Insurance

Medicare FFS beneficiaries with metastatic cancer received broad genomic profiling more often than MA patients.

Insured patients paying over $15 in generic drug co-pays may save more buying direct through a direct-to-consumer pharmacy like Cost Plus Drugs

US health care faces massive shifts: rising ACA deductibles, federal health leadership shakeups, and major care gaps in women's health and dermatology.

ACA enrollment drops 21.5% in 2026 after enhanced subsidies end. Deductibles hit record $3786 as enrollees shift to high-deductible bronze plans.

Investigators found major variation in prior authorization rules across commercial insurers, highlighting limited standardization and transparency.

This study evaluated differences in racial and ethnic disparities in surgical outcomes between Medicare Advantage and traditional Medicare beneficiaries, finding consistent but nonuniform smaller disparities within Medicare Advantage.

Fears that the telemedicine boom would send health care costs soaring haven’t been borne out, a major new study finds, and the timing couldn’t be more critical for federal policy makers.

Here is a policy briefing for chief medical officers and managed care leaders on key pressure points about the Medicaid funding cuts.

Their study found cost nudges had minimal effect on clinic selection, as 85% already chose lower-cost tiers, suggesting tiered benefit design works.

Hospital at home is linked to lower mortality and ED use vs inpatient care in Medicare patients.

This week, a Capitol hearing spotlights Medicare fraud gaps, reports warn of equity setbacks, community oncology boosts survival, and Medicaid work rules loom.

Experts at AXS26 laid out why advanced therapies are underutilized and what payers, providers, and manufacturers must do together to change that.

The new work requirements for Medicaid eligibility, included in the One Big Beautiful Bill Act, will officially be required in January 2027.

A new Commonwealth Fund report finds persistent racial health disparities nationwide despite coverage gains, with major gaps in care, access, and outcomes.

Specialty pharmacies play a critical role in connecting patients with assistance programs to combat growing financial complexities.

The 2018 permanent authorization of dual-eligible special needs plans marked a significant long-term commitment by policy makers and coincided with substantial growth in plan offerings and enrollment.

OUD diagnoses have declined, but use of medication to treat OUD has increased among Medicaid beneficiaries, highlighting policy gains and ongoing state-level disparities.

Black Maternal Health Week spotlights disparities, Medicaid postpartum coverage gains, and ongoing policy efforts to reduce maternal mortality.

High co-payments for potentially curative cell and gene therapies create avoidable access barriers; value-based insurance design should eliminate patient cost sharing for these therapies.

The expiration of subsides for health coverage starting in 2026 has left millions facing higher premiums with little notice.

The increased costs of premiums after the expiration of enhanced subsidies have led to an increased percentage of those not able to make their payments.

Esketamine's monotherapy approval and new real-world data are forcing a reckoning for managed care.

Major health plans cut millions of preapproval hurdles, add 90-day continuity protections, and push real-time e-authorization to speed care access.

Manufacturer-sponsored biologic coupons have decreased since 2018, with rising per-claim values, impacting patient costs and formulary incentives.

Social determinants of health can delay access to NGS, limiting targeted therapy use and survival outcomes in advanced cancers.