May 2025

This study validates the Predicting Risk of CVD Events (PREVENT) score across diverse racial and ethnic populations, highlighting its effectiveness in predicting cardiovascular risk and mortality, regardless of race or ethnicity.

Health technology navigators share perspectives on barriers to and facilitators of digital health access for older, linguistically diverse patients in a Los Angeles safety-net system.

Covered California and Health Net’s novel data exchange initiative significantly improved quality measurement and potentially reduced costs by more than $640,000.

The Maryland All-Payer Model was associated with an increase in population-based rates of elective major joint replacements, with a more pronounced effect observed in Maryland-only hospitals.

This study compared 6 algorithmic fairness–improving approaches for low-birth-weight predictive models and found that they improved accuracy but decreased sensitivity for Black populations.

Laundromats offer a promising outreach setting for Medicaid payers because Medicaid enrollees represent a majority of laundromat users and have disproportionately high levels of unmet needs.

Enrollment in Medicare coverage without out-of-pocket protections was associated with a higher likelihood of reporting cost and access barriers to care.

A longitudinal, relationship-based case management approach significantly reduced health care costs and improved quality of life for Medicaid enrollees with complex needs over 1 year.

This commentary, part of the Price Crisis campaign, focuses on the role of employers and business coalitions in advocating for policy change.

To mark the 30th anniversary of The American Journal of Managed Care (AJMC), each issue in 2025 includes reflections from a thought leader on what has changed over the past 3 decades and what’s next for managed care. The May issue features a conversation with John Michael O’Brien, PharmD, MPH, a member of AJMC’s editorial board and the president and CEO of the National Pharmaceutical Council. This interview has been lightly edited for clarity.

Altruism values for treatments of rare, severe pediatric diseases have not been estimated. This study found the altruism value for a hypothetical new Duchenne muscular dystrophy treatment to be $80 per year.