April 2026

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.

This article presents a microcosting analysis of resources needed for the implementation and sustainment of the Massachusetts model evaluated in the PROUD trial.

Initiators of biosimilar insulin glargine-yfgn were more likely to reside in rural areas, live in long-term care facilities, or have multiple prescribers and were less likely to have previously used an originator insulin glargine product.

The authors updated a diagnosis list to identify low-acuity emergency department visits by veterans and applied it to examine trends and predictors of veterans’ low-acuity utilization.

Complex Medicaid patients randomly assigned to receive outpatient social worker care coordination services experienced increased hospitalizations but no differences in emergency department visits or costs.

Community response teams can adapt hospital rapid response principles for managed care organizations, targeting rising-risk members to prevent costly clinical deterioration and generate measurable cost savings.

Findings from a randomized controlled trial on reducing information barriers for consumers selecting primary care clinics in a tiered network design demonstrate limited marginal effect of the intervention.

Inpatient encounters for Medicare patients 65 years and older are associated with higher coding intensity compared with commercially insured, Medicaid, or self-pay hospitalizations for those same individuals prior to age 65 years.

This retrospective analysis examines employees with obesity and reports on glucagon-like peptide-1 receptor agonist use, comorbidities, and work outcomes over time.

Outpatient electronic health records at an academic medical center showed that only 1% of visits by tobacco users were associated with a bill for cessation counseling.

The authors sought to understand the differential impact of payer-led community-based care management approaches on stakeholder-oriented outcomes for publicly insured adults with multiple chronic conditions.

Changing the FDA biosimilar interchangeability standards is a necessary but likely insufficient step to improve biosimilar competition in the US.