Health Care Cost

There will likely be a 7% increase in Affordable Care Act (ACA) Marketplace plan premiums next year across the 324 participating insurers from the 50 states and Washington, DC.

John M. O'Brien, PharmD, MPH, of the National Pharmaceutical Council, discusses his recent study, which sheds light on how important rebates are when choosing benefits for employers and who advises employers on these choices.

Almost half of insured Americans report receiving unexpected medical bills, leading to financial strain and contributing to worsening health outcomes for many patients, The Commonwealth Fund report reveals.

The Center on Health Equity & Access reported on new research in youth mental health, with expert perspectives on HIV, liver cancer, and health outreach.

Trusted community organizations can effectively communicate and connect underserved populations to necessary health services, Tiara Green, MSEd, Accessia Health says in an interview.

As pharmacy benefit managers (PBMs) come under increased scrutiny from regulatory agencies, here are 5 things to know about their role in the health care system.

A new study has found that prior authorizations for anti–vascular endothelial growth factor treatment led to a delay in patient care for most patients.

Researchers estimate the financial impact of respiratory syncytial virus (RSV) in cardiorespiratory hospitalizations using MarketScan data and CDC viral positivity rates.

Those in minority groups face barriers even after they’ve made the hard decision to seek mental health care. The Department of Labor aims to address systemic issues on a personal level.

Smokers with diabetes on Ozempic are less likely to receive smoking cessation interventions; initiative incentivizes hospitals to eliminate medical debt for low- and middle-income patients; high costs prevent mental health treatment.

Crystal S. Denlinger, MD, FACP, CEO of the National Comprehensive Cancer Network, discusses possible federal policies to help mitigate ongoing and future cancer drug shortages.

The hospitalization rate for patients with pulmonary hypertension (PH) and interstitial lung disease (ILD) doubled over a 2-year period, and total health care costs more than doubled over the same period.

Patients with alopecia areata (AA) face significant out-of-pocket costs for treatments, despite many having limited efficacy.

This week, the Center on Health Equity & Access delved into the state of equity as it relates to national spending, ovarian cancer care, health technology, insurance coverage, and postpartum depression.

Patients with fibrosing interstitial lung disease (ILD) who began supplemental oxygen therapy had triple the per patient per month ILD-related health care costs compared with those who did not.

Melissa Clarke, MD, CMQ, the chief health equity officer at Elevance Health, explains "Health Equity by Design" and how Elevance Health is committed to ensuring a personalized and intentional approach for all its members.

Efforts to regulate social media for youth face resistance; MK-1654 meets key goals in mid-to-late stage trial; active drug shortages remain above 300 for sixth consecutive quarter.

A new report provided updated figures estimated the birth prevalence of spinal muscular atrophy (SMA) in the US.

This study examined employers’ understanding of rebate guarantees, dependency upon rebate dollars, and the role that pharmaceutical rebates or employer benefits consultants play in their pharmacy benefits manager selection.

On this episode of Managed Care Cast, we're talking with the author of a study published in the July 2024 issue of The American Journal of Managed Care® that estimates the insurance value of novel Duchenne muscular dystrophy (DMD) treatment.

Almost half of all Americans struggle to afford quality health care and prescription medications; the cyberattack on UnitedHealth Group's Change Healthcare unit will cost the company between $2.3 billion and $2.45 billion in 2024; CMS releases the final part 2 guidance for plan outreach and education for the Medicare Prescription Payment Plan.

A trio of experts discuss the challenges of diagnosing and managing paroxysmal nocturnal hemoglobinuria (PNH), a rare and life-threatening disorder.

A retrospective database analysis demonstrated the high clinical burden experienced by patients with severe deficiencies of ADAMTS13 and thrombotic thrombocytopenic purpura (TTP)–related diagnoses.

Patients with both diabetes and atherosclerotic cardiovascular disease (ASCVD) have about 1.5 times higher total direct health care expenditures than those without diabetes.

The Federal Trade Commission (FTC) is preparing a lawsuit against the 3 largest drug middlemen over their use of rebates for insulin and other drugs; Sen Bernie Sanders (I, Vermont) feels confident that Novo Nordisk will cut Ozempic and Wegovy costs after hearing; CMS proposed a payment rule that would increase Medicare reimbursement for hospital outpatient departments by 2.6% next year.