":"block","style":"normal","_key":"TREvj9Su","markDefs":[],"children":[{"_type":"span","text":"I think the issue, from a value-based marketplace, is whether we are being priced fairly, right? Are they being used appropriately, right? And are we getting the outcomes that were advertised, right? I think that’s where the value-based discussion goes from here. I think it’s still to be written. There’s some concern that our intermediaries continue to be motivated by a model that’s gotten outdated. It was a market-share model based on rebates that ultimately evolved into a rebate model, right? We need to fix that, but I don’t think that’s going to be enough. That’s part of the solution, but it’s not the only part of the solution. This is still very much an evolving area, but I think it’s an area that’s on everybody’s radar and we need to stay focused on it.","_key":"Vd7AiyxP"}]},{"_type":"block","style":"normal","_key":"DBvYF1yQ","markDefs":[],"children":[]},{"markDefs":[],"children":[{"_key":"mB5qxcDI","_type":"span","text":"Well, thank you all for participating in this. This has been fascinating and very engaging. Before we end this discussion, I’d like to open the floor and ask each of you to provide some final thoughts. Dr. Crighton?"}],"_type":"block","style":"normal","_key":"z6fe2WJZ"},{"markDefs":[],"children":[],"_type":"block","style":"normal","_key":"fUYSgSd4"},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Andrew Crighton, MD:","_key":"u8irc5Dh"},{"_type":"span","text":" I think the No. 1 thing is, it’s a complicated issue that is not going to be easy to solve. But if we keep the patient in mind, and outcomes that improve their lives, we can get to where we need to be. We may have small successes as we go along, but we better celebrate those. We have to be moving in the right direction, or we’re going to be really far behind.","_key":"zG0Qeu9h"}],"_type":"block","style":"normal","_key":"8wArH2gH"},{"_key":"dVVLbNmp","markDefs":[],"children":[],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"4hTej5hm","markDefs":[],"children":[{"marks":["strong"],"text":"Michael Thompson: ","_key":"DMER1yNb","_type":"span"},{"_type":"span","text":"Great. 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Thompson:","_key":"tJvyznEK","_type":"span"},{"_type":"span","text":" Just picking up on the intermediary, I want to go to the price in a second. But first, the intermediaries. One of the things that 1 of our coalitions found was that it is in not only these high-priced drugs but also the low-value drugs where things seem to be askew. Things are being covered that shouldn’t be covered, for no other reason than that the business model rewards low value. Are you seeing that type of thing? Corollary to that, you know there are policy discussions right now about moving away from a rebate model. What are the implications of that? Is that a good thing, or is that a concern?","_key":"7hhKMsur"}],"_type":"block","style":"normal","_key":"x5dRUa46","markDefs":[]},{"_key":"8PaZBdQM","markDefs":[],"children":[],"_type":"block","style":"normal"},{"style":"normal","_key":"gy5C2Gr6","markDefs":[],"children":[{"marks":["strong"],"text":"Patricia Haines:","_key":"AIqoKeHN","_type":"span"},{"text":" I don’t think I would know that yet. I know that it has lowered our cost by having direct share in rebates. We pass that on population-wide, so we have at least an interim concern if we were to reverse that. It would benefit patients, but we’d also have to increase our cost across the total population. It feels in many ways to me sort of like sin money. We’ll buy a lot, and you’ll give it. It’s a kickback. Let’s call it what it is—a kickback. It’s a little unnerving to begin with. I think I’d really rather just have transparent cost and guarantees if I were creating a slightly more perfect world.","_key":"iXOaDVsa","_type":"span"}],"_type":"block"},{"style":"normal","_key":"p3hyUTlj","markDefs":[],"children":[],"_type":"block"},{"style":"normal","_key":"gBubuD0G","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Andrew Crighton, MD:","_key":"8x3wGRsS"},{"_type":"span","text":" I think the rebates have served their purpose. Like we need to move from fee-for-service, we need to move away from rebates. They served their purpose, and now they become a little bit skewed in the wrong way. The transparency needs to be there, but the rebates are inhibiting probably effective drugs for people too. New drugs may come out for rheumatoid arthritis, but they already got the rebates with these 2 drugs, and we’re going to just put this as a higher tier. Then it’s a barrier for that patient if that’s the drug that’s best for them. It’s like taking an ax to something that needs a scalpel right now.","_key":"fyK54Xk1"}],"_type":"block"},{"_type":"block","style":"normal","_key":"SEEhePHx","markDefs":[],"children":[]},{"style":"normal","_key":"Fx3801Dg","markDefs":[],"children":[{"_key":"esUSNYHe","_type":"span","marks":["strong"],"text":"Michael Thompson: "},{"_type":"span","text":"Yeah.","_key":"RzE4DkGX"}],"_type":"block"},{"_key":"Wa9HMJEW","markDefs":[],"children":[],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"qwfwzwRI","markDefs":[],"children":[{"marks":["strong"],"text":"Bruce Sherman, MD:","_key":"RQyB4c8o","_type":"span"},{"text":" Agreed. It’s 1 of a series of not-so-transparent components of contracting that makes at least me inherently suspicious of the delivery system. When we look at financial performance, should we be surprised that large healthcare companies have tremendous revenues? What are we missing? A transparent model would help us at least better understand how the pharmacy supply chain is working and where there may be some other opportunities for us to perhaps more effectively align our mutual interest.","_key":"joWdEjtA","_type":"span"}]},{"markDefs":[],"children":[],"_type":"block","style":"normal","_key":"4OzjEdjk"},{"children":[{"_type":"span","marks":["strong"],"text":"Michael Thompson: ","_key":"VIO0f2fN"},{"_key":"bhzUxvBz","_type":"span","text":"Let’s talk on the pricing side of this thing. Some of those prices that we hear and read about are being driven in part because of the need to generate rebates. What we’re paying here in the United States versus other countries is outrageous. Is there a need for us to somehow push back on that? How do we deal with that? There are policy proposals, but it seems to me we’ve kind of given a blank check, and it continually gets abused. How do you deal with that issue?"}],"_type":"block","style":"normal","_key":"OekE13NF","markDefs":[]},{"_type":"block","style":"normal","_key":"SyUkh3ru","markDefs":[],"children":[]},{"_type":"block","style":"normal","_key":"a7TiP7A0","markDefs":[],"children":[{"marks":["strong"],"text":"Patricia Haines: ","_key":"KtNtvCgr","_type":"span"},{"_type":"span","text":"I don’t think, as individual plans, that we could deal with it. I think that’s going to take a real volume effort. We’re not directly negotiating with pharma, so we’re kind of outside that negotiation path. Directly contracting would be meaningless for any organization, as an individual organization.","_key":"AodKIS2V"}]},{"style":"normal","_key":"HeytzMEB","markDefs":[],"children":[],"_type":"block"},{"_key":"v31fokRJ","markDefs":[],"children":[{"marks":["strong"],"text":"Andrew Crighton, MD: ","_key":"4Z4h2ztB","_type":"span"},{"_type":"span","text":"I know coalitions and other groups are combining to directly contract with hospitals. Why wouldn’t you come as a coalition and start directly contracting with manufacturers? Maybe it’s something. If they feel that they’re squeezed out of the PBM [pharmacy benefits management] by a tier, they may be open to this too. I don’t think anybody has really asked that question.","_key":"70aC0mif"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[],"_type":"block","style":"normal","_key":"Xl34U9Wy"},{"style":"normal","_key":"FT6dGiNB","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Bruce Sherman, MD: ","_key":"pqaeZm7L"},{"_type":"span","text":"Yeah. I think 1 of the challenges has been how to disrupt the status quo. Is there a big enough entity—and I think this is where coalitions certainly could have a role\u0026mdash;to think much in the way that we have created? Or has the marketplace of third-party administrators evolved relative to health plans? Maybe there’s an opportunity for a pharmacy benefit administrator that simply processes the claims data for pharmacy claims, and the direct contracting for the purchase of the drugs was done by another entity.","_key":"f5TEAQyo"}],"_type":"block"},{"_type":"block","style":"normal","_key":"sjCaKVU7","markDefs":[],"children":[]},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Michael Thompson: ","_key":"UESD5gCb"},{"_type":"span","text":"Yeah, I don’t pretend to say any of these are simple issues. But to say that there aren’t issues here would be a mistake too. It’s a big area that we’re trying to get our hands around too, in terms of where to take it.","_key":"sBvl72hf"}],"_type":"block","style":"normal","_key":"mnHkMEZt"},{"style":"normal","_key":"Q5Euk0dx","markDefs":[],"children":[],"_type":"block"},{"_type":"block","style":"normal","_key":"6GpyNRMh","markDefs":[],"children":[{"marks":["strong"],"text":"Patricia Haines: ","_key":"Rw5BiEui","_type":"span"},{"text":"I really worry about the affordability for patients. For most patients taking most drugs, they are the difference between quality of life and less quality of life. Most people don’t take drugs just because. They’re actually treating something—particularly diabetics. I hear story after story about the expense of just managing type 2 diabetes. Between test strips and insulin and doctor’s visits and the eye exams, it’s a really expensive disease. We want people to be adherent. The affordability issue on drugs is particularly a patient-centered issue.","_key":"Z12d76Py","_type":"span"}]},{"style":"normal","_key":"SzT3VeVO","markDefs":[],"children":[],"_type":"block"},{"markDefs":[],"children":[{"marks":["strong"],"text":"Bruce Sherman, MD: ","_key":"UVrLTZxY","_type":"span"},{"_type":"span","text":"I think you raise a really interesting point. And coming back to a topic of earlier discussion, the issue of prevention, I think, is critical. Much in the way with oncology, earlier detection of cancers can be potentially curative. Similarly, earlier attention to management of the prediabetic could potentially mitigate the need for some of those diabetic drugs. 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That’s a different animal.","_key":"jWpBKckr"}],"_type":"block","style":"normal","_key":"z7ks6rpJ"},{"_type":"block","style":"normal","_key":"UOHZWija","markDefs":[],"children":[]},{"_key":"FRKTkMXB","markDefs":[],"children":[{"text":"Patricia Haines:","_key":"WHlSPtpi","_type":"span","marks":["strong"]},{"_type":"span","text":" Oh, yeah.","_key":"4msdS5xN"}],"_type":"block","style":"normal"},{"children":[],"_type":"block","style":"normal","_key":"kHLNA4mw","markDefs":[]},{"_key":"cFZpoAuC","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Michael Thompson: ","_key":"6q2q8pp6"},{"_type":"span","text":"I know for employers it’s not the biggest spend, but it’s the fastest-growing spend. There’s a lot of attention here, and frankly, a little bit of controversy in this area too in terms of what’s happened. Some of it is the underlying emergence of very innovative drugs and very expensive drugs—specialty drugs. How are employers viewing the specialty drugs, the emergence of these highly, highly expensive\u0026mdash;but in some instances very highly effective\u0026mdash;drugs that are coming out?","_key":"2fVB7QxK"}],"_type":"block","style":"normal"},{"_key":"3ArzB24t","markDefs":[],"children":[],"_type":"block","style":"normal"},{"_key":"zzuxtB2a","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Andrew Crighton, MD:","_key":"bGy8trjb"},{"_type":"span","text":" I think there is a lot of concern because of this increased cost, but if you’d sit back and look at how are you reducing the medical spin—I’ll pick on the hepatitis C drugs. Everybody was worried about this, and we saw it an increase in the uptake of the hepatitis C drugs. Once people got treated, it went down, and the medical claims followed too. Those that are curative are great. Those for chronic diseases\u0026mdash;that are more disease-modifying, that they have to take for life\u0026mdash;may still be concerning. If we look at the medical span, we may still be saving some money. So it’s looking at that total cost of care versus just a silo of the pharmacy.","_key":"FAZYcJJe"}],"_type":"block","style":"normal"},{"style":"normal","_key":"cmNnuSu5","markDefs":[],"children":[],"_type":"block"},{"children":[{"_type":"span","marks":["strong"],"text":"Patricia Haines: ","_key":"tNpZjTCm"},{"_type":"span","text":"Yeah, I’d agree. I think there’s good news and bad news. Certainly, some of the high-cost drugs that our members are taking are saving on the medical side. Oncology, I’m not so sure, because with all the development in oncology drugs, 2 things are happening, at least in our population. It is extending a period of disability, and it is really not eliminating an ultimate outcome. I don’t know much about the quality of life in between, but I do know that that cancer has moved for us to a chronic disease. It is being managed with very high-cost-infused drugs. I just don’t know if they’re the answer. I think that’s something that I would need more information about.","_key":"e8Qbm5QN"}],"_type":"block","style":"normal","_key":"QZGyAd5K","markDefs":[]},{"_type":"block","style":"normal","_key":"uuaetCIs","markDefs":[],"children":[]},{"children":[{"_type":"span","marks":["strong"],"text":"Bruce Sherman, MD:","_key":"B3ggFOqu"},{"_type":"span","text":" I think it’s a real ethical dilemma, especially in the setting of cancer. How much should—or how much is acceptable\u0026mdash;an employer to spend to prolong life, disability or no disability? And where should that line be drawn to say, “This is cost prohibitive” or, “If you want to purchase this, you can using your dollars, but we as the employer are not going to pay for it.” That’s such a sensitive issue that I don’t know whether we have any easy answers for that just yet.","_key":"HS5PbNvG"}],"_type":"block","style":"normal","_key":"hXEbMEkN","markDefs":[]},{"markDefs":[],"children":[],"_type":"block","style":"normal","_key":"1pMNYaSA"},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Patricia Haines: ","_key":"hrrxqFto"},{"_key":"rUdGCr7P","_type":"span","text":"I’m not sure it’s an employer issue. I think it’s an ethical, medical-world issue. How much care is too much care?"}],"_type":"block","style":"normal","_key":"JiAB7Z4B"},{"style":"normal","_key":"DM5v7PLI","markDefs":[],"children":[],"_type":"block"},{"children":[{"_type":"span","marks":["strong"],"text":"Michael Thompson: ","_key":"yeFofTaq"},{"_type":"span","text":"It is interesting, to that point. At some level employers have kind of ceded determinations on this to their intermediaries—the PBMs [pharmacy benefit managers] and, in some instances, health plans. What is the role of that intermediary, and how are they performing as it relates to drug management? I know we hear some noise, but I’m wondering what you’ve observed.","_key":"1CE40DAi"}],"_type":"block","style":"normal","_key":"3Bxy0Ct7","markDefs":[]},{"markDefs":[],"children":[],"_type":"block","style":"normal","_key":"ztb4fUZ8"},{"style":"normal","_key":"8Qk3wkeY","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Andrew Crighton, MD: ","_key":"SROMv56i"},{"_type":"span","text":"I think it is difficult. As you said, some of these used to be acute diseases that ended up with death and now are chronic diseases. HIV is along that line too. People are still trying to figure out what that end point should be, and it’s probably going to get worse…. Some of this personalized medicine, based on the genetic markers of these tumors, is going to complicate it even more. The jury is still out on this, and I think it’s going to get murky before it ever gets clear.","_key":"GOpI0BFl"}],"_type":"block"},{"style":"normal","_key":"9Wdmrw9O","markDefs":[],"children":[],"_type":"block"},{"children":[{"marks":["strong"],"text":"Patricia Haines: ","_key":"IGd3etQO","_type":"span"},{"_key":"203Wvzsf","_type":"span","text":"I will take a slightly cynical view of the intermediaries. Although they’re a necessary evil—if they didn’t exist, we’d have to invent them. Even though they all tout P\u0026T [pharmacy and therapeutics] committees and are constantly looking at clinical efficacy, it’s an economic decision at the end of the day. We had a drug moved from tier 2 to tier 3\u0026mdash;a specialty drug, with no alternatives\u0026mdash;and we say, “Why, if there’s no alternative?” The whole purpose of tiering on a formulary is to drive to a lower-cost alternative, but there isn’t any. I think it’s because they weren’t getting any rebates. That’s the cynical part of me. But again, they’re necessary. It’s a very complicated purchase. It’s a very complicated business to manage, and I admit that we need them."}],"_type":"block","style":"normal","_key":"lUyGmOmy","markDefs":[]},{"style":"normal","_key":"PeWDH7Nu","markDefs":[],"children":[],"_type":"block"},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Bruce Sherman, MD: ","_key":"OeoBbbfv"},{"_type":"span","text":"From a philosophical standpoint, we have new technologies in the laboratory that are enabling the development of new categories of drugs that we didn’t know could even exist. Those come at a cost. I think it’s incumbent upon us—as employers and coalitions\u0026mdash;to push back in the same way on the pharmacy side as we are on the medical side. 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This is an area in which we have directories full of providers, and apparently it’s kind of hard to get an appointment with a provider, particularly if you’re a new patient. What are you seeing there, and where do we go from here? I mean, this is a big challenge, I think. Pat?","_key":"GpxwQyXI"}],"_type":"block"},{"style":"normal","_key":"1rplsBhc","markDefs":[],"children":[],"_type":"block"},{"children":[{"marks":["strong"],"text":"Patricia Haines:","_key":"fza03rUh","_type":"span"},{"_type":"span","text":" I’m thinking this is an area in which telemedicine may have a role—at least in the short term\u0026mdash;because you’re right, the access is really hard. I think we use a pretty broad network, and we still hear all the time that there just aren’t the providers there. This is an area in which I think\u0026mdash;at least for initial consult, or some intervention, or somebody to talk to\u0026mdash;telemedicine might be effective for mental health.","_key":"lXQxgiAM"}],"_type":"block","style":"normal","_key":"FPOBRqBZ","markDefs":[]},{"children":[],"_type":"block","style":"normal","_key":"9cjq6YNu","markDefs":[]},{"style":"normal","_key":"e9F02QWa","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Andrew Crighton, MD:","_key":"tpQapytR"},{"_key":"aUNZDaq1","_type":"span","text":" Yeah. I think this is your classic supply and demand. You do not have enough mental health providers. Therefore, they don’t have to be part of the networks. They can be out of a network and thrive and do well, and a lot of times it’s easier on the practice. They don’t have to hire as much administrative staff and deal with all the headaches of having to file claims and things like this."}],"_type":"block"},{"_type":"block","style":"normal","_key":"4myb4mtw","markDefs":[],"children":[]},{"markDefs":[],"children":[{"_type":"span","text":"First of all, there’s not enough. And second, as you said, there may be a list of providers, but they may not be taking any more new patients with this plan. I think we need to get more mental health providers, whether it’s an issue of reimbursement or things like that. But it’s difficult. It’s like primary care—a difficult profession to get providers to go into.","_key":"uBzwQV1Z"}],"_type":"block","style":"normal","_key":"zSIkQSSI"},{"markDefs":[],"children":[],"_type":"block","style":"normal","_key":"bDqUIkM4"},{"_type":"block","style":"normal","_key":"qE9dDEJ2","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Bruce Sherman, MD:","_key":"UeV50J07"},{"_type":"span","text":" I would completely agree, and I think 1 of the challenges is, are they as providers being appropriately compensated for the services that they provide? They don’t have procedures like a number of other clinical entities. I think to a good extent that creates an incentive or is a limitation that creates an incentive, for those individuals who want to be paid in parity with other individuals in the profession.","_key":"ZPkzG5eg"}]},{"markDefs":[],"children":[],"_type":"block","style":"normal","_key":"ouYICj3G"},{"children":[{"marks":["strong"],"text":"Michael Thompson: ","_key":"SxVYTBic","_type":"span"},{"_type":"span","text":"This also relates to integration of behavioral health into primary care. Most of the prescription drugs that are being offered for a behavioral health issue are coming through primary care, yet our primary care physicians are not trained in behavioral typically, right? There were new codes established just over the last few years, and Medicare is paying for them. When we did our deep dive, we found there are not a lot of claims coming through on that space. How important is it to get that fixed?","_key":"LB8zbIkw"}],"_type":"block","style":"normal","_key":"ncQ7L50w","markDefs":[]},{"_type":"block","style":"normal","_key":"Oc08xFY1","markDefs":[],"children":[]},{"_type":"block","style":"normal","_key":"TyLCf7Kv","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Andrew Crighton, MD: ","_key":"2GJSXUoJ"},{"_type":"span","text":"I think it’s very important, because as we talk about this in employer groups too, 1 of the solutions to taking care of lack of access to behavioral health professionals is centered on primary care. And you’re already short-staffed there. That’s just not a solution at all. I think for primary care providers, as they add a behavioral health individual into their practice, there’s just such a wealth of support there—not only because somebody may have a mental health condition. Some of the people with chronic illness need that behavioral health counseling to kind of turn the corner. I think it can make a primary care provider’s job much easier too.","_key":"YCIj2eET"}]},{"markDefs":[],"children":[],"_type":"block","style":"normal","_key":"O3bvSU0P"},{"style":"normal","_key":"hSWqwhQY","markDefs":[],"children":[{"text":"Patricia Haines: ","_key":"xQpYKn3L","_type":"span","marks":["strong"]},{"text":"The ideal primary care office would have behavioral health specialists and a nutritionist all under the same group.","_key":"7GwK36gz","_type":"span"}],"_type":"block"},{"markDefs":[],"children":[],"_type":"block","style":"normal","_key":"JE64xFFg"},{"children":[{"_type":"span","marks":["strong"],"text":"Michael Thompson: ","_key":"WQrhIF0Z"},{"_type":"span","text":"There are still a lot of solo practitioners or small practices, and we shouldn’t discount virtual care in this. Virtual care is the way that we can deliver integration even in small practices, but we have to have a will to help make that happen and push that through. I do think, to your point, interestingly what I have heard from providers is that they have gone to integrating behavioral health into their primary care practice, and they will never go back. Once they’ve experienced what it means to serve their patients effectively and comprehensively, they realize it’s better for their patients and better for them—it’s all good.","_key":"o0OYN4Hb"}],"_type":"block","style":"normal","_key":"qhkuwGkF","markDefs":[]},{"markDefs":[],"children":[],"_type":"block","style":"normal","_key":"TbA8qSXa"},{"_key":"ctpzbnCU","markDefs":[],"children":[{"_type":"span","text":"I think that there’s a lot of work to be done still in the medical-delivery system. I think some of the central themes are, we need to look at payment reform, and we need to look at delivery reform. When you put more emphasis on primary care, the triple aim and quadruple aim still remain there. We need to be able to differentiate on quality. We need to understand what the costs are. 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I’ve also seen that there was a greater level of satisfaction—for the patient and the provider.","_key":"bQCQmRXN"}],"_type":"block","style":"normal","_key":"ZecfUVLt"},{"children":[],"_type":"block","style":"normal","_key":"CxdxYose","markDefs":[]},{"_key":"WlKCqc1j","markDefs":[],"children":[{"_type":"span","text":"We know from other studies that effective use of primary care at a population level results in substantially lower overall healthcare costs for individuals who are engaged. So there’s a compelling business case.","_key":"rsVfP4sf"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[],"_type":"block","style":"normal","_key":"PWL6bFd5"},{"children":[{"text":"Michael Thompson: ","_key":"OsBBHXnQ","_type":"span","marks":["strong"]},{"_type":"span","text":"That is a bright spot we’ve seen in the last 15 years in some of these emerging models—on-site clinics, near-site clinics, and sometimes building new clinics in communities. Frankly, we’ve had some concern as primary care has gotten bought by health systems. Their orientation is not the same as advanced primary care. In fact, have you seen anything like that, in terms of any issues?","_key":"SU84DWS8"}],"_type":"block","style":"normal","_key":"yLmhFKQJ","markDefs":[]},{"markDefs":[],"children":[],"_type":"block","style":"normal","_key":"5Wyqdks6"},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Andrew Crighton, MD: ","_key":"jTqSDK0w"},{"_type":"span","text":"We do see more churning, so that relationship with the patient is less likely to happen. You may not see the same provider the next time you go to this group, so you haven’t developed the trust. Are you going to follow through on the recommendation? There needs to be a relationship. Second, it’s easier to refer to a specialist. Rather than taking care of the issue and trying to address it, it’s like, “I have 7 minutes. 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If we can truly improve the health of our population, then why wouldn’t we operate with that?"}],"_type":"block","style":"normal","_key":"I7eepYtn"},{"children":[],"_type":"block","style":"normal","_key":"wgXo8ubk","markDefs":[]},{"_type":"block","style":"normal","_key":"3USJQCdR","markDefs":[],"children":[{"_type":"span","text":"Pat, you mentioned before that we’re not going to get great primary care if we keep treating primary care the same way we do today.","_key":"phaf4O0P"}]},{"_type":"block","style":"normal","_key":"7tj2ji9j","markDefs":[],"children":[]},{"_type":"block","style":"normal","_key":"ns34TUXl","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Patricia Haines:","_key":"HIYLHCHH"},{"_type":"span","text":" Right. I strongly believe that they have these limited periods of time, and there aren’t enough of them. I think they’re not choosing it because they’re not rewarded appropriately.","_key":"tTzG197s"}]},{"_type":"block","style":"normal","_key":"MzvVYTNX","markDefs":[],"children":[]},{"_key":"8uezWqjr","markDefs":[],"children":[{"marks":["strong"],"text":"Michael Thompson: ","_key":"jtAtVocS","_type":"span"},{"_key":"6aQE7Gqp","_type":"span","text":"I think there are new emerging business models to help make that happen. Part of that is physician extenders and team-based care, which allows primary care to use the professionals at the top of their profession."}],"_type":"block","style":"normal"},{"markDefs":[],"children":[],"_type":"block","style":"normal","_key":"REVHvnTX"},{"children":[{"text":"Patricia Haines: ","_key":"2iFBPl2d","_type":"span","marks":["strong"]},{"_type":"span","text":"How about the impact of urgent care and telemedicine? We’re seeing a very high use of telemedicine. I think that’s good but maybe not so good. 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Or is it integrated delivery networks and health systems that have telemedicine capabilities? We’re still learning what services and what proportion of those services are being used by which individuals, because you have the potential for further fragmentation of care delivery. Retail clinics are another potential risk of that happening. But if there is effective communication with the primary care practices, then it may be less of a concern.","_key":"Pwym4fPo"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[],"_type":"block","style":"normal","_key":"2ZlMvJ9F"},{"style":"normal","_key":"ewmPMtHE","markDefs":[],"children":[{"_type":"span","text":"The other issue is, are we creating or inducing demand, by virtue of making access to healthcare easier through telehealth? 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Employers obviously spend a lot of activity providing designs and programs for their employees, but they’re also a big influence on the supply chain as well, especially when they work together. And frankly, this is an area that seems to be going in the wrong direction in some instances, right? We’ve been living with fee-for-service medicine for a long time, but it’s not clear that this is getting better. Any thoughts on some of the factors that are contributing to that?","_key":"VvQbPrH5"}],"_type":"block","style":"normal","_key":"BSBFiOfK","markDefs":[]},{"_key":"y1Zyh00d","markDefs":[],"children":[],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"marks":["strong"],"text":"Andrew Crighton, MD:","_key":"4YHjJp6J","_type":"span"},{"_type":"span","text":" I think when you look in the medical system, it’s still driven by RVUs, relative value units. So the doctor is being rewarded on how serious the condition is and how many times they see this. So the more conditions they see, the more patients they see—it’s driven by volume, which is that same methodology for fee-for-service. So even if it’s not a fee-for-service, the basics of the physician reward are still in the health system itself.","_key":"U4l8CwIi"}],"_type":"block","style":"normal","_key":"YquN3WnE"},{"_type":"block","style":"normal","_key":"F7ViHMcb","markDefs":[],"children":[]},{"_key":"zOPrPDzi","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Patricia Haines:","_key":"zUOO2ZSc"},{"_type":"span","text":" Do you think the increased number of salaried physicians with in-house systems changes any of that?","_key":"RfJJGwGb"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[],"_type":"block","style":"normal","_key":"pAVxkfmS"},{"_key":"cA65PlJL","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Andrew Crighton, MD: ","_key":"podywtQV"},{"text":"It depends on how the salary is based. 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But getting back to the original point, I think salary providers—when the income stream is assured based on a fee-for-service model, what impetus do individuals have to accept any risk from the supply side to change the way that they contract, because that could result in lower earnings.","_key":"D4ya3CDB","_type":"span"}],"_type":"block","style":"normal","_key":"xxUVdk3w","markDefs":[]},{"_key":"UTnTsNP0","markDefs":[],"children":[],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"jMHXnVgr","markDefs":[],"children":[{"_type":"span","text":"They don’t really have a compelling motivation to transition from fee-for-service necessarily to a risk-based model. My sense is when entities within those individual marketplaces start to move in that direction, they will cause a shift in the rest of the service or the service providers to move more in that direction. And I think that’s where—Mike, to your point\u0026mdash;employers have a powerful role to play.","_key":"Gp5qer5P"}]},{"markDefs":[],"children":[],"_type":"block","style":"normal","_key":"AekgqhRe"},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Michael Thompson: ","_key":"BOsiVxrI"},{"text":"To what degree have the employers, in many instances, insisted on broad networks contributing to the problem? Do you see that as part of the issue?","_key":"C7ltNOn0","_type":"span"}],"_type":"block","style":"normal","_key":"D3LnwdTn"},{"style":"normal","_key":"BduniW3D","markDefs":[],"children":[],"_type":"block"},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Andrew Crighton, MD: ","_key":"jMsNy2j4"},{"_type":"span","text":"You have less influence, I guess. In the narrower networks, you have better contract negotiations, or the price for service is already negotiated. 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But then on the flip side, you have to watch: if you have a narrow network and everybody else does too, well, then you’re overloading these providers, and it may be hard to get into them too.","_key":"h5V9jSlC"}],"_type":"block","style":"normal","_key":"DTIzblQK"},{"_key":"vMhYbcnl","markDefs":[],"children":[],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Bruce Sherman, MD: ","_key":"mphWNtXM"},{"_type":"span","text":"I think this is a great opportunity for employers to come together as coalitions to be able to work together to identify who those higher-quality providers are and use evidence to support the development of more high-value networks rather than call them narrow semantics, probably lean toward high value.","_key":"aB9D9eza"}],"_type":"block","style":"normal","_key":"hVa8hwhL"},{"markDefs":[],"children":[],"_type":"block","style":"normal","_key":"PFWKEn9t"},{"markDefs":[],"children":[{"_key":"8upjlu4B","_type":"span","marks":["strong"],"text":"Michael Thompson: "},{"_type":"span","text":"Well, maybe it isn’t all about narrow networks. It’s about value differentiation within our programs. Right? And we need information to help better understand who the higher-value providers are, and we need people have a better incentive to go in that direction.","_key":"gBWOMdzU"}],"_type":"block","style":"normal","_key":"F5VUj15Q"},{"_type":"block","style":"normal","_key":"Z6h1VgPB","markDefs":[],"children":[]},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Patricia Haines: ","_key":"Pt3IncGu"},{"_type":"span","text":"I was sitting here thinking, “I’d put in front of any narrow network high performing,” and qualify it that way. We’re hugely dispersed, and so we don’t really have the leverage, I think, in any given market to do that. But I have really appreciated the work of the Greater Philadelphia Business Coalition on Health because, just by its existence and the creation of certain standards, there are more hospitals now feeling pressured to participate in leapfrog than before. So there is strength in numbers. If you coalesce around values and issues of quality, someone is going to sit up and pay attention.","_key":"aMH9668H"}],"_type":"block","style":"normal","_key":"xyvSdBAV"},{"_key":"NmXfZTz8","markDefs":[],"children":[],"_type":"block","style":"normal"},{"style":"normal","_key":"wu74KpsX","markDefs":[],"children":[{"text":"Michael Thompson: ","_key":"5lyUVFNA","_type":"span","marks":["strong"]},{"_type":"span","text":"I want to shift gears a little bit in terms of payment reform. We know that there are experiments with payment reforms through the various carriers, and we know Medicare is now doing a lot of experimentation in Medicare in payment reform as well, particularly around bundled payments. And 1 observation I would make is that we really need people to do the same thing, right? Providers don’t react well when everybody is doing something different. 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They know it’s going to be this type of payment, and I think you start aligning everyone’s goals. I think that’s what we’ve been talking about: there are misaligned goals in the system right now. With this one, there are few procedures that this makes sense for, but if you can align those goals, you’re going to get better outcomes at a better price.","_key":"gn0813wy","_type":"span"}],"_type":"block"},{"_key":"2SaFUM6a","markDefs":[],"children":[],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Bruce Sherman, MD: ","_key":"miGZjP4o"},{"_type":"span","text":"Certainly at the Coalition, we’ve been involved with bundled pricing and implementation. We have a number of coalitions that are at various stages of implementation. I think 1 of the biggest challenges has been coming up with a standard set of definitions in terms of how when we look at quality, we see the same thing. Health plans use different measures. 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and, in some instances, growing challenges. And I think back to how we got a handle on substantial improvement in the smoking rates in the country. And it wasn’t 1 thing. It was a lot of things that happened over a period of years. And we have 2 persistent key issues: obesity and opioids. What are your thoughts? What do we need to do there? I’ll bet it’s not 1 thing. But what are some of the things we need to do if we’re going to get our hands around those 2 issues?"}],"_type":"block","style":"normal","_key":"4eAktjMy"},{"children":[],"_type":"block","style":"normal","_key":"v1VPy99y","markDefs":[]},{"children":[{"text":"Andrew Crighton, MD:","_key":"RAQiDWgW","_type":"span","marks":["strong"]},{"_type":"span","text":" I’ll let Bruce take that one.","_key":"oYYqzbkm"}],"_type":"block","style":"normal","_key":"3DdeIBqB","markDefs":[]},{"markDefs":[],"children":[],"_type":"block","style":"normal","_key":"nisX5kku"},{"_key":"mrU44J3E","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Michael Thompson: ","_key":"zKKAADJW"},{"_type":"span","text":"Go ahead, Bruce.","_key":"2Tfd5VfM"}],"_type":"block","style":"normal"},{"children":[],"_type":"block","style":"normal","_key":"5mjWuQsG","markDefs":[]},{"children":[{"_type":"span","marks":["strong"],"text":"Bruce Sherman, MD:","_key":"HDQJGYJ3"},{"_type":"span","text":" No easy answers. I think from an opioid standpoint, there’s the piece of this that’s related to overprescribing both in terms of frequency and volume of opioids through the current healthcare system. And I think we’re taking steps to reasonably address that. I think the bigger issue is how the current environment is creating, especially for individuals in lower-income categories, sustained depression and stress. Opioids represent, for some individuals, a very attractive escape from that. And until we address some of those underlying issues, we have a challenge on our hands.","_key":"AVmFrCxH"}],"_type":"block","style":"normal","_key":"sNsx3r18","markDefs":[]},{"_type":"block","style":"normal","_key":"DbYKoxQn","markDefs":[],"children":[]},{"_type":"block","style":"normal","_key":"9AY3yMVL","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Andrew Crighton, MD: ","_key":"mjGMWB6i"},{"_key":"NkLbcgor","_type":"span","text":"Yes, I would agree. I think the social support is important. The purpose is driven; those people are probably less likely to rely on an outlet such as opioids. When you look at the obesity aspect, that is much more complicated than people think. People think, “Oh, we’ll just eat less, exercise more,” but there are a lot of genetic components, too, that are being identified. So it’s more complicated than just, and so it’s probably a symptom of other things going on versus an actual disease. I mean, it leads a lot of things, but I think it’s a symptom of other things going on, and it’s multifactorial."}]},{"markDefs":[],"children":[],"_type":"block","style":"normal","_key":"VBBOfjIu"},{"_key":"4mhAtRLf","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Patricia Haines:","_key":"Pla50vdU"},{"_type":"span","text":" Our population suffers the same way others do: less from the opioids honestly, probably less than an average population, but certainly from obesity and just lifetime habits. And that’s behavior modification that if we had it, that would be key. I will say that we’ve had fair success with bariatric surgery. That’s become much more acceptable. I remember talking to a patient once who said it just felt like such a defeat to her that it was what she had to do. And I don’t think patients are feeling quite that way as much. I think that’s because they’re going through steps beforehand, and it’s more acceptable, and the outcomes are pretty decent. At least they have been with our handful of patients.","_key":"jKLEvYiY"}],"_type":"block","style":"normal"},{"children":[],"_type":"block","style":"normal","_key":"kZV7E7Uo","markDefs":[]},{"children":[{"_type":"span","marks":["strong"],"text":"Michael Thompson: ","_key":"fH9Wp1cc"},{"_type":"span","text":"I’ve heard people say that in the case of obesity, in terms of our bias around individuals with obesity, we are where we were with mental health 10 years earlier, right? There’s a little bit of a blame element to this, and yet there is a physiology that is continuing some of these issues. And I agree with everybody; it’s not a simple one. I’d also say the lesson from smoking is that it’s not going to be 1 thing. It’s going to be everybody putting oars in the water, pulling in the same direction, and that includes collaborating—public and private sectors together.","_key":"i8IuTLdw"}],"_type":"block","style":"normal","_key":"bLC0Ftez","markDefs":[]},{"markDefs":[],"children":[],"_type":"block","style":"normal","_key":"fuFL0cP5"},{"children":[{"_type":"span","marks":["strong"],"text":"Patricia Haines: ","_key":"BLcWYu5r"},{"_type":"span","text":"Well, the various communities that have imposed taxes on sugar drinks, that struck me as a no-brainer. There was outcry around that, but that’s 1 of those little pieces. That’s a contributor, so we’re going to make it a little harder to get, just like cigarettes. 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What is the saying? Zip code predicts obesity rates better than diet. What are we doing? I know it’s a challenge for employers to get their hands around this, but how does it manifest itself in our population-health strategies?","_key":"aHGm42KI"}],"_type":"block","style":"normal","_key":"r5OaxyJM","markDefs":[]},{"markDefs":[],"children":[],"_type":"block","style":"normal","_key":"ZinDpqr1"},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Bruce Sherman, MD:","_key":"XvfP6GVU"},{"_type":"span","text":" A little bit of background is important to share, and that is that social determinants really have been the domain of public health representatives and not employers, who were the commercially insured populations. And as a result, health plans really haven’t looked at that. We’ve not, when we have evaluated claims data at the employer level. We’ve not looked at socioeconomic measures that may be associated with health until recently. And now there is a growing body of literature, and many more entities are looking at social determinants of health in commercially insured populations.","_key":"QdlZFPe2"}],"_type":"block","style":"normal","_key":"Qmh6iTMC"},{"style":"normal","_key":"dsuclhsR","markDefs":[],"children":[],"_type":"block"},{"markDefs":[],"children":[{"text":"One of the things that emerges very clearly is that wage is certainly a strong influencer of healthcare utilization. It’s also, interestingly, a predictor of mental health illness prevalence with lower-income individuals having a higher prevalence of behavioral health conditions. Interestingly, low-wage status is also associated with higher risk of or higher prevalence of unhealthy lifestyle behaviors. Those are, in turn, associated with a number of chronic conditions. So we’ve not historically looked at the association of social determinants in subpopulations of employees in commercially insured groups. I think it’s now incumbent upon us to start to look more seriously at those populations and embrace tactics and strategies, as the 2 of you have with your benefit design, to make access to care more equitable.","_key":"qS0IJzjN","_type":"span"}],"_type":"block","style":"normal","_key":"eWlckLCs"},{"markDefs":[],"children":[],"_type":"block","style":"normal","_key":"jpgQUfzO"},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Patricia Haines:","_key":"KUeq64o6"},{"text":" It would be harder for us from a regional perspective since we like to say we have a pastor in every zip code. I don’t think it’s quite that dense, but there are no real pockets. In terms of community influence, I suspect—although we’ve not really looked at it\u0026mdash;that for those pastors in rural areas versus those in more urban areas, there are differences there. Access to care is different. But I don’t think we’ve done anything specifically. We acknowledge pastors are low paid, but they’re highly educated, so that’s kind of a contrast right there.","_key":"GsCT3HLO","_type":"span"}],"_type":"block","style":"normal","_key":"Xrwzzka2"},{"_key":"zFzjk8Gb","markDefs":[],"children":[],"_type":"block","style":"normal"},{"children":[{"marks":["strong"],"text":"Michael Thompson: ","_key":"4r39R6yj","_type":"span"},{"text":"Any thoughts on that, Andy?","_key":"GJEzspKU","_type":"span"}],"_type":"block","style":"normal","_key":"9JMRzHQw","markDefs":[]},{"markDefs":[],"children":[],"_type":"block","style":"normal","_key":"Pb7Y8kn7"},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Andrew Crighton, MD:","_key":"wJNnWrgp"},{"_type":"span","text":" No, I think it is seen. It’s seen in the average life span. In New Jersey, I was looking on-site. Just in the city of Newark, there are 4 wards. The wards differ in average life span by 18 years.","_key":"f5sWQY4o"}],"_type":"block","style":"normal","_key":"ilneNxmy"},{"_type":"block","style":"normal","_key":"yNrM4ZCg","markDefs":[],"children":[]},{"_key":"bksQkJNi","markDefs":[],"children":[{"_key":"gOAOXOOp","_type":"span","marks":["strong"],"text":"Patricia Haines: "},{"_type":"span","text":"Oh my gosh.","_key":"Z6EDhVyB"}],"_type":"block","style":"normal"},{"style":"normal","_key":"4oiLmHGB","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Andrew Crighton, MD: ","_key":"nTQu0ptC"},{"_type":"span","text":"One ward is high. I think it’s like 67 years is the average life span. Then you go outside Newark, and in areas it’s up to 91. So just the discrepancy in longevity and mortality, which translates into more healthcare and chronic health conditions.","_key":"3BRsXrN6"}],"_type":"block"},{"markDefs":[],"children":[],"_type":"block","style":"normal","_key":"b1GYkFGM"},{"style":"normal","_key":"ByDgDXPs","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Michael Thompson: ","_key":"9zTXO4Q0"},{"_type":"span","text":"Some of what we’ve seen is that as we talk about care navigators, we talk about health navigators, too, and getting more intimate with the individual. When those people get more intimate with those people, they’re hearing issues that aren’t just about what their diet is but also about some of those underlying issues. And so indirectly and on a more personalized basis, to your point before, they are actually understanding what some of those underlying issues are. And I think when we’re starting to think about total health, we need to look at the total person’s existence in that context and actually help them navigate. It ties into prevention because we haven’t talked a lot about prevention. Wellness is part of prevention. But what is the current state of thinking around prevention? Any thoughts?","_key":"7eQPq01r"}],"_type":"block"},{"_key":"7eQBYiP4","markDefs":[],"children":[],"_type":"block","style":"normal"},{"children":[{"text":"Andrew Crighton, MD: ","_key":"lGwwunfA","_type":"span","marks":["strong"]},{"_type":"span","text":"I think in regard to primary prevention, it’s very important. Just the basics—smoking, activity, things like that\u0026mdash;are helpful. I think, as you mentioned, when you get into disease and preventing the complications of that, these are things we’ve just pushed to the side all the time. And I think we need to bring that to the forefront. But along the lines of education of the patient or the healthcare consumer, we’ll call them and understand the importance of prevention and what it means to them. But then, what are their own thoughts, their bias, their cultural aspect in regard to this? That’s got to be factored in there.","_key":"nCbkvoeW"}],"_type":"block","style":"normal","_key":"ifszEzXY","markDefs":[]},{"style":"normal","_key":"U4XK77eA","markDefs":[],"children":[],"_type":"block"},{"_key":"elFGyK83","markDefs":[],"children":[{"_type":"span","text":"I know that a lot of times, as you’re doing a treatment with someone, based on their background and their race, they may focus on the complications of the treatment versus somebody else who’s focused on the advantages of taking the treatment too. So take the time, have the time to understand as a provider the person in front of you. What will be their mind-set in following through and being compliant and walking through that? But that takes time, and that takes a relationship, not a transaction. Many times we’re dealing Medicare as a transaction.","_key":"yucyrciU"}],"_type":"block","style":"normal"},{"children":[],"_type":"block","style":"normal","_key":"idzQloDX","markDefs":[]},{"children":[{"_type":"span","marks":["strong"],"text":"Bruce Sherman, MD: ","_key":"Cgq2mGI8"},{"_key":"ijLpn2Jt","_type":"span","text":"Agreed. I think we’re talking around a central point here, and that is that individuals may have personal priorities that are very different from what we think they should be. And Mike, I think this gets back to the theme of patient-centeredness, where if we don’t understand an individual’s personal priorities and we make a recommendation for a particular treatment or care, we may be completely missing the mark when it comes to what’s important to that individual and whether that even is going to resonate for them. So if you have a low-wage earner who’s maybe working 2 jobs, a single mother who has high cholesterol, and we say to her, “You really need to do a better job managing your cholesterol,” that’s not her priority."}],"_type":"block","style":"normal","_key":"1hjYR0jm","markDefs":[]},{"children":[],"_type":"block","style":"normal","_key":"wY62ugqO","markDefs":[]},{"_key":"SxScOgwm","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Andrew Crighton, MD: ","_key":"g9G1LVRP"},{"_type":"span","text":"No.","_key":"mm3KIhLi"}],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"U7dR66WX","markDefs":[],"children":[]},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Bruce Sherman, MD: ","_key":"erbKeMUN"},{"_key":"3DztYK6g","_type":"span","text":"And we have been trained as physicians. Back in the day, at least for me, that wasn’t part of the discussion."}],"_type":"block","style":"normal","_key":"CqBtBo64"},{"markDefs":[],"children":[],"_type":"block","style":"normal","_key":"UEmPArSg"},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Andrew Crighton, MD: ","_key":"MiTuIlFC"},{"text":"No.","_key":"Pmu8nH6i","_type":"span"}],"_type":"block","style":"normal","_key":"rUyHKRkz"},{"_key":"s6OhmF37","markDefs":[],"children":[],"_type":"block","style":"normal"},{"_key":"kvmJfVa7","markDefs":[],"children":[{"_key":"nVK4i13h","_type":"span","marks":["strong"],"text":"Bruce Sherman, MD: "},{"_type":"span","text":"And it now needs to be, and I think that’s what you’re very much alluding to.","_key":"laam6qRH"}],"_type":"block","style":"normal"},{"_key":"NKAvQDHs","markDefs":[],"children":[],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"oaVF7T4N","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Patricia Haines: ","_key":"bjIxe0A5"},{"_key":"YeKFzdkX","_type":"span","text":"People are motivated so differently. 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And so rather than trying to paint a broad brush, I think a lot of companies are starting to step back and are going, “OK, we’ve moved the dial a little bit, but just not enough. What are we missing?” And I think a lot of it’s that personal motivation.","_key":"C6XTrTYF"}]},{"_type":"block","style":"normal","_key":"Y3RXa81z","markDefs":[],"children":[]},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Michael Thompson: ","_key":"qXBs7unb"},{"text":"And what we’re hearing much more about is a culture of health, and of course culture is not the same for every organization. And I know culture is huge in the Presbyterian church. Maybe you could explain how you become relevant to the population that you serve.","_key":"C9mI6UbI","_type":"span"}],"_type":"block","style":"normal","_key":"ZUygrjZa"},{"markDefs":[],"children":[],"_type":"block","style":"normal","_key":"ihyKWkDk"},{"markDefs":[],"children":[{"text":"Patricia Haines:","_key":"ZgXv3tW7","_type":"span","marks":["strong"]},{"_type":"span","text":" I think the word ","_key":"Rc5sXmmD"},{"marks":["em"],"text":"purpose","_key":"GNI1prcU","_type":"span"},{"text":" is really good. And I think we needed to start with recognizing whole person well-being. In a religious faith-based organization, these are men and women who are responsible for the health of a congregation. So to extend that, there’s a renewal program that our pastors are offered during their pastoring and at various intervals. But in this renewal program, they deal with vocational health, they deal with spiritual health, they deal with physical health, financial health, and emotional health. And so we took that as the pillar and have just used those to talk about well-being and create opportunities for them to think about well-being in all kinds of ways.","_key":"ACn9oXL0","_type":"span"}],"_type":"block","style":"normal","_key":"pU4spkjB"},{"markDefs":[],"children":[],"_type":"block","style":"normal","_key":"8zf7lhdJ"},{"style":"normal","_key":"4sZiZ9bG","markDefs":[],"children":[{"_type":"span","text":"Like many organizations, we have a platform, a technology platform, that accumulates credit, so that they get rewards. And rewards for us include a lower deductible, so even though they’re income sensitive, they can be cut in half. And little teeny things like building a garden, taking a walk, or making daily prayer a disciplined part of your life have points associated with them. We don’t have fewer diabetics, by the way, but the feedback that we’ve gotten from them is that you are meeting us where we are, and I think that’s a part of addressing the issue of health.","_key":"nxLAmiLF"}],"_type":"block"},{"_type":"block","style":"normal","_key":"wnMNdpbC","markDefs":[],"children":[]},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Michael Thompson: ","_key":"IyI0XLS2"},{"_key":"CuNHEO0i","_type":"span","text":"And Andy, from a cultural standpoint, it’s very different financially. How do you make it relevant in an organization like a financial entity?"}],"_type":"block","style":"normal","_key":"Ovbq3hKg"},{"markDefs":[],"children":[],"_type":"block","style":"normal","_key":"HPn3rFmE"},{"children":[{"_type":"span","marks":["strong"],"text":"Andrew Crighton, MD: ","_key":"huqnPLCF"},{"text":"Many of our business groups have so many different cultures, and some of it is data driven—where we take the data. 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","_key":"577c14de7e860","_type":"span","marks":[]},{"_key":"577c14de7e861","_type":"span","marks":["50b43464b503"],"text":"We talked about interchangeability"},{"_type":"span","marks":[],"text":" and so on. I don't think that is the same concern now as it once was. I don't think that really is a factor. I think that what you maybe getting towards here are some of the rebate rules and some of the negotiations, and what's the net price and the rebate? Who gets the benefit from the magnitude of the rebate? And so on. And the incentive to put a higher list price so that you can offer larger discount and so on, obfuscates things, confuses things, and I think that that could be a challenge.","_key":"577c14de7e862"}],"_type":"block","style":"normal"},{"style":"normal","_key":"81270b1b991b","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"3e57da29be650"}],"_type":"block"},{"_key":"50d2be4bd00a","markDefs":[],"children":[{"_type":"span","marks":[],"text":"My research certainly suggests, though, that even given that the biosimilars have increasingly become preferred amongst payers. While that may be a hurdle at the beginning and be very obstructive at the beginning of a drug's life cycle, over time, it does seem as if the biosimilars are gaining traction and getting the foothold in the market and often becoming the preferred product in some cases.","_key":"bd87952536400"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"269dc7f0f7710"}],"_type":"block","style":"normal","_key":"9a420e5e6afb"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"While in some ways you could argue that the system is against the new biosimilar entry, over time, it is gaining traction, it is getting a foothold. It is hard to understand those complicated rules, exactly where the money goes, and the system is opaque, and it's hard to figure out. 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Chambers, PhD, professor, Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center.","_key":"a71a0c5c9eeb0","_type":"span"}],"_type":"block","style":"normal","_key":"d1f24fc7b5ad","markDefs":[]},{"_key":"684806c244de","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"521fad7a02890"}],"_type":"block","style":"normal"},{"style":"normal","_key":"9c0ac6886f33","markDefs":[],"children":[{"text":"This transcript has been lightly edited for clarity.","_key":"b2408f69341e0","_type":"span","marks":["em"]}],"_type":"block"},{"_key":"15599a894769","markDefs":[],"children":[{"text":"","_key":"c9faf9fd4e170","_type":"span","marks":[]}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"marks":["strong","underline"],"text":"Transcript","_key":"9be5da6ee1030","_type":"span"}],"_type":"block","style":"normal","_key":"3388e63f1e7a"},{"_key":"ae5374623322","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"The FDA has published draft guidance to remove the requirement for switching studies for biosimilar interchangeability. What is the current challenge with conducting switching studies and how will getting rid of the requirement benefit patients?","_key":"784810c222910"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"marks":[],"text":"In Europe, we've seen much more success with biosimilars, and I think this is part of it. This is analogous, I think, to generic substitution, which is long-standing policy here in the US that a pharmacy can—as long as it's not explicitly told not to do so by the prescribing physician—it can substitute a generic for the prescribed brand. That's important for these biologics. I work at Tufts Medical Center. Tufts Medical Center would like to stock certain drugs and has an incentive to have certain biosimilars on hand and not others. But then, if the insurance companies determine access, then the patient might require others. It does simplify things, in general, because it provides the providers and hospitals greater flexibility of what they stock and how they use these drugs.","_key":"6785019efaf30","_type":"span"}],"_type":"block","style":"normal","_key":"efbb96131082"},{"children":[{"_type":"span","marks":[],"text":"","_key":"eec965cda7df0"}],"_type":"block","style":"normal","_key":"7a4fba9e5908","markDefs":[]},{"markDefs":[],"children":[{"_key":"ed304e3021b40","_type":"span","marks":[],"text":"It would change things, I think, from the payer perspective, because with these step therapy protocols and payers requiring the patient to be treated with drug A before drug B or originator before biosimilar or vice versa, that would become less important moving forward, because of this change. It might also change negotiations between product manufacturers and insurance companies, because the large rebates offered are often done to secure preferred status for their product, and if the insurance company can't offer preferred status, then it might impact the magnitude of the rebate offered, which is not what we're looking for."}],"_type":"block","style":"normal","_key":"3f6e959050e3"},{"markDefs":[],"children":[{"marks":[],"text":"","_key":"5da92ab343070","_type":"span"}],"_type":"block","style":"normal","_key":"799783927d95"},{"markDefs":[],"children":[{"text":"So, I think, I think it's unclear. I mean, certainly the US has been lagging Europe in terms of biosimilars for a while now. In theory that should speed things up. 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What have you been hearing about the negotiations?","_key":"ca4e95567a910"}],"_type":"block","style":"normal","_key":"04688517f9ee"},{"markDefs":[],"children":[{"_key":"3d222dea82b20","_type":"span","marks":[],"text":"I think what I'm hearing is the same thing that everyone else is hearing, which is, as you said, very split. What I tend to hear is that some folks will say this is not as significant as we thought it would be, and then other folks are saying this is more significant than we thought it would be. I think if you're CMS trying to evaluate how you did, that's probably a good sign."}],"_type":"block","style":"normal","_key":"fb6d3603b44f"},{"_type":"block","style":"normal","_key":"5f073254f347","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"6d90d6f306b10"}]},{"_key":"174094635fdc","markDefs":[],"children":[{"_type":"span","marks":[],"text":"A lot of the things that we're paying attention to with the IRA are really sort of outside of the negotiation space, as well. We're looking at the implementation of the out-of-pocket smoothing or the M3P, which is the Medicare Prescription Payment Plan that allows patients to opt in anytime of the year and smooth their payments out. There was a lot of uncertainty when that provision was first passed. CMS has since provided a substantial amount of additional information, educational materials, things like that, but this is a totally new program. I don't know of anything else anywhere that is like this, and I'm very curious to see what the operational aspect of that looks like. That may be something that is a little bit of a sleeper issue.","_key":"ddf6a08ac7430"}],"_type":"block","style":"normal"},{"_key":"ab1ecc6710f3","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"df5e98f680bf0"}],"_type":"block","style":"normal"},{"children":[{"_type":"span","marks":[],"text":"Certainly, the community pharmacists and retail pharmacists are paying a lot of attention to that, because they know that their pharmacists are going to be the frontline for many patients in explaining that. CMS recently put out a sort of a threshold for when someone is likely to benefit from enrolling in that program. The threshold is a single month prescription cost of $600 or more. I think we'll see a lot of maybe confusion among patients. There's going to be a lot of work that needs to be done not just by those retail and community pharmacists but from Part D plan sponsors, as well, to educate their beneficiaries about when this is going to work for them or when it's not going to be something that really benefits them. I'm watching that pretty closely. In addition to the negotiation piece.","_key":"aa6279effa670"}],"_type":"block","style":"normal","_key":"465e429ecdf5","markDefs":[]},{"_type":"block","style":"normal","_key":"47c72835f36c","markDefs":[],"children":[{"_key":"1dc506a100500","_type":"span","marks":[],"text":""}]},{"_key":"3001c008d50b","markDefs":[],"children":[{"marks":[],"text":"I think on the negotiation piece, the big question mark are the various lawsuits. There are some other lawsuits that are pending right now related to, for example, prescription drug affordability boards that may also have implications for the IRA's drug negotiation program. 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Corey McEwen, PharmD, MS, Massachusetts General Hospital (MGH), was a panel participant on “Pharmacy Decision-Making in Value-Based Oncology Care.”","_key":"d7478bcc45710","_type":"span"}],"_type":"block","style":"normal","_key":"cfebbde07bf9"},{"children":[{"_type":"span","marks":[],"text":"","_key":"06776dfeeaf50"}],"_type":"block","style":"normal","_key":"9b2e802eb54f","markDefs":[]},{"style":"normal","_key":"02c2ede19505","markDefs":[],"children":[{"text":"Here he discusses the importance of understanding how your organization defines value and how it hopes to achieve the end goal of providing that to patients, while considering the role of payers in the space and how they influence care choices. McEwen is director of oncology pharmacy services at MGH, one of the largest academic-based research centers in the country, with responsibilities that include leadership and oversight of all clinical trial pharmacy services that support ongoing research efforts at MGH, its cancer center, infusion centers, and several community sites in the greater Boston area.","_key":"07e6aa441bc10","_type":"span","marks":[]}],"_type":"block"},{"_key":"1315b232ebae","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"7f3270778ab50"}],"_type":"block","style":"normal"},{"_key":"070dfd342f92","markDefs":[],"children":[{"_type":"span","marks":["em"],"text":"This transcript has been lightly edited.","_key":"ec900453591f0"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"b1cf258e41c20"}],"_type":"block","style":"normal","_key":"8f6c9932465c"},{"markDefs":[],"children":[{"_type":"span","marks":["strong","underline"],"text":"Transcript","_key":"a6f8522cf20c0"}],"_type":"block","style":"normal","_key":"8e29593c9035"},{"_type":"block","style":"normal","_key":"ca8ff3c45cdd","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Can you address the importance of defining value in pharmacy care within oncology?","_key":"2767b24011400"}]},{"_type":"block","style":"normal","_key":"571e14330647","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"629f16e1c4f80"}]},{"children":[{"marks":[],"text":"I think the biggest thing for me, and the point that I want to get across, is that the big focus of this entire panel discussion [was] value-based care and oncology. And I think my biggest point is, value is not necessarily an objective criteria. I think the most important thing that I found is trying to understand how your organization defines value. I think there are core consistencies across every health care organization, in terms of what they focus on for value, but I think there's intricacies and nuances to each organization. What I found very helpful is trying to understand how my organization defines value and how they hope to achieve value.","_key":"8c1f8843e31f0","_type":"span"}],"_type":"block","style":"normal","_key":"c7473ee13ee4","markDefs":[]},{"_key":"80cbfb4fa2b1","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"660f13c349930"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"I think another thing that always comes up in really anything when you're talking about care in the oncology space is payers and how we're dealing with payer-directed care. That has a big impact on, I think, the value of care that we're providing, and it creates an incredibly complex process for us to navigate and trying to get the discussion out there about that.","_key":"b450bee921f10"}],"_type":"block","style":"normal","_key":"cc62e6ec0a8b"},{"_type":"block","style":"normal","_key":"b3bdc3a33d57","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"81e3281c23fa0"}]},{"children":[{"marks":["strong"],"text":"How does pharmacy decision-making help to optimize treatment outcomes and reduce financial toxicity for patients?","_key":"9f98f85dbd5f0","_type":"span"}],"_type":"block","style":"normal","_key":"a774bd4d2200","markDefs":[]},{"_key":"dea865d615d2","markDefs":[],"children":[{"_key":"5c999f8205a00","_type":"span","marks":[],"text":""}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"This may be a biased opinion. I think we, as pharmacists, are probably the most equipped and have the most unique perspective in health care, both from the clinical expertise as well as the understanding and knowledge of the financial and reimbursement components that go along with care in the oncology setting. We, in pharmacy, ultimately have the responsibility of our drug budget, which for any organization is probably one of the, if not the highest cost centers and expenses in any health care organization.","_key":"9dcffa6674cb0"}],"_type":"block","style":"normal","_key":"bce87911754e"},{"_key":"585bede8c591","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"8e7e14f537990"}],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"440d1c6741a6","markDefs":[],"children":[{"_type":"span","marks":[],"text":"I think our role as pharmacists and leaders in pharmacy is to help educate our peers and help guide that decision-making process. So when we're looking at a particular drug enough or we’re bringing it on formulary, I think the biggest thing that we started to do, in the transition I've seen, is really looking more of the total cost of care, and not looking at just the acquisition cost of the drug, but trying to evaluate more broadly speaking, how is the total cost of care going to be impacted by these drugs?","_key":"dc63bed0f1600"}]}],"url":{"current":"defining-value-in-oncology-pharmacy-insights-on-care-and-costs","_type":"slug"},"contentCategory":{"_updatedAt":"2020-04-03T20:03:44Z","_createdAt":"2020-04-03T20:03:44Z","_rev":"Yw6MEKZDMdk6hC2JCPjfiB","_type":"contentCategory","name":"Videos","_id":"ee14ccb3-3542-4414-9046-927be1198c76"},"link":"/view/defining-value-in-oncology-pharmacy-insights-on-care-and-costs","source":null,"factCheckAuthorMapping":null,"updatedOn":null,"seoTag":["value in cancer care","pharmacy care","oncology","value-based care","financial toxicity"],"thumbnail":{"asset":{"extension":"jpg","metadata":{"hasAlpha":false,"lqip":"data:image/jpeg;base64,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","dimensions":{"_type":"sanity.imageDimensions","width":1200,"aspectRatio":1.7777777777777777,"height":675},"isOpaque":true,"blurHash":"MSHV6y~qtRRPfh?bRjR*oIt7NGWBaekDjY","_type":"sanity.imageMetadata","palette":{"darkMuted":{"population":0.29,"background":"#323f5a","_type":"sanity.imagePaletteSwatch","foreground":"#fff","title":"#fff"},"muted":{"_type":"sanity.imagePaletteSwatch","foreground":"#fff","title":"#fff","population":0.25,"background":"#6186a1"},"lightVibrant":{"background":"#b3c7e3","_type":"sanity.imagePaletteSwatch","foreground":"#000","title":"#fff","population":0.73},"darkVibrant":{"background":"#20567d","_type":"sanity.imagePaletteSwatch","foreground":"#fff","title":"#fff","population":0.88},"lightMuted":{"_type":"sanity.imagePaletteSwatch","foreground":"#000","title":"#fff","population":1.07,"background":"#b0bbce"},"vibrant":{"foreground":"#fff","title":"#fff","population":0.06,"background":"#3279a4","_type":"sanity.imagePaletteSwatch"},"dominant":{"foreground":"#000","title":"#fff","population":1.07,"background":"#b0bbce","_type":"sanity.imagePaletteSwatch"},"_type":"sanity.imagePalette"}},"_rev":"tCpUdDwaYfiJObLAprM2Fb","_createdAt":"2024-10-09T19:41:45Z","_id":"image-dc86db594a283a67f558e7916b10b0a94b9a9f81-1200x675-jpg","uploadId":"fQG68VTCfgzOgI09uy2uzmLMs4yFdhIy","_type":"sanity.imageAsset","sha1hash":"dc86db594a283a67f558e7916b10b0a94b9a9f81","url":"https://cdn.sanity.io/images/0vv8moc6/ajmc/dc86db594a283a67f558e7916b10b0a94b9a9f81-1200x675.jpg","assetId":"dc86db594a283a67f558e7916b10b0a94b9a9f81","path":"images/0vv8moc6/ajmc/dc86db594a283a67f558e7916b10b0a94b9a9f81-1200x675.jpg","_updatedAt":"2024-10-09T19:41:45Z","mimeType":"image/jpeg","size":200200,"originalFilename":"McEwen TN.jpg"}},"_id":"d4e38d72-8f99-4c80-a3ca-0522afd5c8ac","is_visible":true,"published":"2024-10-10T14:25:48.415Z","ExcludeFromPubMedXML":false},{"body":[{"_type":"video","videoID":"6362519617112","disableAutoPlayVideo":false,"source":"brightcove","_key":"c4220b895756","videoObject":{"videoDuration":"PT4M21S","videoDescription":"The pharmacist is a critical member of the care team to help manage patients on treatment and contain costs of cancer care.","_type":"videoDetails","videoTitle":"Role of the Pharmacist in the Care Team to Contain Costs in Oncology","thumbnail":{"asset":{"_ref":"image-f698018f94ae99ba6f548f81a15462f47765951b-1280x720-png","_type":"reference"},"_type":"image"}}},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Including a pharmacist placed among the care team of patients with cancer is crucial, because the pharmacist can provide support, ensure guideline-concordant care, and educate patients, explained Kirollos S. Hanna, PharmD, BCPS, BCOP, FACCC, director of pharmacy, Minnesota Oncology, and assistant professor of pharmacy, Mayo Clinic School of Medicine.","_key":"49da0ccddb640"}],"_type":"block","style":"normal","_key":"c2f0c3b27869"},{"style":"normal","_key":"5c88a52a8ff6","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"83343809975c0"}],"_type":"block"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Hanna chaired an Institute for Value-Based Medicine","_key":"caa04d9676b40"},{"_type":"span","marks":["superscript"],"text":"®","_key":"5e4a5cb8901a"},{"_type":"span","marks":[],"text":" (IVBM) meeting with Minnesota Oncology and ","_key":"ac99eb8aada4"},{"_type":"span","marks":["em"],"text":"The American Journal of Managed Care","_key":"caa04d9676b41"},{"_key":"caa04d9676b42","_type":"span","marks":["superscript"],"text":"®"},{"marks":[],"text":" on September 10 in Minneapolis, Minnesota.","_key":"3ec028d7da63","_type":"span"}],"_type":"block","style":"normal","_key":"5d6215fe108a"},{"style":"normal","_key":"887cfbb75bde","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"b7cdb240d5060"}],"_type":"block"},{"children":[{"_type":"span","marks":["em"],"text":"This transcript has been lightly edited for clarity.","_key":"2f6c05c93a570"}],"_type":"block","style":"normal","_key":"340bf4f1a4ec","markDefs":[]},{"markDefs":[],"children":[{"marks":[],"text":"","_key":"6f0dd749e78b0","_type":"span"}],"_type":"block","style":"normal","_key":"b084d0af6dba"},{"children":[{"_type":"span","marks":["strong","underline"],"text":"Transcript","_key":"7b65065561000"}],"_type":"block","style":"normal","_key":"2f4ea0db259c","markDefs":[]},{"style":"normal","_key":"6a1dc5c98fc8","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"As cancer therapies become more complex, how does the pharmacist’s role evolve in patient care?","_key":"e05143b2593c0"}],"_type":"block"},{"children":[{"_type":"span","marks":[],"text":"Pharmacists play a critical role in the cancer care armamentarium, whether that is as a reactive role or a proactive role. It is inevitable that you have to somehow place a pharmacist among the care team. There are multiple ways that pharmacists can help in terms of cost containment and providing value. You look at biosimilar adoption and biosimilar integration and various other things. We got out of this IVBM program that we had that many of our pharmacists help support our bispecific antibody program, whether that is remote monitoring of patients or clinical interventions when patients need it.","_key":"f1e3301337760"}],"_type":"block","style":"normal","_key":"d18007b59682","markDefs":[]},{"style":"normal","_key":"3a7f2226ec40","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"65cb4d640bb10"}],"_type":"block"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Our pharmacists are doing clinical reviews on every brand new regimen that's selected for our patients to ensure that we're providing guideline-concordant care, not only within our pathway but also National Comprehensive Cancer Network and the best clinical practice. They can catch things like laboratory parameters that may be needed, particular monitoring that may be needed, and obviously pharmacists play a critical role in education of patients. There are multiple things that I think pharmacy has been able to demonstrate as a value or return on investment. I would say that within the care team, it's extremely important to ensure that a pharmacist is placed among the care team.","_key":"9ca8985b03870"}],"_type":"block","style":"normal","_key":"535da35671d9"},{"children":[{"_type":"span","marks":[],"text":"","_key":"9fcbcb42c15c0"}],"_type":"block","style":"normal","_key":"29dcfe9ff432","markDefs":[]},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"How are pharmacists and doctors working together to manage costs in cancer care?","_key":"356ff1adc61f0"}],"_type":"block","style":"normal","_key":"10e221b3d6d8"},{"_key":"6ca4372463be","markDefs":[],"children":[{"_type":"span","marks":[],"text":"I think there are multiple opportunities where our providers, our prescribers, and the pharmacy team really come together to really help control the cost of care. Number one, when we look at that partnership through an organizational lens, we know both of these stakeholders play a critical role on your P\u0026T committees, your pharmacy and therapeutic committees. Through our P\u0026Ts, we're evaluating clinical trials, we're evaluating drug portfolios, we're evaluating group purchasing organization contracts to really help us place and navigate oncology, which is always complex, always changing. We utilize our pharmacy team as well as our providers to come together and serve on a committee to help us place certain therapeutics on pathways, to help us prefer certain biosimilars. And there are a lot of opportunities I think within that space as we try to help control cost.","_key":"595a67450e150"}],"_type":"block","style":"normal"},{"_key":"70f43f99f89a","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"f5d787ef14cb0"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Now the other aspect of it is now in actual clinical practice, our providers are seeing patients and they're prescribing. Our pharmacy teams play a reactive role based on orders that come through or regimens that are adopted or selected for patients, and our pharmacists ensure that the P\u0026T decisions, that the formulary decisions, that the pathway decisions are actually in effect, and they will reach out and work side by side with our providers to recommend potential changes or alternates based on what the system has in place.","_key":"e0ffe6b47e290"}],"_type":"block","style":"normal","_key":"6778e38865c9"},{"style":"normal","_key":"2a562925f4d9","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"8cbaca9c959b0"}],"_type":"block"},{"_type":"block","style":"normal","_key":"3b963c6341d8","markDefs":[],"children":[{"_type":"span","marks":[],"text":"The other side of it, too, to help manage cost—pharmacists can help avoid and prevent cost as it relates to just really oncology altogether. Oral chemotherapy monitoring programs: pharmacists calling patients, checking on adherence and compliance, responding to lab results. All of that is proactive so that your patient doesn't accidentally take the medication incorrectly. Maybe the patient needs some type of supportive care that through a collaborative practice the pharmacist can prescribe. All of these things also free up the physician time.","_key":"87a7359235200"}]},{"style":"normal","_key":"853a5ec6803d","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"076b9260a3ba0"}],"_type":"block"},{"children":[{"text":"There’s a lot of opportunity, I think, across the spectrum and it's never a one-size-fits-all model. 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","_key":"dbc969238b7b2"},{"_type":"span","marks":["ecdc5c6541e6"],"text":"UPMC","_key":"cf49d930ac73"},{"_type":"span","marks":[],"text":" Center for High-Value Health Care, discussed the important grant-funded work they do to address disparities in behavioral health care in the rural and underserved communities they serve, against the backdrop of National Recovery Month.","_key":"f8b7c6062e5f"}]},{"markDefs":[],"children":[{"_key":"c35d9aefe5520","_type":"span","marks":[],"text":""}],"_type":"block","style":"normal","_key":"cbfe41510f2e"},{"markDefs":[],"children":[{"marks":[],"text":"Here they go more into why grants are necessary to growing tailored programs for these communities that work hard to address the complex physical and behavioral health care needs of these communities’ residents and provide advice for organization who may be seeking funding of their own for similar initiatives.","_key":"1bd5d94396970","_type":"span"}],"_type":"block","style":"normal","_key":"c3f1862d11a5"},{"_key":"d15d56b9bf89","markDefs":[],"children":[{"_key":"0d35938d29cb0","_type":"span","marks":[],"text":""}],"_type":"block","style":"normal"},{"children":[{"_key":"506a06e6137b0","_type":"span","marks":["em"],"text":"This transcript has been lightly edited."}],"_type":"block","style":"normal","_key":"a4b46a2be762","markDefs":[]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"24711fe9e51e0"}],"_type":"block","style":"normal","_key":"78afe5256498"},{"_type":"block","style":"normal","_key":"a2904fe62561","markDefs":[],"children":[{"_key":"bcc63b2c6bb80","_type":"span","marks":["strong","underline"],"text":"Transcript"}]},{"_type":"block","style":"normal","_key":"b008d9fd1f97","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Please tell us about yourself and your work with UPMC.","_key":"035f1a7619d00"}]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"584a21cb38160"}],"_type":"block","style":"normal","_key":"97f7931db8eb"},{"style":"normal","_key":"778a0735f47c","markDefs":[],"children":[{"text":"Meyers: ","_key":"446d82fcbe090","_type":"span","marks":["strong"]},{"_type":"span","marks":[],"text":"I'm the senior advisor for implementation at the UPMC Center for High-Value Health Care. I get the distinct honor and privilege of working closely with our internal and external stakeholders to secure and implement and evaluate grant-funded projects, specifically in rural communities.","_key":"446d82fcbe091"}],"_type":"block"},{"children":[{"marks":[],"text":"","_key":"371e15dfd4340","_type":"span"}],"_type":"block","style":"normal","_key":"e9f6aa3ffbd9","markDefs":[]},{"_type":"block","style":"normal","_key":"7204fa30ae4c","markDefs":[],"children":[{"marks":["strong"],"text":"Herschell: ","_key":"779af5da3ea10","_type":"span"},{"_type":"span","marks":[],"text":"Hello, my name is Amy Herschell. I am the AVP of program implementation and evaluation for Community Care Behavioral Health Organization of the UPMC Insurance Services Division. Community Care manages the Medicaid funding for behavioral health for 43 of Pennsylvania's counties. We cover about 1.2 million lives, so 1.2 million members, and I have the good fortune of working with teams to understand more about the outcomes for those members, as well as our program implementation around school-based services and evidence-based practices.","_key":"779af5da3ea11"}]},{"markDefs":[],"children":[{"marks":[],"text":"","_key":"647c225561df0","_type":"span"}],"_type":"block","style":"normal","_key":"20ecf42b614f"},{"_type":"block","style":"normal","_key":"d981b4f263f9","markDefs":[],"children":[{"text":"What advice would you give to managed care organizations looking to apply for grant funding to enhance behavioral health outcomes in their communities?","_key":"2b5837de233c0","_type":"span","marks":["strong"]}]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"a78e42fb19070"}],"_type":"block","style":"normal","_key":"9c067a425e17"},{"_key":"6c76a22d656f","markDefs":[],"children":[{"text":"Meyers: ","_key":"3f688f239f3e0","_type":"span","marks":["strong"]},{"_type":"span","marks":[],"text":"I would say that this type of collaboration isn't just a way of keeping the target population in mind. It actively involves them in cocreating solutions, and it not only helps to keep everybody engaged, but also helps to avoid some of the most common challenges. It can be very time consuming and resource intensive to implement the right solution and results in more innovative and creative solutions. Through that collaboration is key to working through and doing this work with grant funding to enhance behavioral health outcomes in rural communities.","_key":"3f688f239f3e1"}],"_type":"block","style":"normal"},{"children":[{"_type":"span","marks":[],"text":"","_key":"6994823e6f2a0"}],"_type":"block","style":"normal","_key":"b59c9717600a","markDefs":[]},{"children":[{"marks":["strong"],"text":"Why are grants such an important part of the work that you do?","_key":"f161ba9f775a0","_type":"span"}],"_type":"block","style":"normal","_key":"0f1fcbba5137","markDefs":[]},{"_key":"b23278df9df5","markDefs":[],"children":[{"_key":"325f69e507bf0","_type":"span","marks":[],"text":""}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"marks":["strong"],"text":"Herschell:","_key":"ab3728de971a0","_type":"span"},{"_type":"span","marks":[],"text":" They are an important part because we really want to work with our community partners to deliver the most innovative care and the most effective services to our members. The grants really help us to make sure that those 2 goals are in place, and so the grants help us not only to think through what gaps are in services and fill those gaps or needs, but also to make sure that the services are as innovative and state-of-the-art. And they help us also to sometimes have additional resources to evaluate the outcomes of services—so the grants give us the extra evaluation resources, and by resources, I mean sometimes it's the staff time and effort and availability to be able to do the more sophisticated evaluations that accompany grant applications. 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Looking ahead to 2025, Green is particularly interested in the potential for combination therapies in managing cardio-renal-metabolic diseases."}]},{"_type":"block","style":"normal","_key":"0f87a737278e","markDefs":[],"children":[{"_key":"e8c00957911b","_type":"span","marks":[],"text":""}]},{"_type":"block","style":"normal","_key":"7cf8bf81a20d","markDefs":[],"children":[{"_type":"span","marks":["em"],"text":"This transcript has been lightly edited for clarity.","_key":"64a0b962dda6"}]},{"_type":"block","style":"normal","_key":"e49b79251a56","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"fb8d172eddb5"}]},{"markDefs":[],"children":[{"marks":["strong","underline"],"text":"Transcript","_key":"101b545c2cc1","_type":"span"}],"_type":"block","style":"normal","_key":"e2e32c236ccd"},{"_type":"block","style":"normal","_key":"92a19e10c7b0","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"3d600195ae93"}]},{"_key":"a627ea7e20eb","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"CMS recently announced the negotiated drug prices for the first 10 drugs under the IRA. What is your reaction to the announced prices?","_key":"b51a05c947cd0"}],"_type":"block","style":"normal"},{"children":[{"_type":"span","marks":[],"text":"","_key":"932e450b9693"}],"_type":"block","style":"normal","_key":"653c2c926019","markDefs":[]},{"_key":"ddd90af8cfbb","markDefs":[],"children":[{"text":"I think it's wonderful, but I think it is important to understand that it may not, at this time, change the amounts that our patients need to pay out of pocket for medications. ","_key":"7b0f6539e5d80","_type":"span","marks":[]}],"_type":"block","style":"normal"},{"style":"normal","_key":"d4c84b15b108","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"ce647002df64"}],"_type":"block"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"However, if there is the ability at a higher level to negotiate drug prices, what that may mean is greater availability of newer and more expensive drugs to patients, ultimately. So, I'm very happy to see that, and I hope it continues.","_key":"bb6b9792063a"}],"_type":"block","style":"normal","_key":"946cd97e45a6"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"7151621994b7"}],"_type":"block","style":"normal","_key":"cb30e66631e7"},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"How can we ensure we’re doing a better job of addressing the modifiable factors that can reduce the risk of complications in patients with diabetes?","_key":"6cf37905e9b70"}],"_type":"block","style":"normal","_key":"f73434254d1c"},{"_key":"18269cdccef2","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"446c300392ed"}],"_type":"block","style":"normal"},{"children":[{"_type":"span","marks":[],"text":"I think that there are both challenges and opportunities there. We're learning more about interventions that improve outcomes in one of those respects. For example, cardiovascular outcomes are also likely to benefit kidney outcomes and maybe even diabetes management. So, we need to think about efficiency of prescribing so that what we are choosing to treat people with can treat multiple conditions. ","_key":"e6e59d7cb0170"}],"_type":"block","style":"normal","_key":"f18cfe11b4af","markDefs":[]},{"_key":"bfe91607eb00","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"16e51a2857cf"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"We do need each system to figure out how we can best implement those interventions because, right now, for the most part, it's a little bit scatter shot. So, I think more focus on the implementation of guideline-based therapy is going to be very, very important.","_key":"edd2ac4ae6de"}],"_type":"block","style":"normal","_key":"a81dde5b47c4"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"8d45f980b2f7"}],"_type":"block","style":"normal","_key":"7b8bbb597e77"},{"children":[{"_key":"fd6f17dd15e80","_type":"span","marks":["strong"],"text":"What changes in the cardio-renal-metabolic landscape are you keeping an eye on for 2025?"}],"_type":"block","style":"normal","_key":"81af50f90959","markDefs":[]},{"_type":"block","style":"normal","_key":"6115f9b874c1","markDefs":[],"children":[{"_key":"acb8748a2b40","_type":"span","marks":[],"text":""}]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"I am very interested in understanding how the guidelines will incorporate newer information about the effects of GLP-1 receptor agonist therapy in patients with type 2 diabetes and chronic kidney disease. 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translational research at Optum Care, discussed the potential impact of tiering glucagon-like peptide 1 (GLP-1) therapies for patients with ","_key":"1f0dd8f27821"},{"_type":"span","marks":["c58d08fef35c"],"text":"diabetes","_key":"16d6bc4a5726"},{"text":", emphasizing that their use should be based on comorbidities like body mass index (BMI), ","_key":"683d8483c3d8","_type":"span","marks":[]},{"marks":["dde177b9d6bb"],"text":"cardiovascular disease (CVD)","_key":"d26434b98c67","_type":"span"},{"text":", or ","_key":"8642afa46dde","_type":"span","marks":[]},{"_type":"span","marks":["d49dacd769cc"],"text":"chronic kidney disease (CKD)","_key":"45e7b3f74130"},{"_type":"span","marks":[],"text":" to ensure cost-effectiveness. ","_key":"8f9d5c5e02a2"}],"_type":"block","style":"normal","_key":"1a06343f16c2"},{"children":[{"marks":[],"text":"","_key":"1a33349a733a","_type":"span"}],"_type":"block","style":"normal","_key":"13c8ce1518fb","markDefs":[]},{"markDefs":[],"children":[{"marks":[],"text":"Similarly, he highlighted concerns about low-value care in diabetes, stressing the importance of aligning treatments with patient comorbidities. Lastly, looking ahead, Cohen pointed to the rising issue of metabolic-associated fatty liver disease, which may become a leading cause of liver transplantation by 2030.","_key":"9cf1e9db48b2","_type":"span"}],"_type":"block","style":"normal","_key":"5632bcbf2a3b"},{"style":"normal","_key":"e404627c96de","markDefs":[],"children":[{"marks":[],"text":"","_key":"71bcbbf35ac2","_type":"span"}],"_type":"block"},{"children":[{"_key":"ae80c39277c8","_type":"span","marks":["em"],"text":"This transcript has been lightly edited for clarity."}],"_type":"block","style":"normal","_key":"1662978fbfc4","markDefs":[]},{"style":"normal","_key":"9755b4804558","markDefs":[],"children":[{"text":"","_key":"44eaf91a574f","_type":"span","marks":[]}],"_type":"block"},{"markDefs":[],"children":[{"_type":"span","marks":["strong","underline"],"text":"Transcript","_key":"5b15148fdddf"}],"_type":"block","style":"normal","_key":"e2743e17ba87"},{"_key":"2a1858130eb4","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"ac9f39ae8727"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"text":"CMS recently announced the negotiated drug prices for the first 10 drugs under the Inflation Reduction Act (IRA). What is your reaction to the announced prices? Do you see this impacting the commercial space?","_key":"05471b8a19e30","_type":"span","marks":["strong"]}],"_type":"block","style":"normal","_key":"f2a7e018c4fa"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"dfcf68fa7d23"}],"_type":"block","style":"normal","_key":"a8fa2f99328f"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"I certainly hope that it will spill over into the commercial space. I think it is long overdue, whereas the rest of the health care system in this country, although our prices are not well controlled, it does operate as a free market, whereas the pharmaceutical industry really doesn't. ","_key":"22366d0de65f0"}],"_type":"block","style":"normal","_key":"9550a80180ba"},{"_key":"48554989d969","markDefs":[],"children":[{"text":"","_key":"1ea16cfda020","_type":"span","marks":[]}],"_type":"block","style":"normal"},{"style":"normal","_key":"53a5ceb5b650","markDefs":[],"children":[{"text":"There haven't been price controls, and the prices that are charged for our drugs are not a function of the cost-effectiveness of those drugs; that's been a major problem.","_key":"d10ea06ef984","_type":"span","marks":[]}],"_type":"block"},{"_type":"block","style":"normal","_key":"b149a8703165","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"c59f8de5d470"}]},{"_key":"3e4b1e98d461","markDefs":[{"blank":true,"_type":"link","href":"https://www.managedhealthcareexecutive.com/view/glp-1-tiering-agreement-reached-says-optum-rx-president","_key":"fb3d51a5123c","nofollow":false}],"children":[{"text":"Earlier this year, Managed Healthcare Executive ","_key":"cbc5d17e7c6d0","_type":"span","marks":["strong"]},{"_type":"span","marks":["strong","fb3d51a5123c"],"text":"reported","_key":"f69d3d165266"},{"_type":"span","marks":["strong"],"text":" that Optum was conducting negotiations to allow for tiering covering of GLP-1s. What would a tiering structure mean for patients with diabetes looking to access GLP-1s?","_key":"a72c8ce21f9d"}],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"c805fcea2e48","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"63c206341329"}]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Well, I haven't been part of those negotiations, so I don't know exactly what they have in mind, but when I think about tiering around GLP-1s, I think about what the comorbidities are that would make it the appropriate choice for any given patient. ","_key":"71bc829a76530"}],"_type":"block","style":"normal","_key":"5ef29b5e0f63"},{"children":[{"_type":"span","marks":[],"text":"","_key":"979401e6f110"}],"_type":"block","style":"normal","_key":"79409d613693","markDefs":[]},{"children":[{"marks":[],"text":"So, if you had, for example, an individual who did not have an elevated BMI and did not have underlying CVD or CKD, it may not be the appropriate choice. Certainly, in the context of significant obesity or diabetes with obesity, ultimately, those drugs might be cost-effective.","_key":"6b9996fce2e9","_type":"span"}],"_type":"block","style":"normal","_key":"e1e1ef3e8bfc","markDefs":[]},{"_type":"block","style":"normal","_key":"5493187a054d","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"96bc2afc8526"}]},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"What are some areas of low-value care in diabetes that we can better address and remove when possible?","_key":"6fd12f9b94650"}],"_type":"block","style":"normal","_key":"e9828bf37e9e"},{"_type":"block","style":"normal","_key":"07d0845292cd","markDefs":[],"children":[{"marks":[],"text":"","_key":"0f20e397a02b","_type":"span"}]},{"_key":"5b3891784147","markDefs":[],"children":[{"_type":"span","marks":[],"text":"I think a lot of the low-value care around diabetes is related to the lack of alignment of drugs and comorbidities. For example, there are patients that have underlying comorbidities that clearly indicate the need for an SGLT2i [sodium-glucose cotransporter-2 inhibitor], for example. ","_key":"794dcf8825ed0"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"61a2569cc895"}],"_type":"block","style":"normal","_key":"a5ccfca96d5b"},{"children":[{"_type":"span","marks":[],"text":"On the other hand, if you had a diabetic who had no underlying CVD or CKD, it may not be the most appropriate drug in terms of the cost. So, I think it comes down to cost-effectiveness and low-value care.","_key":"5211bcd809b3"}],"_type":"block","style":"normal","_key":"1bb1a87c6ae0","markDefs":[]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"d6ecec07d701"}],"_type":"block","style":"normal","_key":"5284fca243dd"},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"What changes in the cardio-renal-metabolic landscape are you keeping an eye on for 2025?","_key":"5abb6cadbe8e0"}],"_type":"block","style":"normal","_key":"58d94e281a8c"},{"children":[{"marks":[],"text":"","_key":"18a0134a8905","_type":"span"}],"_type":"block","style":"normal","_key":"8ecd2af03f14","markDefs":[]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"One of the areas that I'm most interested in because I think it gets the least attention is the spectrum of metabolic-associated fatty liver disease progressing to MASH [metabolic dysfunction-associated steatohepatitis] and cirrhosis. The spending on that is going to be about $175 billion in the next decade, and, by the end of the decade, may be the most common reason for liver transplantation. 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Although Neeland eagerly anticipates new developments in glucagon-like peptide-1 (GLP-1) medications and other cardio-renal-metabolic therapies, he noted that medication adherence concerns in patients with ","_key":"cc9ef034e434"},{"_type":"span","marks":["e181fbdaa281"],"text":"cardiovascular disease","_key":"75ebce2bb3a6"},{"_key":"6c7872192b43","_type":"span","marks":[],"text":" highlight the risks of access barriers."}],"_type":"block","style":"normal","_key":"bf235eaf630a"},{"_type":"block","style":"normal","_key":"701741c8d82b","markDefs":[],"children":[{"_key":"2ebb6bc744d6","_type":"span","marks":[],"text":""}]},{"children":[{"_type":"span","marks":[],"text":"Neeland is also an associate professor of medicine at the Case Western Reserve University School of Medicine.","_key":"708afc5be26a"}],"_type":"block","style":"normal","_key":"8ba6fb8671fb","markDefs":[]},{"style":"normal","_key":"9fa7b4ee4063","markDefs":[],"children":[{"_type":"span","marks":[],"text":"\n","_key":"4821ff4884ab0"},{"_type":"span","marks":["em"],"text":"This transcript has been lightly edited for clarity.","_key":"4821ff4884ab1"}],"_type":"block"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"43eb77b31f3c"}],"_type":"block","style":"normal","_key":"fd3c12279fb2"},{"markDefs":[],"children":[{"_key":"564edefefe7f","_type":"span","marks":["strong","underline"],"text":"Transcript"}],"_type":"block","style":"normal","_key":"00b39d6b02b7"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"8e3d632ff0fc"}],"_type":"block","style":"normal","_key":"9dd2649101fa"},{"_key":"64c57a3fec0e","markDefs":[],"children":[{"marks":["strong"],"text":"CMS recently announced the negotiated drug prices for the first 10 drugs under the IRA. What is your reaction to the announced prices?","_key":"02c5eda4543b0","_type":"span"}],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"80f1c80517ad","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"efe94791944a"}]},{"markDefs":[],"children":[{"text":"I think it's a very positive move. I think that access to evidence-based therapies has been hindered by cost, especially for folks with Medicare who can't afford the donut hole and those issues that go along with it, so I think this is a great step forward. As many people who can access appropriate care as possible is always a positive thing.","_key":"d85efb9e67e10","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"d022031bd37d"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"7cb78c4b0fd1"}],"_type":"block","style":"normal","_key":"811cb63be63a"},{"style":"normal","_key":"6483f9bfe32e","markDefs":[],"children":[{"text":"What does a team approach look like when treating a patient with diabetes to prevent or address other health issues they have?","_key":"2409f3a2f6470","_type":"span","marks":["strong"]}],"_type":"block"},{"_type":"block","style":"normal","_key":"20fff7f46474","markDefs":[],"children":[{"marks":[],"text":"","_key":"f98531665d9f","_type":"span"}]},{"_type":"block","style":"normal","_key":"2018527ee962","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Because diabetes is a complex disease with issues related to not just blood sugar control but cardiovascular, kidney, other metabolic [diseases], and obesity, you need a comprehensive team and a management plan that can address all of those different issues together in a way that can attack the central problem and, therefore, resolve many of the issues together. ","_key":"cbe7c013bf310"}]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"a10f88061ef5"}],"_type":"block","style":"normal","_key":"0e4c1ad616d5"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"So, a team-based approach that's patient centered and comprehensive is, in my opinion, the best way forward in treating diabetes and its complications.","_key":"52032fa033aa"}],"_type":"block","style":"normal","_key":"81c3cb5dd199"},{"style":"normal","_key":"f110c516d2a9","markDefs":[],"children":[{"marks":[],"text":"","_key":"0dfe6ae5be6c","_type":"span"}],"_type":"block"},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Are there patients who we know are likely to benefit the most from the use of GLP-1s?","_key":"9dff51b7458a0"}],"_type":"block","style":"normal","_key":"6e0157609bf2"},{"_type":"block","style":"normal","_key":"dff298146356","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"47493160d15e"}]},{"style":"normal","_key":"26de2105f966","markDefs":[],"children":[{"marks":[],"text":"Patients who have multiple comorbidities, for example, diabetes, obesity, and cardiovascular disease, those patients would most likely benefit from GLP-1–related therapies, because they address many of those different comorbidities together in a comprehensive fashion.","_key":"273ca05712160","_type":"span"}],"_type":"block"},{"children":[{"text":"","_key":"bd6d912da881","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"048ca0dd5491","markDefs":[]},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"What is the prevalence of adherence to medication among patients with cardiovascular disease and how does that impact the risk of developing something else down the line?","_key":"b70c151d27070"}],"_type":"block","style":"normal","_key":"c52d2d0b2495"},{"style":"normal","_key":"d338ba827dc9","markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"2eab64d9f85e"}],"_type":"block"},{"_type":"block","style":"normal","_key":"0f0515bfd679","markDefs":[],"children":[{"_type":"span","marks":[],"text":"It depends on the type of medication in terms of how adherent one may be. In general, it's about 80% adherence to therapies, with about 20% of individuals who can't tolerate certain therapies and are unable to take them. ","_key":"fa5014b1b9e00"}]},{"style":"normal","_key":"3af5a91c1852","markDefs":[],"children":[{"marks":[],"text":"","_key":"6fffa4ba5842","_type":"span"}],"_type":"block"},{"_type":"block","style":"normal","_key":"a904d22cbfc6","markDefs":[],"children":[{"_type":"span","marks":[],"text":"There's also an issue of access. Even if patients want to take the therapies, they may not be able to get the therapy paid for, so that can have deleterious consequences down the line. If patients are not on appropriate therapies, they're at high risk for recurrent cardiovascular events and even death.","_key":"78cc5d3c2b61"}]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"bc1592a2ae85"}],"_type":"block","style":"normal","_key":"0bbff46cfb6d"},{"_type":"block","style":"normal","_key":"cbcd8bc71236","markDefs":[],"children":[{"text":"What changes in the cardio-renal-metabolic landscape are you keeping an eye on for 2025?","_key":"6fceed0931380","_type":"span","marks":["strong"]}]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"7977c42d8dcd"}],"_type":"block","style":"normal","_key":"53101f790405"},{"children":[{"_type":"span","marks":[],"text":"I think new compounds and new advances in therapies are very exciting. There [are] GLP-1–related therapies, and there [are] more coming down the market in terms of different agonists, dual- [and] triple-agonists, and even antagonists, that are now out there. 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