Health Care Delivery

With deadlines looming in 2026 and 2027 for compliance with the CMS Advancing Interoperability and Improving Prior Authorization Final Rule, a survey indicates a concerning lack of readiness among payers and providers to meet the new requirements for data sharing.

Joseph Saseen, PharmD, discussed the importance of knowing lipoprotein a (Lp[a]) levels to enable clinicians to provide the best patient care and spread awareness to those who might be affected.

A report published today by Shatterproof and The Bowman Family Foundation underscores the potential of the collaborative care model to lower suicide risk across diverse patient populations and health systems.

New data from the National Comprehensive Cancer Network (NCCN) reveal that socially vulnerable and minority patients with metastatic pancreatic cancer are less likely to receive recommended treatments and achieve longer survival.

Adam Colborn, JD, associate vice president for congressional affairs, Academy of Managed Care Pharmacy, highlights key policy updates that are impacting managed care pharmacy.

Hospitalized patients with opioid use disorder (OUD) who received in-hospital addiction consultation services were more likely to receive evidence-based OUD care, a new study found.

Lipoprotein a (Lp[a]) is a valuable tool for assessing a patient's risk of cardiovascular disease, which can facilitate earlier intervention efforts and reduce health care costs, argued Jeremy Wigginton, MD.

Taxing imports to the US could spell major consequences for health care prices, innovation, and access, as a great amount of medical supplies and ingredients are manufactured overseas.

A higher percentage of accountable care organization (ACO) primary care providers was associated with physician leadership, upside financial risk, and financial compensation of physicians tied to performance measures.

The Center on Health Equity & Access delves into the latest policy shifts, research, and expert perspectives on advancing equity and improving access to care.

Clinical approaches to non-Hodgkin lymphoma in younger and older patient groups generally do not differ, according to Andrew Evens, DO, but he emphasized the need for deeper clinical insights into potential biologic differences in younger oncology patients.

Addressing the accessibility and high costs of chimeric antibody receptor (CAR) T-cell and bispecific therapies is crucial for maximizing their impact in multiple myeloma (MM).

Adolescent and Young Adult Cancer Awareness Week serves as an opportunity to shed light on the special considerations and experiences of younger oncology patient populations.

Findings from the SUMMIT, Altshock-2, and FAIR-HF2 trials were presented at the American College of Cardiology 2025 Annual Scientific Session.

Accessing equitable health care is an ongoing struggle in the US for minority communities due to historical pretexts with new setbacks surfacing as recent administrative changes emerge, highlighting the urgent need for continued advocacy during National Minority Health Month.

Countries located in sub-Saharan Africa would be most affected by all funding cuts to the international HIV response.

Care coordination engagement increases over time in long-term high-cost, high-need patients, with no identifiable data-driven times for when to initiate patient care de-escalation.

Patient-reported outcomes measures in generalized myasthenia gravis (gMG) are more important than ever, for both those treating and being treated for the chronic autoimmune neuromuscular disorder, to have a more nuanced understanding of experiences and difficulties.

Mobile self-management programs like that offered by Hello Heart can benefit employers and patients alike as they seek to manage and prevent heart disease.

This commentary explores the current state, challenges, and potential of artificial intelligence (AI) in health care revenue cycle management, emphasizing collaboration, data standardization, and targeted implementation to enhance adoption.

Social determinants of health been long understood to influence health outcomes, and this new analysis explores more deeply the link between social risk exposure and rates of health care resource utilization.

To mark the 30th anniversary of The American Journal of Managed Care® (AJMC®), each issue in 2025 will include 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 April issue features a conversation with Hoangmai H. Pham, MD, MPH, a member of AJMC’s editorial board and the president and CEO of the Institute for Exceptional Care (IEC).

Strategies to enhance virtual care through quality assurance frameworks, technological innovation, and provider support were laid out in a pair of posters presented at the recent AMGA Annual Conference.

Implementing artificial intelligence (AI) has transformed clinicians' and health systems' ability to screen for and distinguish forms of cardiorenalmetabolic disease.

Mapping care management needs by defining patient populations and then stratifying them according to risk and their needs can help to spur the transformation of a siloed health care system into an integrated system that is able to better provide holistic, value-based care despite the many transitions that continue among hospital, primary, specialty, and community care environments.

Keep up with the latest moves made in health policy under President Donald Trump's second administration. This timeline will be updated as orders and policy progress.

Medication nonadherence to oral anticoagulants and oral anti–prostate cancer medication has been scrutinized through new research conducted among patients and health care providers and presented by the American Medical Group Association at its 2025 annual meeting, held March 26-29 in Grapevine, Texas.

For higher-risk multiple myeloma (MM), successful patient selection and monitoring strategies are vital for the management of adverse events and the disease itself.

Weight loss is a key effect of glucagon-like peptide-1 receptor agonists (GLP-1 RAs), but these drugs may also provide liver health benefits independent of this mechanism.

In the wake of the 2025 measles outbreak and lingering vaccine hesitancy, here are 5 things to know about the safety, efficacy, myths, and more related to childhood vaccinations.