Payers

Latest News

PACE participants | Image: National PACE Association

PACE Program Expansion Requires For-Profit Investment, Reduced Regulatory Burden, and Greater Patient Eligibility

August 19th 2025

Given the track record of good outcomes and savings, policy leaders must do more to promote growth of for-profit PACE programs, the author asserts.

Zopapogene imadenovec, a non-replicating adenoviral vector-based immunotherapy, expresses a fusion antigen made up of selected regions of human papillomavirus (HPV) types 6 and 11 proteins. | Image Credit: aznan - stock.adobe.com

FDA Approves Zopapogene Imadenovec for Recurrent Respiratory Papillomatosis

By Rose McNulty

August 19th 2025

While the findings suggest that switching to onasemnogene abeparvovec after non–gene therapy treatments could be beneficial to patients with spinal muscular atrophy, it is not clear which patients may benefit the most from switching therapies. | Image credit: Rochu_2008 - stock.adobe.com

Switching to Gene Therapy After Nusinersen or Risdiplam May Benefit Patients With SMA

By Rose McNulty

August 15th 2025

DYNE-251 Granted FDA Breakthrough Therapy Designation for DMD

By Rose McNulty

August 13th 2025

The Impact of Health Benefit Design on Patients With Infertility

By Richard A. Brook, MS, MBA
Sanghyuk Seo, PharmD, MS

August 5th 2025

More News

Dawn Holcombe Addresses the Continuing Challenges of Defining Evidence and Value in Oncology

November 30th 2011

Mark Zitter Discusses Providing Telephone Counseling Services to End-of-Life Cancer Patients

November 28th 2011

Mark Zitter Addresses How Oncology Payers Are Becoming Stricter About Covered Therapies

November 28th 2011

Diabetes Benefit Management: Evolving Strategies for Payers

Albert L. Tzeel, MD, MHSA, FACPE

November 11th 2011

The Structure of Risk Adjustment for Private Plans in Medicare

Joseph P. Newhouse, PhD;Jie Huang, PhD;Richard J. Brand, PhD;Vicki Fung, PhD;John Hsu, MD, MBA, MSCE

June 23rd 2011

Health plan accounting data are used to test how well the CMSHCC risk adjustment system tracks relative costs of treating various diagnoses: not very well.

Identification of Patients Likely to Benefit From Care Management Programs

Tobias Freund, MD;Cornelia Mahler, MA, RN, PhD;Antje Erler, MD, MPH;Jochen Gensichen, MD, MA, MPH;Dominik Ose, DrPH, MPH;Joachim Szecsenyi, MD, MSc;Frank Peters-Klimm, MD

May 23rd 2011

Three approaches to prospective patient identification for care management programs were compared: predictive modeling, selection by primary care physician, and a combination of both.

Health Insurance in India: Need for Managed Care Expertise

Thomas K. Thomas, MBA

March 14th 2011

India's emerging health insurance sector faces significant operational challenges that managed care models can help to address.

Abolishing Coinsurance for Oral Antihyperglycemic Agents: Effects on Social Insurance Budgets

Kostas Athanasakis, MSc;Anastasis G. Skroumpelos, MSc;Vassiliki Tsiantou, MSc;Katerina Milona, MSc;John Kyriopoulos, PhD

March 7th 2011

A coinsurance rate decrease can result in increased adherence to oral antihyperglycemic agents and improved clinical outcomes and cost savings for the healthcare system.

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