Payers

Latest News

Based on western blot testing, patients who received gene therapy at 2 years old showed a mean dystrophin expression of 93.87% of normal. | Image Credit: Treecha - stock.adobe.com

DMD Gene Therapy Shows Efficacy, Safety in Patients Treated at 2 Years Old

May 23rd 2025

Delandistrogene moxeparvovec, a gene therapy for Duchenne muscular dystrophy (DMD), showed high dystrophin expression and a favorable safety profile in young patients.

The new report highlights several barriers to CGT use, including cumbersome referral processes, high price tags, complex logistics, and uncertainties around reimbursement. | Image Credit: Treecha - stock.adobe.com

CGTs Have Potential to Transform Care, but Challenges Persist

By Rose McNulty

May 14th 2025

Quantitative magnetic resonance imaging seemed to show that delandistrogene moxeparvovec protects muscle from progressive damage in DMD. | Image credit: OlegKachura - stock.adobe.com

Quantitative Magnetic Resonance Outcomes Suggest Gene Therapy Slows DMD Progression

By Rose McNulty

May 14th 2025

Using Data Exchange to Improve Quality Reporting, Target Outreach, and Reduce Cost

By Barbara Rubino, MD
Chelsea Hart-Connor, MA

May 13th 2025

Health Outcomes Under Full-Risk Medicare Advantage vs Traditional Medicare

By Kenneth Cohen, MD
Boris Vabson, PhD

May 9th 2025

More News

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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