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Community oncology practices can close the gap between innovation and implementation by building patient feedback into real-time clinical pathways, using AI to speed up physician decision-making, and better supporting caregivers of patients on CAR T and bispecific therapies, according to leaders from the American Oncology Network (AON). In the first of 2 podcasts from Patient-Centered Oncology Care 2026, Melody Chang, RPh, MBA, BCOP, is joined by Fred Divers, MD; Puneeth Indurlal, MD; and Brooke Peters, PharmD. They recap their PCOC panels and explain how the discussions connect to AON's work on clinical trials, rural access, and caregiver education.

This week's Managed Care Cast episode features a conversation between The American Journal of Managed Care® (AJMC®) and Grace Mackleby, PhD, a research scientist at the USC Schaeffer Center, about her study, "Plan Switching Among Medicare Advantage Enrollees Dually Eligible for Medicaid," published in the September 2026 issue of AJMC. The study examined how often beneficiaries switched from one Medicare Advantage (MA) plan to another or from MA to traditional Medicare (TM). It compared enrollees dually eligible for Medicaid with those eligible for Medicare only. Mackleby explained that dually eligible beneficiaries account for about one-fifth of the Medicare population and tend to have more chronic conditions, higher costs, and greater needs; they are also subject to different rules on when they can switch plans. Mackleby and coauthors Angela Liu, PhD, and Erin Trish, PhD, used administrative Medicare enrollment data to track switching from 2016 to 2022. She highlighted 3 main results. First, about 22% of fully dually eligible enrollees switched MA plans in 2022, up from about 12% in 2016. Second, these enrollees were roughly 6 times more likely to switch to another MA plan than TM. Third, dually eligible beneficiaries overall switched MA plans more often than those eligible for Medicare only. The study did not examine causes, but Mackleby pointed to 2 likely drivers: the growing number of available MA plans and the strong competition among insurers, which have heavily marketed supplemental benefits such as flex cards and dental coverage. For non–dually eligible beneficiaries, she added, it is difficult in most states to obtain Medigap coverage after enrolling in MA, which makes returning to TM financially unappealing. Switching also varied by race and ethnicity. Black, Hispanic, and American Indian/Alaska Native fully dually eligible enrollees switched MA plans more often than non-Hispanic White enrollees. Mackleby said geography may play a role. However, higher switching could also indicate lower satisfaction with available plans, which warrants further study, she noted. Looking ahead, Mackleby emphasized the need to understand whether switching helps or harms beneficiaries, including its effects on access to care and cost sharing. She also called for research on how switching shapes market performance. "I think looking at it from a beneficiary welfare perspective is going to be really important, and then also looking at it from a market perspective is going to be important too," Mackleby concluded.

On this episode, I spoke with Jonathan Kimmelman, PhD, professor of biomedical ethics and associate member of the Department of Experimental Medicine at McGill University, about the ethical concerns surrounding Kalshi as it relates to clinical trial outcomes and FDA approvals.

During Suicide Prevention Month, UPMC experts discuss how lived experience, peer support, and connection strengthen suicide prevention.

September is Blood Cancer Awareness Month, and to mark it, we have a special Director's Cut episode of Managed Care Cast. My name is Maggie Shaw, lead editor at AJMC, and my guest today is Surbhi Sidana, MD, associate professor of medicine at Stanford University, where she leads the Myeloma Disease Focused Group and serves as associate director for clinical research in the BMT and Cell Therapy Division. We talk about her path into myeloma research, the field's shift from a once-fatal diagnosis to real conversations about cure, the barriers patients face accessing CAR T-cell therapy, and her advice for the next generation of hematologists.

Health-system pharmacy is entering a decade of change, and Future-Proofing Pharmacy is built to keep asking what that future should look like. In this debut episode, host Mark Makhinson, PharmD, senior director of outpatient and specialty pharmacy at Mount Sinai Health System, introduces the podcast's mission: exploring how pharmacy leaders can build organizations that are clinically meaningful, scalable, and ready to adapt, rather than simply reacting to financial pressure, workforce shifts, and drug shortages as they arise. Makhinson lays out the questions the series will return to throughout its run, including what a health system pharmacy enterprise looks like in 2035, where artificial intelligence can meaningfully help, and where human judgment should remain central. Episode 1 kicks off with Nilesh Desai, PharmD, chief pharmacy officer at University of Miami Health System, who shares the pharmacy enterprise he would build from scratch in 2035 and the lessons that shaped his thinking during a major pharmacy transformation at Baptist Health, including the development of a consolidated pharmacy service center.

This week's Managed Care Cast episode features a conversation between The American Journal of Managed Care® and August 2026 authors Jeff Romine, PhD, and Kofi Essel, MD, MPH, about their study, "Insurance-Provided Grocery Assistance and Health Care Outcomes Among Patients With Diabetes." It examined the association between a commercial health plan's grocery assistance benefit and health care use and outcomes among members with type 2 diabetes, offering evidence in a space where prior food-as-medicine research has centered largely on Medicare and Medicaid populations. The benefit provided members between $1200 and $3000 annually, distributed across pay periods on a card usable at a range of grocery chains. Purchases excluded alcohol, tobacco, and preprepared foods, with an emphasis on fruits, vegetables, and other healthy items. Essel noted the design was a deliberate light touch, requiring no dietitian or health coach support, which he said made it more scalable than medically tailored meal programs that have driven much of the existing food as medicine literature. Romine, an economist by training, added that the appeal of studying a lighter intervention was the chance to observe how members made decisions about food and health without the more rigid structure of prior research. To evaluate the benefit, the team used a difference-in-differences design, comparing changes in utilization and clinical outcomes over time for members receiving the benefit against a control group of members with type 2 diabetes who were not eligible. Romine highlighted 3 main results: a 3.1% decrease in diabetes complications, no significant change in overall health care utilization, and improved medication adherence. He said the utilization finding was a positive surprise, since it suggested members retained access to needed care even within a narrower network. Essel pointed to a secondary finding as especially notable: the largest reduction in diabetes complications occurred among members living in lower socioeconomic areas, indicating a potential role for grocery assistance in narrowing health disparities. He emphasized that Elevance Health's approach to food as medicine considers both diet-related chronic conditions and social drivers of health such as food and nutrition insecurity, rather than treating them as separate levers. Looking ahead, Essel said future iterations of the benefit could be strengthened by tailoring groceries to individual cultural and dietary needs, adding nutrition education such as medical nutrition therapy or culinary counseling, and integrating the benefit more closely with primary care and specialist providers. "We are incredibly excited to see what we've seen here, and we can continue to build off of these learnings across the board," Essel concluded.

Socially vulnerable Medicare patients see dramatically better outcomes—such as fewer emergency department visits, fewer preventable hospital admissions, and 23.4% to 30% less use of high-risk medications—when their physicians take on full financial risk for their care compared with those in traditional fee-for-service Medicare. That's the core finding of a new study published in the June issue of Population Health, Equity & Outcomes, and the subject of this conversation between Ken Cohen, MD, chief medical officer for Optum Health, and host Sophia Humphreys, PharmD, vice president of health system strategy and innovation at The American Journal of Managed Care.

UPMC and Birth Root Community Doula describe a 4-year partnership addressing food insecurity, housing, and maternal health disparities in Erie, Pennsylvania.

In this episode of Managed Care Cast, Alvin Thomas, PhD, clinical psychologist at the University of Wisconsin-Madison, discusses the mental health challenges facing Black and Latino boys and young men.

For this Managed Care Cast episode, The American Journal of Managed Care® (AJMC®) spoke with Anuraag R. Kansal, PhD, who leads health economics research at GRAIL, about his study, “State Medicaid Budgetary Implications of New Cancers," published in the July 2026 issue; it examined how new cancer diagnoses affected state Medicaid budgets. He conducted the study with Amanda C. Chen, PhD, of the USC Mann School of Pharmacy and Pharmaceutical Sciences, and David C. Grabowski, PhD, of Harvard Medical School. Kansal explained to AJMC that despite Medicaid's younger population, cancer remains the third-largest source of program spending. Most existing research had focused on commercial and Medicare populations rather than Medicaid specifically. Consequently, using de-identified CMS claims data, he and his team identified new cancer diagnoses, defined as no prior cancer evidence in the preceding 6 months, and compared spending, hospitalizations, and emergency department use between metastatic and non-metastatic cases. Kansal highlighted the core finding, which was that metastatic diagnoses were associated with significantly higher spending than non-metastatic diagnoses across most cancer types. Notably, health care utilization patterns were consistent between fee-for-service and capitated Medicaid states, suggesting that cost drivers stemmed from the disease itself, particularly the shift to systemic therapies once cancer spread, rather than from program administration models. Kansal pointed to the 4 cancer screenings recommended by the US Preventive Services Task Force, namely lung, breast, colorectal, and cervical, as opportunities to reduce late-stage diagnoses and their associated costs while noting that cancers without established screening protocols presented a distinct policy challenge. On balancing innovative treatment access with cost sustainability, he emphasized that Medicaid's state-by-state administration means that no single policy solution applied universally. Still, Kansal emphasized that earlier detection could offer states greater financial flexibility to support innovative therapies for patients with true clinical need. “Intervening earlier is one of the opportunities we might have to really make a difference,” he concluded.

Expanding Support Systems for Black Maternal Health by Managed Care Cast

On this episode of Managed Care Cast, The American Journal of Managed Care® (AJMC®) was joined by Erin L. Duffy, PhD, MPH, an author of a study published in the June 2026 issue. She is a health policy researcher at the Schaeffer Center for Health Policy & Economics at the University of Southern California, with a focus on health care affordability, access to care, and how health systems can better serve patients. Duffy’s study, "Availability of Hospital Financial Assistance Documents in Non-English Languages," found that nonprofit and system-affiliated hospitals have superior language access. During her conversation with AJMC, she discussed what inspired the research, the study's key findings, and ways to improve equitable access to information about financial assistance, regardless of language. To conclude, Duffy previewed her study to be published in the July 2026 issue of AJMC, which builds on this work by evaluating the readability of financial assistance documents.

Most patients with metabolic dysfunction–associated steatotic liver disease (MASLD) go undiagnosed until significant liver damage has already occurred, despite the availability of simple, guideline-supported screening tools that remain notoriously underused in both primary care and weight management settings. That's according to a conversation between Naim Alkhouri, MD, chief medical officer at Summit Clinical Research and director of the Steatotic Liver Disease Program at the Clinical Research Institute of Ohio, and Chika Anekwe, MD, obesity medicine clinical director at the Massachusetts General Hospital Weight Center and an instructor in medicine at Harvard Medical School. In this episode of Beyond the Silo: Integrated Care Across the CRM Continuum, the third installment in a series examining the cardio-renal-metabolic continuum, Alkhouri and Anekwe discuss why MASLD and its more aggressive form, metabolic dysfunction–associated steatohepatitis (MASH), belong alongside the heart and kidney in conversations about cardiometabolic risk. The pair walk through how Fibrosis-4 Index for Liver Fibrosis calculations can identify high-risk patients before liver damage becomes irreversible, why ownership of screening often falls through the cracks between primary care, obesity medicine, and specialty clinics, and how the recent FDA approvals of resmetirom and semaglutide for MASH have raised the urgency of early detection. The conversation also covers strategies for closing equity gaps in liver disease screening, including the role of telehealth and artificial intelligence in extending care to underserved and rural communities.

In this episode, Bhavana "Tina" Bhatnagar, DO, discusses how the field of acute myeloid leukemia has been fundamentally transformed; what this means for patients in rural, underserved settings; and where hematologic oncology is headed next.