CMS finalized Transparency in Coverage updates as a researcher warns ghost rates and missing inpatient data limit payer price files.

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

FDA accepted United Therapeutics' sNDA for inhaled treprostinil in IPF. Here's what it could mean for patient access, coverage, and costs

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.

CMS is adding value-based care (VBC) risk faster than many providers can build the data and tech capacity they need to succeed.

Phase 3 wins for ianalumab and dazodalibep bring targeted therapies closer for Sjögren disease as patients face diagnostic delays and high costs.

CMS finalized the mandatory GLOBE Model, tying Part B drug rebates to international prices in areas covering 25% of beneficiaries from Jan. 1, 2027.

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