Health Care Cost

Removing out-of-pocket costs for follow-up colonoscopy led to an immediate and sustained increase in utilization.

Susan Escudier, MD, FACP, of Texas Oncology, suggests actionable insights to improve equitable access to patient cancer care

Medicare Advantage grocery supplemental benefit use is associated with increased outpatient care, suggesting that policy changes allowing for nonmedical supplemental benefits could improve beneficiaries’ health, especially for dual-eligible beneficiaries.

Counseling patients with obstructive sleep apnea on using GLP-1s effectively prior to starting treatment can help ensure adherence, said Matthew Biszewski, PharmD.

Medicare expenditures for patients with amyotrophic lateral sclerosis are more than 3 times those of the average Medicare beneficiary, and drug therapies are an important cost driver.

Andrew Wolf, MD, discusses the growing costs, treatment advances, and geographic disparities in multiple sclerosis care.

A new report shows Vermont, Utah, and Minnesota lead, while Louisiana, Mississippi, and Kentucky lag in Medicare performance.

Measures need to be taken to elevate engagement both from employees and the general public as public confidence in the US health care system declines.

Adults with diabetes were 24% less likely to visit an emergency department in 2021 than in 2019.

ACOs serving patients with complex needs are on the rise, but policy changes are needed to support providers treating special populations.

Infliximab biosimilars created price competition causing insurance claims costs for infliximab originator and infliximab biosimilars to decrease, generating significant savings to the health care system.

Lindsey Valenzuela, PharmD, explains how cost, coverage gaps, and tech literacy hinder women’s access to early arrhythmia detection tools.

AstraZeneca has struck a deal with the Trump administration to sell lower-priced drugs via TrumpRx, following a similar agreement with Pfizer.

Explore the implications of the Most Favored Nation Order on US drug pricing reform and its potential impact on patient access and innovation.

UC Davis Health enhances patient care through a shared services center, ensuring continuity of care and optimizing pharmacy growth strategies.

Robert Andrews, CEO of the Health Transformation Alliance, addresses Medicaid rebates, cost-shifting concerns, and value-based pricing trends.

Robert Andrews, CEO of the Health Transformation Alliance, discusses the implications of the new TrumpRx platform on drug pricing policy.

Public health must address emotional and structural inequities, emphasizes Perry N. Halkitis, PhD, MS, MPH, dean of the Rutgers School of Public Health.

Today, Amgen announced the launch of AmgenNow, a direct-to-patient program offering evolocumab (Repatha) at nearly 60% below the current US list price.

This article examines how prices, insurer payments, and patient payments for outpatient surgeries differ by site of care and network status.

Stronger partnerships between primary care and oncology improve patient outcomes by ensuring coordinated care and addressing financial and systemic barriers, says Mark Fendrick, MD.

This national study of neonatology services found no clear evidence that state surprise billing regulations influenced prices or provider network participation for the commercially insured.

To mark the 30th anniversary of The American Journal of Managed Care, each issue in 2025 includes a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The October issue features a conversation with Ge Bai, PhD, CPA, professor of accounting at Johns Hopkins Carey Business School and professor of health policy and management at Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland.

Although overall costs have not declined with the Oncology Care Model (OCM), supportive care costs have decreased through greater use of cost-effective therapies.

An eHealth survey revealed widespread confusion, low awareness of 2026 Medicare plan changes, and growing interest in artificial intelligence support.