The CMS Prior Authorization Rule: Opportunities for Automation and AI

Presented by MCG Health

Wednesday, July 10 | 1:00 PM - 2:00 PM ET

Delve into the nuances of the 2024 CMS Interoperability and Prior Authorization Final Rule (CMS-0057-F) and its impact on the health care ecosystem. Drawing on their expertise from being among the nation's first implementers of the new standard, MCG interoperability experts will discuss the details of the prior authorization API mandate, offering guidance for impacted payers, providers, and their patients. 

Join this event featuring a closer look at a new Health Affairs research article, “FDA Breakthrough Therapy Designation Reduced Late-Stage Drug Development Times,” published in the July 2024 issue of the journal.

This event is exclusive to our Health Affairs Insiders.

Join us Tuesday, July 23, for a Health Affairs Journal Club event discussing the US Food and Drug Administration’s breakthrough therapy designation (BTD) program, one of several programs designed to expedite the development and approval of critical new drugs.

In “FDA Breakthrough Therapy Designation Reduced Late-Stage Drug Development Times,” Kathleen L. Miller and colleagues analyze drug approval data and estimate that “the BTD program lowers late-stage clinical development time by 30 percent.”

The authors assert that the findings will “inform future regulatory and innovation policies aimed at driving efficiency in medical product development to ensure timely patient access to the most clinically meaningful therapies.”

On July 23, Miller, the deputy director in the Division of Science and Public Health Policy in the HHS Office of Science and Data Policy, will discuss the paper’s findings, data and methods with Health Affairs Deputy Editor Jessica Bylander.

Date: Tuesday, July 23, 2024
Time: 3:00 p.m. – 4:00 p.m. Eastern
Place: Online details will be shared with registrants 24 hours in advance of the event

Wednesday, July 24 | 11 am - 12 pm CT

"Rethinking Context in Continuing Professional Development in the Health Professions?"

Free for SACME Members | $30 Non-Members

Session Overview

This month we continue our series with authors who contributed publications to the recent Journal of Continuing Education in the Health Professions (JCEHP) supplement themed “Conceptual Advances in Continuing Professional Development in the Health Professions.” Join us for the opportunity to hold conversations with scholars in our field who are examining and challenging some of the prevailing assumptions and proposing new empirical and theoretical insights.

It has been argued that continuing professional development (CPD) to improve patient and health outcomes effectively requires a theoretically informed understanding of how context influences clinical behaviors and, thus, the success of interventions.  Frameworks that incorporate and consolidate constructs from a broad array of theories have been purported to allow researchers to capture and evaluate behavioral determinants.  

In this session, the authors will outline frameworks commonly cited in the CPD literature and explore how they tend to conceptualize context as structured lists of barriers and facilitators.  Using an illustrative example of diabetes, a clinical condition for which continuing education has been positioned as a strategy to overcome clinical inertia, we explore how a framework approach to context may obscure consideration of how the dynamic relationships between clinicians, patients, and the social environments shape the possibilities for knowledge transfer into practice. They will then lead us in the discussion about how theories that draw attention to the social dynamics beyond what occurs within the controlled environment of the interventions themselves can increase the depth and richness of the contextual nature of why interventions succeed or fail.  

As always, we welcome your thoughts and perspectives and hope to see you engaged in our VJC.

Presenters

René Wong, MD, PhD

Wilson Centre Scholar and Associate Professor, 
Department of MedicineTemerty Faculty of Medicine

University of Toronto, Canada

Professor Simon Kitto, PhD

Assistant Dean (Humanities)

Co-Director, Medical Education Research and Scholarship Unit

Editor-in-Chief, Journal of Continuing Education in the Health Professions 

Lee Kong Chian School of Medicine, Nanyang Technological University

Singapore 

Host & Facilitator

 Mila Kostic, CHCP, FACEHP

Primary References and Pre-Reading
Wong, René MD, PhD; Kitto, Simon PhD. Rethinking Context in Continuing Professional Development: From Identifying Barriers to Understanding Social Dynamics. Journal of Continuing Education in the Health Professions 43(4S):p S9-S17, Fall 2023. | DOI: 10.1097/CEH.0000000000000543

Food As Medicine Across Managed Care Populations

Presented by Mom’s Meals

AHIP Select Member

Wednesday, July 24 | 1:00 PM – 2:00 PM ET

Discover how medically tailored meals can revolutionize healthcare outcomes and reduce costs. Dive into insightful discussions with AmeriHealth Caritas DC and Mom’s Meals, revealing the impactful results on crucial metrics like readmissions, preventable admissions, and overall cost of care. Gain invaluable insights into program implementation, including operational strategies and member experience, as we showcase compelling outcomes and ROI findings. 

Discussion with CCIIO: Role of Network Adequacy in Consumer Protection

Presented by Quest Analytics

Thursday, July 25 | 1:00 PM – 2:00 PM ET

Join Quest Analytics® and leadership from the CMS Center for Consumer Information and Insurance Oversight (CCIIO) as they discuss Plan Year 2025's network adequacy and access standards and their role in consumer protection. You’ll gain a comprehensive understanding of the changes coming in PY2025, directly from the leadership responsible for these policies.