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

MA-to-MA switching among dually eligible beneficiaries rose sharply from 2016 to 2022, AJMC study author Grace Mackleby, PhD, found.

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.

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

Sustainable models require asking what a result shows, what design produced it, and whether the design was built to measure value or just produce a number.

Build scalable obesity care with multidisciplinary teams, clear triage, and monitoring protocols; address GLP-1 gaps, Medicare access and price barriers, including oral GLP-1.