Reimbursement

Remote therapeutic monitoring with ePROs powered by AI cuts hospitalizations and boosts therapy time—now a key oncology leader promotes guidelines and reimbursement to make it standard of care.

Community oncology practices face major infrastructure and reimbursement gaps when delivering bispecific antibodies.

Medication adherence is a key to improving outcomes, reducing costs, and strengthens the patient experience, making it an important lens into how health care is serving patients

The COA Community Oncology Conference will tackle AI, the rollout of bispecifics and CAR T in the community setting, plus reimbursement, radiation oncology, and patient access strategies.

Quality metrics for screening tests must evolve to mandate diagnostic resolution, ensuring financial and clinical incentives prioritize the complete screening continuum over initial test uptake.

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.

Todd Doyle, MD, of OneOncology, warns that commercial payers lag on updating bundled codes, which has slashed radiation oncology revenue and risks community cancer access in 2026.

Prior authorization and PBM utilization management delay oncology and hematology novel therapies, shifting reimbursement risk to patients in Medicare Advantage.

KFF Health Tracking Poll finds prior authorization tops patient hassles; Drew Altman, PhD, warns complexity delays care, hitting chronic patients hardest.

Value-based care in oncology: why CMS’ models have fallen short and how new partners can sustain navigation, symptom monitoring, and savings.

Lalan Wilfong, MD, a medical oncologist well known for his work in practice transformation, said he looks forward to creating "something more or less from scratch."

The law stems from the case of a beneficiary of the state workers health plan, repeatedly denied an alternative cancer treatment, only to be approved after he was too ill to be a candidate.

Legislation that passed the Senate will introduce reform in how pharmacy benefit managers are addressed by CMS starting in 2028.

Thyme Care bets on ePRO-driven toxicity monitoring to cut Medicare oncology adverse events, infections and ED visits—making value-based care finally work.

The website officially launched on February 5, introducing a key part of the Trump administration’s health care plan.

ACOs entering MSSP with higher spending were consistently more likely to earn bonuses—a gap that persisted after a 2017 benchmarking policy change.

Reform priorities aim to reshape PBM oversight, delink compensation from drug prices, boost transparency, and protect pharmacy access.

Medicare Advantage beneficiaries face forced disenrollment in 2026 as plan exits drive coverage termination, pushing millions toward traditional Medicare and Part D’s $2100 cap.

The editor in chief of Evidence-Based Oncology lauds Congress' authorization of a path for Medicare coverage for multicancer early detection.

Oral semaglutide (Wegovy; Novo Nordisk) expands GLP-1 weight-loss options, but pharmacy budgets and health care cost pressures persist.

Collaborative care use has surged 26-fold, but state reimbursement gaps leave many patients without integrated mental health care in primary care.

The ACCESS Model signals a shift toward outcome-aligned payments and a necessary reframing of what “value” actually means.

AI revolutionizes pharmacy by automating workloads, enhancing patient care, and navigating drug pricing challenges amid evolving federal policies.

The most-viewed content focused on the “One Big Beautiful Bill,” the Most Favored Nation drug policy, and other changes under the Trump administration.