Policy

Nearly half of working-age adults were inadequately insured in 2026, and half went without needed care due to cost, a Commonwealth Fund survey found.

AMCP Nexus 2026 brings managed care leaders to San Diego October 26-29 to tackle Medicare negotiation, drug pricing policy, AI, and patient access.

Medicare’s GLP-1 Bridge program aims to expand obesity treatment, but eligibility hurdles and drug costs leave many seniors paying hundreds monthly.

Birth centers are unavailable in 10 states, and 39% of birth center births are self-pay, as licensing and Medicaid pay limit access, a report finds.

At CHEST 2026, 3 speakers explained why respiratory medications stay expensive, assessed what recent federal, state, and industry fixes have achieved, and urged clinicians to use their voices on behalf of patients.

The editor in chief of Evidence-Based Oncology, who was recently named medical director of Precision Medicine for The US Oncology Network, discussed milestones met and those still to be achieved.

Siva Mohan, MD, explains how drug costs drive silent nonadherence, PA burden, and biosimilar hesitancy, and what payers can do about it.

In states that covered obesity-labeled GLP-1 RAs, total GLP-1 RA use rose less than obesity-labeled use alone, suggesting possible substitution.

HR 1 brings Medicaid work requirements and narrower immigrant eligibility by January 2027, and CBO projects 10 million more uninsured by 2034.

CMS ends ACA subsidies for 189,000 enrollees with duplicate Medicare, Medicaid, or CHIP coverage or listed as deceased, with a 30-day dispute window.

MedHaul’s platform streamlines nonemergency medical transportation, boosting on-time oncology visits, reducing costs, and helping patients reach critical care across underserved regions.

CMS' rule ending Medicaid and CHIP funding for pediatric sex-rejecting procedures is now in effect.

Medicare drug price negotiations lowered out-of-pocket costs for some beneficiaries, but those reaching the annual Part D cap saw no direct savings.

Medicaid expansion was associated with lower colorectal cancer mortality, with the largest reductions in Hispanic patients and stage IV disease.

Older adults on Medicare report the best access to care among 10 countries but more cost-related problems and higher out-of-pocket spending.

Even when physicians prescribe guideline-preferred therapies, step therapy and prior authorization can delay or restrict access to CLL therapies.

Michael Mina, MD, PhD, explains Invivyd's accelerated approval path for VYD2311 and how it could change the timing of COVID-19 protection.

The trade group says CMS lacks authority to impose GLOBE, which is set to begin January 1.

A legal fight over a single amino acid could set retatrutide's exclusivity window, its Medicare negotiation clock, and its competitive future.

Panelists ask whether cancer care will shift toward home-administered infusions as payers push for change. Other topics in this forward-looking session include new delivery tech and practice-led solutions.

CMS finalized Transparency in Coverage updates as a researcher warns ghost rates and missing inpatient data limit payer price files.

A traditional Medicare out-of-pocket (OOP) cap could reduce beneficiaries’ costs but increase annual federal spending by $39 billion to $96 billion.

CMS is adding value-based care (VBC) risk faster than many providers can build the data and tech capacity they need to succeed.

The article explores the use of dose-intensive IV iron replacement to achieve long-term hemoglobin stability in patients with moderate to severe HHT-related bleeding. The approach recognizes what the author calls "the relentless and recurrent nature of HHT-associated bleeding," and may help patients achieve better quality of life.

CMS finalized the mandatory GLOBE Model, tying Part B drug rebates to international prices in areas covering 25% of beneficiaries from Jan. 1, 2027.

FDA accepted United Therapeutics' sNDA for inhaled treprostinil in IPF. Here's what it could mean for patient access, coverage, and costs

Average stand-alone Part D premiums are projected to rise by less than $1 a month as a temporary subsidy program ends after 2026.