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Description
Learn about managed care policies and benefit designs from the health plan decision makers working to create them – and the clinicians who navigate them. PayerTalkCE brings you engaging discussions between payer and clinician experts on both specific conditions from atopic dermatitis to retinal disease as well as issues like social determinants of health and the impact of biosimilars. This unique look at health care in America features hosts from the cutting edge of managed care innovation and clinician experts from across the US. All PayerTalkCE podcasts are certified for free continuing education credit also, be sure to visit the show pages to earn yours.
37 Episodes
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In this episode of PayerTalkCE®, we will delve into the innovations around HER2-targeting therapies and their role in the treatment of select gastrointestinal cancers. Topics will include the latest evidence and the integration of new treatments into health care systems, insurance coverage, reimbursement challenges, and the overall impact on health care policy.
This activity is certified for CME/CNE/CPE credit. To participate and earn
credit, visit us at https://www.impactedu.net/gi-cancer-management/.
In this episode of PayerTalkCE® we will explore the epidemiology and burdens of gastroesophageal and biliary tract cancers. Experts will discuss the importance of early and accurate diagnosis in managing treatment efficacy and cost. The episode will also delve into the role of personalized medicine and multidisciplinary approaches and provide collaborative and actionable insights on how managed care professionals can adapt their strategies to better accommodate the complexities associated with rare GI cancers, ultimately aiming to enhance patient care while managing resource allocation effectively.
This activity is certified for CME/CNE/CPE credit. To participate and earn
credit, visit us at https://www.impactedu.net/gi-cancer-trends/.
This podcast explores macular telangiectasia (MacTel), a rare and progressive retinal disease, with a focus on advancing early detection, appropriate treatment, and health system coordination. Retina specialist Dr. Jay Chhablani discusses the shift in understanding MacTel as a neurodegenerative—not vascular—condition, highlighting the limitations of anti-VEGF therapy and the significance of a newly approved, durable implant that targets neuroprotection. The discussion outlines the importance of benefit design that facilitates timely access, supports multidisciplinary care, and emphasizes early intervention to prevent irreversible vision loss. Practical payer strategies—including reducing artificial barriers and prioritizing education—are addressed to optimize outcomes.
This activity is certified for CME/CNE/CPE credit. To participate and earn
credit, visit us at https://www.impactedu.net/mactel-strategies-ce/.
This podcast highlights opportunities for managed care organizations to improve COPD management by aligning coverage policies with current clinical evidence and treatment guidelines. Experts discuss new therapies, including recently approved biologics and inhaled agents, and their roles in treating patients with frequent exacerbations or type 2 inflammation. The session also addresses implementation barriers such as limited spirometry access, inconsistent pulmonary rehab availability, and disparities in care. Strategies for payer engagement include expanding telehealth, integrating social determinants of health data, enhancing care coordination, and supporting multidisciplinary care models to reduce hospitalizations and improve outcomes in patients with moderate to severe COPD.
This activity is certified for CME/CNE/CPE credit. To participate and earn
credit, visit us at https://www.impactedu.net/type2-inflammation-copd-management-ce/.
This podcast features expert discussion on the emerging role of type 2 (T2) inflammation in chronic obstructive pulmonary disease (COPD) and the implications for payer and provider decision-making. Faculty review key pathophysiologic mechanisms and biomarkers—particularly eosinophil counts—that identify patients most likely to benefit from targeted biologic therapies. The conversation also explores updated GOLD guideline recommendations, strategies to optimize formulary access, the impact of T2 inflammation on long-term outcomes, and opportunities to reduce hospitalizations and oral steroid use. Health plan professionals will gain insights into aligning policies with evolving clinical evidence and enhancing care coordination to improve outcomes.
This activity is certified for CME/CNE/CPE credit. To participate and earn
credit, visit us at https://www.impactedu.net/type2-inflammation-copd-management/.
This podcast reviews a case-based discussion on managing age-related macular degeneration (AMD), a leading cause of blindness among older adults, particularly those enrolled in Medicare Advantage plans. Experts review the progression of AMD, key diagnostic tools, and the importance of timely anti-VEGF therapy to prevent vision loss. The conversation highlights payer considerations, including step therapy requirements, treatment burden, and long-term cost implications. It also addresses challenges such as healthcare access in rural areas and potential strategies for improving patient adherence and outcomes. The discussion underscores the need for balanced policies that optimize clinical efficacy and economic sustainability.
This activity is certified for CME/CNE/CPE credit. To participate and earn
credit, visit us at https://www.managedcareeye.com/amd-case-challenge-ce/.
This podcast explores the challenges of managing diabetic retinopathy in patients with type 1 diabetes, focusing on a case study of a working-age patient with barriers to care. Expert insights highlight the importance of early screening, timely intervention, and payer strategies to facilitate access to specialty care. Discussion covers diagnostic approaches, treatment selection, and the role of anti-VEGF therapies, including considerations around step therapy and treatment adherence. The conversation emphasizes the impact of social determinants on care continuity and explores how health plans can improve patient outcomes through streamlined authorization processes and better care coordination within multidisciplinary teams.
This activity is certified for CME/CNE/CPE credit. To participate and earn
credit, visit us at https://www.managedcareeye.com/t1-diabetes-case/.
This podcast provides health plan professionals with expert insights on best practices for managing moderate to severe asthma, focusing on type 2 inflammation. Discussion topics include current treatment guidelines, the role of biomarkers in therapy selection, and the impact of biologics on reducing exacerbations and healthcare utilization. Experts also examine challenges in asthma management, such as adherence barriers, care fragmentation, and affordability, while highlighting opportunities for payers to support multidisciplinary care and improve patient outcomes. The conversation underscores the importance of collaboration between payers and providers to ensure appropriate utilization of therapies and enhance access to high-quality asthma care.
This activity is certified for CME/CNE/CPE credit. To participate and earn
credit, visit us at https://www.impactedu.net/type2-inflammation-asthma-management-ce/.
This podcast provides health plan professionals with an in-depth discussion on the role of type 2 (T2) inflammation in asthma pathophysiology and the evolving treatment landscape. Experts explore the mechanisms driving T2 inflammation and how biomarkers can help guide therapy selection. The conversation highlights biologic treatments' clinical and economic considerations, including their impact on reducing exacerbations, optimizing outcomes, and managing healthcare costs. Panelists also discuss payer strategies for ensuring appropriate utilization, balancing financial stewardship with patient access, and the importance of collaboration between payers and providers to improve asthma care and reduce healthcare resource utilization.
This activity is certified for CME/CNE/CPE credit. To participate and earn
credit, visit us at
https://www.impactedu.net/type2-inflammation-asthma-management-ce/.
This podcast explores payer best practices in managing atopic dermatitis, emphasizing the role of type 2 inflammation and its impact on patient outcomes. Experts discuss current treatment guidelines, the efficacy of emerging therapies, and strategies for tailoring care to patient needs, including those with darker skin tones. Key barriers such as access to dermatologists, treatment complexity, and psychosocial impacts are highlighted, with insights on payer strategies to improve access and affordability. Topics include clinical guidelines, innovative payer programs, formulary management, and value-based contracting to enhance care quality while controlling costs.
This activity is certified for CME/CNE/CPE credit. To participate and earn
credit, visit us at https://www.impactedu.net/type2-inflammation-atopic-dermatitis-management.
This podcast provides an in-depth exploration of type 2 inflammation and its role in the pathophysiology and management of atopic dermatitis, tailored for health plan professionals. Experts discuss the molecular mechanisms driving the condition, including key cytokines like IL-4 and IL-13, and highlight the clinical and quality-of-life impacts for patients. The conversation covers the evolution of targeted therapies, including biologics and JAK inhibitors, and emphasizes the importance of shared decision-making and timely treatment. Special attention is given to addressing health disparities in diagnosing and treating patients with darker skin tones, underscoring the need for equitable care strategies.
This activity is certified for CME/CNE/CPE credit. To participate and earn credit, visit us at https://www.impactedu.net/type2-inflammation-atopic-dermatitis-management.
This PayerTalkCE podcast, hosted by Dana McCormick and Dr. Jordan Graff, focuses on managing diabetic retinopathy (DR) and diabetic macular edema (DME) in underserved populations. Key challenges include limited access to care, transportation, and socioeconomic barriers. They highlight the importance of early intervention, remote screening technologies, and advancements in anti-VEGF therapies to reduce treatment burden and improve outcomes. Discussions emphasize balancing the cost of newer, more effective treatments with their ability to reduce the frequency of visits and improve patient adherence. Collaboration between payers and providers is critical to enhance access, manage costs, and optimize care for vulnerable populations.
This activity is certified for CME/CNE/CPE credit. To participate and earn credit, visit us at https://www.managedcareeye.com/managing-dr-dme-ce/.
In this PayerTalkCE podcast, Dr. Gary Owens and Dr. Adrienne Scott discuss the care coordination challenges and treatment strategies for patients with age-related macular degeneration (AMD) and comorbid conditions like hypertension and diabetes. They emphasize the importance of individualized therapy, including treat-and-extend protocols and balancing treatment burden with efficacy. Key challenges include patient adherence, travel burden, and out-of-pocket costs. They explore payer roles in supporting patient care through formulary flexibility, feedback on prescribing patterns, and patient support services. The conversation highlights collaboration between payers and providers to optimize outcomes and cost-effectiveness for patients with AMD.
This activity is certified for CME/CNE/CPE credit. To participate and earn credit, visit us at https://www.managedcareeye.com/amd-care-coordination-ce/.
In this discussion, Dana McCormick, RPh, introduces a CE program on managing eosinophilic esophagitis (EoE) with insights from Dr. Evan Dellon and Dr. Drake Reiter. Dr. Dellon highlights advancements in EoE treatment guidelines, including new pharmacologic options, and stresses individualized care strategies. Dr. Reiter emphasizes the value of clinical guidelines for payers in managing EoE, aligning formularies, and supporting optimal outcomes. They discuss barriers to EoE care, such as access to specialists, insurance coverage, and treatment costs. They also explore potential solutions like telehealth, patient education, and payer-supported multidisciplinary care models to improve accessibility and efficiency in EoE management.
This activity is certified for CME/CNE/CPE credit. To participate and earn
credit, visit us at
https://www.impactedu.net/type2-inflammation-eoe-management.
This podcast addresses the role of type 2 inflammation in the pathophysiology and management of eosinophilic esophagitis (EoE), with a focus on evolving treatment strategies. Dr. Evan Dellon discusses the mechanisms behind EoE, the limitations of current allergy testing, and the challenges in diagnosing the condition due to non-specific symptoms. He reviews current therapeutic approaches, including dietary modifications, proton pump inhibitors, topical steroids, and biologics like dupilumab, which target specific inflammatory pathways. Emerging therapies and combination treatments are also explored, highlighting opportunities for optimizing patient outcomes in this chronic condition.
This activity is certified for CME/CNE/CPE credit. To participate and earn credit, visit us at https://www.impactedu.net/type2-inflammation-eoe-management.
This podcast focuses on improving equity in pediatric atopic dermatitis management, highlighting key challenges in access to care for children with moderate to severe cases. Dr. Joy Wan emphasizes the importance of timely referrals to dermatologists, noting the frustrations families face due to delays in treatment. She discusses the complexities of treatment, considering safety, efficacy, and the individual needs of children. The discussion also underscores the psychosocial impact of atopic dermatitis, including sleep disruption and mental health concerns. Payers are encouraged to adapt policies that consider these unique challenges to ensure appropriate access and support for families managing this chronic condition.
This activity is certified for CME/CNE/CPE credit. To participate and earn credit, visit us at https://www.impactedu.net/atopic-dermatitis-pediatric-management.
The podcast features an expert panel discussing trends and opportunities for continuous glucose monitoring (CGM) in managing diabetes within managed care. Dr. Timothy Gilbert emphasizes technological advancements in CGM, illustrating benefits in improving glycemic control and reducing diabetes-related complications. The conversation highlights CGM's role in patient engagement by providing real-time data to manage diabetes effectively. Dr. Maureen Hennessey discusses the integration of CGM into quality measures like HEDIS, focusing on its potential to enhance diabetes care and address health disparities. Susan Wescott and Sean Chitwood elaborate on health plan best practices, financial benefits, and the impact of CGM on quality metrics.
This activity is certified for CME/CNE/CPE credit. To participate and earn credit, visit us at
https://www.managedcarecgm.com/diabetes-quality-and-cgm.
This PayerTalkCE episode provides an in-depth examination of the management and treatment of Multiple Sclerosis (MS) from both a clinical and payer perspective. Experts discuss various MS subtypes, emphasizing the importance of tailored treatments based on individual patient needs and disease progression. Key considerations include drug efficacy, side effects, comorbidities, and the economic aspects such as cost-effectiveness and payer coverage. The conversation highlights the challenges and strategies in optimizing treatment pathways, navigating benefit design complexities, and the potential of personalized medicine in improving patient outcomes. The discussion is highly relevant for health plan professionals, focusing on the integration of clinical insights with payer policies to enhance the management of MS.
This activity is certified for CME/CNE/CPE credit. To participate and earn credit, visit us at
https://www.impactedu.net/ms-current-strategies.
To participate in this on-demand continuing education activity and earn credit, visit us at https://www.impactedu.net/psoriasis-advancements/. In this episode of PayerTalkCE you will learn about:
Emerging and recently approved psoriasis therapies
Strategies to improve and expedite access to high quality care
Comorbidities, history, and patient preferences that influence therapeutic selection
This activity is certified for nurses, pharmacists, and physicians. Please review the front matter at https://www.impactedu.net/psoriasis-advancements/ for full accreditation information.
To participate in this on-demand continuing education activity and earn credit, visit us at https://www.managedcareeye.com/retinal-unmet-needs/. In this episode of PayerTalkCE you will learn about:
Systems change to improve access to eye care
How treatment innovations are improving outcomes
This activity is certified for nurses, pharmacists, and physicians. Please review the front matter at https://www.managedcareeye.com/retinal-unmet-needs/ for full accreditation information.
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