Payers

Ameet Patel, MD, concludes by outlining strategies to overcome operational, financial, and payer challenges in delivering advanced multiple myeloma therapies.

Catherine Gaffigan, MD, Elevance Health's President of Health Solutions, discusses value-based care initiatives and payer-provider relationships.

Penetration of Medicare Shared Savings Program accountable care organizations and Medicare Advantage was not associated with substantive changes in health care use among commercial enrollees.

Oral GLP-1 costs, insurance gaps, and formulary switches reshape drug pricing and access—learn how to navigate coverage.

Epcoritamab delivers lasting 3-year remissions in relapsed large B-cell lymphoma, with over half of complete responders staying progression-free.

New bipartisan legislation would ban parent companies from owning insurers or PBMs and providers or management services organizations simultaneously.

The visual nature of head and neck cancer calls for treatment strategies that will minimize toxicities related to radiation therapy. Advances in precision radiation techniques, supportive care, and multidisciplinary approaches have improved outcomes, improving quality of life.

A large commercial insurer is increasingly covering acupuncture, which is a safe and effective alternative to opioids, for multiple pain conditions.

This article highlights challenges in prior authorization and offers practical, experience-based strategies to streamline workflows, reduce delays, and improve patient access to necessary treatments.

Medicare Advantage enrollment has increased in the US and Puerto Rico, with a dramatic growth among Puerto Rico beneficiaries with end-stage renal disease.

Increasing Medicare Advantage payments for full Medicaid enrollees was not associated with meaningful changes in inpatient or nursing home use.

There is a shift happening in mental health care, with real-world data and holistic evaluations improving patient outcomes and reducing disparities.

The most-viewed content focused on the “One Big Beautiful Bill,” the Most Favored Nation drug policy, and other changes under the Trump administration.

Industry leaders discuss how policy, pricing, and innovation will shape the future of oncology care and patient access.

How strategic partnerships in oncology can enhance patient care by addressing diverse needs through collaboration.

Experts discuss the evolving dynamics between payers and providers in oncology, emphasizing value-based care, data transparency, and collaborative reform opportunities.

Oncology leaders warn that declining reimbursements and policy gaps threaten patient access and drive inequities in cancer care.

Onasemnogene abeparvovec-brve is now the first gene replacement therapy approved for spinal muscular atrophy in patients 2 years and older.

Adam Brufsky, MD, PhD, addresses how the COVID-19 pandemic affected breast cancer screening rates across Pittsburgh.

Utilizing the Health Insurance Disparities Index for assessment, the authors found that New York’s Medicaid health maintenance organizations (HMOs) outperformed Medicaid HMOs nationally in addressing health care disparities from 2019 to 2023.

Only 4% of NIH prevention projects target health disparities, revealing a major gap between equity research and real-world implementation.

The White House announced significant drug pricing cuts for GLP-1s for diabetes and obesity for Medicare and Medicaid beneficiaries and on TrumpRx.

Experts at AMCP Nexus 2025 highlighted how real-world data can improve CAR T-cell therapy access and outcomes.

A multidisciplinary approach that includes addressing social determinants of health reduces time to remission despite higher initial costs.

Payers cited high upfront costs, long-term uncertainty, and narrow coverage criteria as factors continuing to limit access and reimbursement innovation.