Payers

Over the next 18 to 24 months, Humana is exiting the commercial health plan business to focus on government-funded programs, like Medicare Advantage, and specialty businesses.

Utilizing real-world evidence that applies to the specific care needs of certain patient populations can promote timely decision-making among payers and providers on the use of effective cancer therapies available on the market, said panelists at the 2022 Patient-Centered Oncology Care® (PCOC) meeting.

At Patient-Centered Oncology Care®, Debra Patt, MD, PhD, MBA, of Texas Oncology, discussed managed care considerations that arise from the groundbreaking DESTINY-Breast04 study presented earlier this year.

A panel of experts discussed the explosion of information and advances in cancer genomics and the accompanying challenges of understanding the data and taking action.

There are 2 ranibizumab biosimilars approved in the United States, and with more ranibizumab and the first aflibercept biosimilars on the horizon, gaps in knowledge among retinal physicians should be addressed.

When the first adalimumab (Humira) biosimilar launched at the end of January, it was just the beginnings of a wave of coming biosimilars for anti-inflammatory biologics.

China’s angry reaction after spy balloon retrieval rouses drug supply chain anxiety; after allegedly overcharging California’s Medi-Cal program, managed care company Centene will pay millions in a settlement; major drug companies are chasing new pharma deals amidst dropping patent exclusivity.

Virtual care not only means saved time and costs for employees, but improvements to employers' bottom lines, through more proactive management of health concerns, notes UCM Digital Health CEO and co-founder Keith Algozzine.

In this column, a health insurance executive discusses 2 ways to address rising inflation, including moving past the traditional fee-for-service payment model.

The government is allowing Medicare Advantage (MA) plans to delay returning hundreds of millions of dollars or more in government overpayments; a proposed new extension of the Affordable Care Act (ACA) might make birth control coverage more accessible for certain private insurance plans; a study found that students lost around 33% of their school year because of the pandemic’s educational barriers and are struggling to regain that lost time.

The Biden administration has said it would give 60 days notice before ending the public health emergency, which was set to end April 11, and the national emergency was set to end March 1.

The first of at least 8 adalimumab biosimilars has finally launched in the United States after being kept off the market for years due to settlement agreements with the maker of the reference product, Humira.

Adults with diabetes who were forced to switch from an employer-sponsored health plan to a high-deductible health plan (HDHP) were 25% more likely to require an emergency department (ED) or hospital visit for hyperglycemia, but not for hypoglycemia, than those who did not switch plans.

Amazon’s announcement of a prescription subscription service that charges a flat monthly fee instead of offering discounts on each prescription fill represents the retail giant’s latest foray into the health care space.

Jodi Fenner, senior director at Elevance Health, speaks on the key themes she presented during her session at the 2023 Health Equity Summit in San Diego, California, titled, "Promoting Health Equity through Primary Care."

N. Benjamin Fredrick, MD, of Penn State Hershey Medical Center and Penn State University College of Medicine, speaks on the key themes he presented during his session at the 2023 Health Equity Summit in San Diego, California, as well as topics related to the measurement, creation, and implementation of health equity initiatives.

Big data has valuable implications for analyzing datasets and in day-to-day clinical practice, explained Ken Cohen, MD, director of translational research for Optum Care.

According to Eli Lilly's statement, the investigational drug worked quickly, so too few patients in the phase 2 study took it for a full year.

Ken Cohen, MD, director of translational research for Optum Care, talks about the value of prior authorizations in different contexts, and how simplicity can benefit the process in some situations.