Welcome to Season 3!
Dr. Caroline Carney and CEO Clynt Taylor Discuss Managing the Total Cost of Care in Precision Medicine
In this notable episode, Dr. Caroline Carney, Chief Medical Officer at Magellan Health, and Clynt Taylor, Trapelo Health CEO, join us to discuss how collaborative technologies can help payers more effectively manage the cost of precision oncology while delivering the best outcomes for patients.
Both Dr. Carney and Taylor have lost loved ones to cancer, so their shared mission is as personal as it is professional. They understand the deep emotional toll of waiting for answers, and they know firsthand how the complexities providers and payers face as precision medicine grows makes it all the more important for everyone to collaborate to “get it right” for patients.
As Dr. Carney says, “The explosion of knowledge in this area, especially regarding genetic testing and the understanding of the genome as it relates to malignancies, is so rapidly changing that no single individual, no single medical director at a health plan or a health system can stay on top of it.”
She notes that a typical request for an oncology product requires the oncologist to first choose a lab and then understand what testing in that lab looks like. For instance, a test that is called one name by one lab may be bundled or called something different by another lab, and then by a third and fourth lab. Once oncologists have cleared that hurdle, they must then get prior authorization from a health plan before ordering the test.
Both Taylor and Dr. Carney agree that this current process is so complex that providing decision-support technology and evidence-based insights to primary care providers has never been more important. This complexity is also why Trapelo Health and Magellan Health are working closely together.
Their shared mission is to take time and waste out of the system while providing the right kind of decision support, the right treatment, the right clinical trials, and the right process along the way.
Dr. Carney concludes, “So, we can't just look at this as this is the cost of the test, or this is the cost of the drug, or this is the cost of the hospitalization. We need to look at what is the best treatment, the best time, the best place, the best outcome.” She adds, “This is an area where aligning from the very beginning of treatment and getting the best care has to be done, because that is the most cost-effective and cost-saving way to get there.”
Learn more about how Magellan Health and Trapelo Health are collaborating to tackle these issues by listening to the entire episode and by reading the official press release.
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About Our Guest
Caroline Carney, MD, MSc, FAPM, CPHQ
Chief Medical Officer, Magellan Health and Magellan Rx Management
Dr. Caroline Carney is a board-certified internist and a board-certified psychiatrist. She joined Magellan Health in 2016 and serves as Magellan Health’s Chief Medical Officer, while continuing as chief medical officer for Magellan Rx Management. Her previous experience includes the role of SVP Chief Medical Officer of Magellan Behavioral Health and Magellan Specialty Health. She served as the chief medical officer for regional health plans where she gained experience in Medicaid, Medicare, Exchange, and commercial populations.
She has served as the medical director for the Indiana Office of Medicaid Policy and Planning, helping to launch the Medicaid expansion product as well as the behavioral health transformation for the state’s community mental health services. While in Indiana, she served on the Governor’s Mental Health Commission. She is a frequent speaker about behavioral health services, integrated and collaborative care, and the importance of self-care during the pandemic.
Dr. Carney is a published author and co-author for over 100 peer and non-peer reviewed publications focusing on issues surrounding comorbid medical and behavioral health conditions. She was a tenured associate professor of Internal Medicine and Psychiatry at Indiana University.
She started her medical and academic career at the University of Iowa where she earned her medical degree, as well as a master’s degree, and directed the Med-Psych residency program. She continues to engage in regular clinical work through supporting the behavioral health team at a federally qualified health center.