Payers

This retrospective study using administrative claims data examining health care resource utilization (HCRU) found that in the months before a diagnosis of eosinophilic esophagitis (EoE), other diseases were more commonly diagnosed.

Medicaid managed care utilization review data for mental health services were analyzed for the calendar years 2017 and 2018. These data indicate low rates of utilization review denials for both inpatient and outpatient mental health services.

The rise in popularity of genetic testing brings along a myriad of challenges ranging from concerns on data privacy to insurance coverage, but, when utilized correctly, it could mark a step forward for significant advancements in individual and population health.

Geoffrey Boyce, CEO of Array Behavioral Care, discusses Array AtHome’s telebehavioral health services, which are now available to approximately 5 million Humana Medicare Advantage members.

Incyte has become the latest company to pull an FDA filing following Gilead and Secura Bio, which both voluntarily withdrew therapies that had been granted accelerated approval but hadn’t completed confirmatory studies for full approval.

Experts discuss current trends in Medicare Advantage during the current annual enrollment period, best practices for communication, and gain clarity about the benefits and costs for both providers and beneficiaries.

Experts discuss current trends in Medicare Advantage during the current annual enrollment period, best practices for communication, and gain clarity about the benefits and costs for both providers and beneficiaries.

Experts discuss current trends in Medicare Advantage during the current annual enrollment period, best practices for communication, and gain clarity about the benefits and costs for both providers and beneficiaries.

Experts discuss current trends in Medicare Advantage during the current annual enrollment period, best practices for communication, and gain clarity about the benefits and costs for both providers and beneficiaries.

Experts discuss current trends in Medicare Advantage during the current annual enrollment period, best practices for communication, and gain clarity about the benefits and costs for both providers and beneficiaries.

Experts discuss current trends in Medicare Advantage during the current annual enrollment period, best practices for communication, and gain clarity about the benefits and costs for both providers and beneficiaries.

Experts discuss current trends in Medicare Advantage during the current annual enrollment period, best practices for communication, and gain clarity about the benefits and costs for both providers and beneficiaries.

Experts discuss current trends in Medicare Advantage during the current annual enrollment period, best practices for communication, and gain clarity about the benefits and costs for both providers and beneficiaries.

Zanubrutinib is a second-generation Bruton tyrosine kinase (BTK) inhibitor that has fewer off-target effects and less cardiotoxicity than ibrutinib, a first-generation BTK inhibitor.

Compared with the European Union, biosimilar use in the United States lags, and the US government, health systems, and medical associations all have a role to play.

The deadline to enroll in health insurance available through the Affordable Care Act on the federal exchange is Saturday, January 15.

The first FDA-approved acne drug with a first-in-class mechanism of action in nearly 40 years launched in the United States in November 2021 after being approved in August 2020.

In a National Coverage Determination decision memo released Tuesday, CMS said it will gather public comment for 30 days about its plan to limit coverage for Alzheimer disease (AD) biologics that target plaque buildup in the brain to patients enrolled in certain clinical trials.

CMS proposed rulemaking Thursday that would pass pharmaceutical price concessions to beneficiaries in Medicare Part D plans and make the medical loss ratio in Medicare Advantage plans more robust.

On this episode of Managed Care Cast, we bring you part 1 of an 8-part video conversation with Blue Cross Blue Shield of North Carolina and Newton Family Physicians about how they adapted to deliver health care in 2020 and 2021.

Projected savings from biosimilars from 2021 to 2025 were $38.4 billion vs conditions as of quarter 4 of 2020 and were driven by new biosimilar entry. Savings were $124.5 billion under an upper-bound scenario.

This 8-part conversation with Blue Cross and Blue Shield of North Carolina and Newton Family Physicians, moderated by The American Journal of Managed Care® (AJMC®), focuses on the role of value-based care, independent care practices, and other aspects of health care that have been and continue to be affected by the continuing COVID-19 pandemic, even as we enter 2022. This is part 8.

This 8-part conversation with Blue Cross and Blue Shield of North Carolina and Newton Family Physicians, moderated by The American Journal of Managed Care® (AJMC®), focuses on the role of value-based care, independent care practices, and other aspects of health care that have been and continue to be affected by the continuing COVID-19 pandemic, even as we enter 2022. This is part 7.

This 8-part conversation with Blue Cross and Blue Shield of North Carolina and Newton Family Physicians, moderated by The American Journal of Managed Care® (AJMC®), focuses on the role of value-based care, independent care practices, and other aspects of health care that have been and continue to be affected by the continuing COVID-19 pandemic, even as we enter 2022. This is part 5.

This 8-part conversation with Blue Cross and Blue Shield of North Carolina and Newton Family Physicians, moderated by The American Journal of Managed Care® (AJMC®), focuses on the role of value-based care, independent care practices, and other aspects of health care that have been and continue to be affected by the continuing COVID-19 pandemic, even as we enter 2022. This is part 5.

This 8-part conversation with Blue Cross and Blue Shield of North Carolina and Newton Family Physicians, moderated by The American Journal of Managed Care® (AJMC®), focuses on the role of value-based care, independent care practices, and other aspects of health care that have been and continue to be affected by the continuing COVID-19 pandemic, even as we enter 2022. This is part 4.

This 8-part conversation with Blue Cross and Blue Shield of North Carolina and Newton Family Physicians, moderated by The American Journal of Managed Care® (AJMC®), focuses on the role of value-based care, independent care practices, and other aspects of health care that have been and continue to be affected by the continuing COVID-19 pandemic, even as we enter 2022. This is part 3.

This 8-part conversation with Blue Cross and Blue Shield of North Carolina and Newton Family Physicians, moderated by The American Journal of Managed Care® (AJMC®), focuses on the role of value-based care, independent care practices, and other aspects of health care that have been and continue to be affected by the continuing COVID-19 pandemic, even as we enter 2022. This is part 2.