Health Care Cost

This commentary proposes a hybrid drug pricing reform model balancing most favored nation (MFN) benchmarking with domestic negotiation strategies that drive equity-focused valuation frameworks.

New research shows immigrant children face higher odds of unmet medical needs as federal and state coverage rules narrow.

Within the same physician groups, 2-sided risk in Medicare Advantage (MA) was associated with higher quality and lower utilization for dually eligible beneficiaries compared with fee-for-service MA and traditional Medicare.

Shared savings reflects continued growth of long-term-care ACOs in Medicare’s value-based models.

Eleanor Perfetto, PhD, explores how most favored nation policy relates to broader drug pricing and cost-effectiveness debates in the US.

The expansion of direct-to-consumer (DTC) pharmaceutical manufacturer models and the upcoming TrumpRx launch offer lower costs but create new complexities for patients.

Experts discuss the clinical and economic burden of idiopathic pulmonary fibrosis (IPF), emerging clinical data, and strategies to improve patient outcomes.

With ACA subsidies and key CMS payment models ending in 2025, premiums are set to rise, shifting costs to consumers and employers.

Requiring individuals on Medicaid to report their work hours has been attempted in other states previously, with mixed results.

Based on this analysis, all 3 gepants are not cost-effective compared with usual care for the treatment of acute migraine.

Cuts to Medicaid could spell trouble for pediatric health, as millions of children rely on Medicaid to cover their hospital expenses.

One in 5 of the highest-revenue drugs of 2022 was exclusively approved for rare conditions, accounting for more than 7% of US pharmaceutical spending.

Experts say proposed pharmaceutical tariffs could raise drug prices, impacting patient access and health care budgets.

A vote on the House floor allowed for the government to reopen immediately, but the fight over the extension of ACA subsidies still goes on.

The Colorectal Cancer Alliance expands its $100 million Project Cure CRC with 3 new grants driving innovation and improving patient outcomes.

In this investigation, the authors evaluated the impact of a voluntary transition to risk-based contracts under Medicare Advantage on health care use.

The introduction of more stringent work requirements for those enrolling or renewing their Medicaid coverage can affect both children and adults.

This article provides insights into patterns of health care use following emergency department visits by high-need, high-cost patients with different types of California Medicaid primary care providers.

RPM may improve patient access to care, especially those with high-risk conditions, but not without a significant cost.

Medbridge is working to refine remote therapeutic monitoring, or RTM, to transform physical therapy and enhance patient care.

Confusion around how to verify work hours could leave millions unenrolled after the passing of the One Big Beautiful Bill Act.

A JAMA study found 30-day outpatient follow-up decreases hospital readmissions, especially for patients with heart failure and heart attack.

Guideline-directed medical therapy used with remote monitoring can potentially reduce hospitalization in patients with heart failure with ejection fraction.

Experts discuss the evolution of cancer care, emphasizing value-based approaches, precision oncology, and the importance of multidisciplinary collaboration for improved patient outcomes.

As open enrollment begins November 1, 2025, millions are signing up under enhanced subsidies that are set to expire at the end of this year.