Expert Interviews

Period-induced alcohol cravings and societal changes are contributing to a rising trend in women drinking, according to new research from Sarah McKetta, M.D., Ph.D., assistant professor, Mailman School of Public Health, Columbia University and Layne Robinson, clinical psychology doctoral student and graduate research assistant in the RISK Laboratory, University of Kentucky.

Michael Abrams, M.A., managing partner at Numerof & Associates, warned that without clear eligibility rules, the new $50 billion rural hospital relief fund could end up helping the wrong providers instead of the rural hospitals most in need.

Panelists discuss how patients with prior type 2 diabetes misdiagnosis showed significantly higher healthcare utilization rates across all categories (inpatient admissions, emergency visits, outpatient visits, lab procedures, and medications) compared to those correctly diagnosed with type 1 diabetes from the beginning.

Managed Healthcare Executive spoke with Michael Abrams, M.A., managing partner at Numerof & Associates, to discuss the newly passed $50 billion rural hospital relief fund and what it could mean for rural health systems. In a conversation that took place just before the legislation passed in the Senate on July 1, Abrams expressed cautious support for the fund while warning that without proper structure, it could fall short of meaningful change.

In an interview with Managed Healthcare Executive ahead of the Senate and House vote and under President Trump's official seal of approval on July 4, Michael Abrams, M.A., warned that without clear eligibility rules, the newly approved $50 billion rural hospital relief fund could be exploited by non-rural providers and fail to support the facilities it was meant to save.

Menopause therapy coverage varies by insurance type and is dependent on FDA approval status, clinical guidelines and prior authorizations, all of which are best navigated with the help of a managed care pharmacy expert, according to Susan Cantrell, CEO, Academy of Managed Care Pharmacy.

Peripheral blood stem cell transplants are safer and easier for the donor and with contemporary graft-vs-host disease (GVHD) prophylaxis, they don't appear to pose any additional GVHD risk for the recipient.

Although improved prophylaxis with post-transplant cyclophosphamide has reduced the chances of graft-vs-host disease developing, the problem has not disappeared entirely, says Antonio Jimenez Jimenez, M.D., of the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine.

"We're trying to move away a little bit from the notion that seven out of eight or six out of eight is better than five out of eight," say Antonio Jimenez Jimenez, M.D., of the Sylvester Comprehensive Cancer Center, about HLA matching.

Less emphasis on full HLA matching means clinicians can find an appropriate donor for any patient, says Antonio Jimenez Jimenez, M.D., of the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, and a leading stem cell transplant researcher.

A panelist discusses how the POD1UM-303 randomized phase 3 trial demonstrated that adding retifanlimab (a PD-1 inhibitor) to carboplatin and paclitaxel significantly improved progression-free survival from 7.4 to 9.3 months with a 37% reduction in progression risk, showed strong trends toward overall survival improvement (23 to 29.2 months despite 45% crossover), increased complete response rates from 14% to 22% and doubled median duration of response from 7.2 to 14 months, establishing this combination as the new standard of care for advanced squamous cell anal carcinoma despite manageable immunotherapy-related side effects.

A panelist discusses how the most effective therapy for squamous cell anal carcinoma is prevention through human papillomavirus vaccination (which may reduce cancer rates in 10-20 years), while acknowledging significant unmet therapeutic needs including personalized approaches for high-risk locoregional disease with 40% recurrence rates and improved treatments for metastatic disease where median survival remains under 20 months, leading to the recent adoption of carboplatin/paclitaxel plus retifanlimab as the new NCCN-preferred first-line regimen based on the PODIUM-303 trial results.

While the impact of Medicaid changes on employer-sponsored insurance remains to be seen, competition between providers is a steadfast way to stabilize the system for everyone, according to Christoph Dankert, chief network officer of Carrum Health.

Panelists discuss how their study compared healthcare resource utilization between newly diagnosed patients with type 1 diabetes with and without prior type 2 diabetes misdiagnosis, using a retrospective claims database analysis to examine utilization patterns across different healthcare services.

Sonali Kulkarni, M.D., M.P.H., Medical Director in the Division of HIV and STD Programs at the Los Angeles County Department of Public Health, recently sat down with Managed Healthcare Executive to explain the barriers within the traditional healthcare system for homeless HIV patients and the importance of mobile care clinics.

The financial balancing act between providers, government programs and commercial insurers, according to Christoph Dankert, chief network officer of Carrum Health.

An expert discusses how early diagnosis of vitiligo is primarily important for limiting the area requiring repigmentation, while explaining that genetic predisposition, autoimmune thyroid disease and skin trauma are key risk factors for developing the condition.

An expert discusses how vitiligo involves a complex autoimmune mechanism where the body’s immune system destroys melanocytes, presenting as either segmental vitiligo (rapid, localized to one body area) or nonsegmental vitiligo (slower, scattered patches), with treatment success depending on the presence of pigmented hairs in affected areas.

A panelist discusses how the historical standard of care for metastatic squamous cell anal carcinoma evolved from cisplatin-based regimens to carboplatin and paclitaxel as the established backbone treatment based on the InterAACT trial, which demonstrated superior progression-free survival and overall survival (20 months vs 12 months) with better tolerability, until recent changes with the POD1UM-303 trial shifted the current standard of care.

A panelist discusses how squamous cell cancer of the anal canal has nearly doubled in incidence over 30 years, with human papillomavirus infection being the primary risk factor that is significantly amplified by immunosuppression from conditions like HIV, immunosuppressive medications or organ transplantation, particularly affecting older patients and women at higher rates.

Panelists discuss how type 1 diabetes is diagnosed using autoantibody testing and the challenges clinicians face, including the common misdiagnosis of adults with type 1 diabetes as having type 2 diabetes due to age bias and the misconception that type 1 diabetes only occurs in childhood.

There are a variety of reasons for this, including stigma, substance use disorders and trauma, according to Sonali Kulkarni, medical director in the Division of HIV and STD Programs at the Los Angeles County Department of Public Health.

In a conversation with Managed Healthcare Executive, 10XBeta CEO Marcel Botha suggested that in order to improve rural healthcare at a time when it’s threatened by potential Medicaid cuts, new technology must be designed with help from local communities. He added that federal policies should better support mobile care and telehealth services.

An experienced team of healthcare providers used to working together will likely be more successful when treating a postpartum hemorrhage, according to Abigail Wooldridge, assistant professor of Industrial and Enterprise Systems Engineering at The University of Illinois.

Managed Healthcare Executive spoke with Ohio Rural Health Association leaders Rosanna Scott and Beth Kluding and Marcel Botha, CEO of healthcare technology company 10XBeta, to discuss how proposed Medicaid cuts and federal program changes could affect rural healthcare access, infrastructure and community well-being.

Nancy Hoyt Taff, M.P.H., is the senior product manager of Medicaid at UCare, an independent, nonprofit health plan providing healthcare and administrative services to more than 600,000 members throughout Minnesota and parts of western Wisconsin.

Jeffrey Casberg, M.S., of IPD Analytics and Luke Greenwalt, MBA, of IQVIA, both members of the Managed Healthcare Executive (MHE) editorial advisory board, will provide a midyear assessment of the pharmacy market and the policy and politics affecting it. Topics to be discussed include the possibility of tariffs, the most-favored nation drug pricing executive order, aspect of the reconciliation bill that could affect the pharmaceutical and pharmacy benefit management industries, pressure on the gross-to-net “bubble,” implementation of the Inflation Reduction Act price negotiations, GLP-1s and notable FDA approvals in the second half of 2025. Note that this a menu and some topics may be added or subtracted depending on time and news up to airtime on June 12. Peter Wehrwein, managing editor of MHE is moderating the discussion.

"All kinds of enhancements" have crept into claims from providers, Ronanki said, and health plans have responded. But his company is impartial about the net value and strives to make the claim accurate in the first place, he said.