September 17th 2025
Syndromic reverse transcriptase–polymerase chain reaction tests for respiratory infections were associated with lower health care resource utilization and costs, implicating potential for improved value in patient care.
September 10th 2025
AI Meets Medicare: Inside CMS’s WISeR Model With Sanjay Doddamani, MD, MBA, Part 2
August 5th 2025In this second part of his interview with The American Journal of Managed Care®, Sanjay Doddamani, MD, MBA, a former senior advisor to CMMI and founder and CEO of Guidehealth, continues a dialogue on the future of value-based care and the promise—and limits—of AI-enabled innovation, reflecting on challenges like rising Medicare costs and patients’ growing financial burdens.
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Long-Term Lebrikizumab Provides Sustained Skin Clearance in Atopic Dermatitis
August 5th 2025In this subanalysis of data from the ADjoin trial of lebrikizumab, the interleukin-13 receptor inhibitor that is also a monoclonal antibody showed itself to be effective over the long term in patients with atopic dermatitis on maintenance therapy.
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Bridging the Gaps: New Strategies for Preventing Cardiovascular Disease
July 31st 2025During the Addressing Cardiovascular Risk and Intervening Early webinar, experts discussed innovative strategies for cardiovascular disease prevention, emphasizing risk assessment, lifestyle changes, and collaborative care to improve patient outcomes.
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LLMs Show Promise, but Challenges Remain in Improving Inefficient Clinical Trial Screening
July 31st 2025Large language models (LLMs) such as GPT-3.5 and GPT-4 may offer a solution to the costly and inefficient process of manual clinical trial screening, which is often hindered by the inability of structured electronic health record data to capture all necessary criteria.
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Trends in Insulin Out-of-Pocket Costs and Use Disparities, 2008-2021
Given trends in cost and use, insulin out-of-pocket cost reduction policies would be more efficient if they targeted members in high-deductible health plans with savings options and low-income patients.
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The Legal Architecture of Psychedelic Therapy: Risks, Responsibilities, and Reimbursement Realities
July 30th 2025Key legal, ethical, and compliance considerations for managed care professionals navigating the evolving landscape of psychedelic-assisted therapy include regulatory risks, data privacy challenges, reimbursement limitations, and the need for culturally informed care models.
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AI Is Not Going to Replace Doctors, It’s Going to Empower Them: Dr Mehmet Oz
July 25th 2025During a visit to AtlantiCare, CMS Administrator Mehmet Oz, MD, MBA, called for rural health systems to modernize IT infrastructure through the $50 billion Rural Transformation Fund, including through artificial intelligence (AI).
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The Evolving Landscape of Myasthenia Gravis Therapies: A Q&A With Miriam Freimer, MD
July 23rd 2025Miriam Freimer, MD, clinical professor of neurology at The Ohio State University Wexner Medical Center, reflects on how findings from the RAISE-XT trial potentially translate to real-world practice and looks to the future of treatment for the autoimmune neuromuscular disorder.
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Primary Care Doctors Lead Rising Physician Exodus From Medicare
July 21st 2025According to the American Medical Association, blame for the ongoing physician shortage may lie with overly burdensome administrative processes, an antiquated Medicare payment system, and lack of education for residents in primary care and psychiatry.
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Addressing Racial Disparities in Minority Mental Health and Finding Support in 2025
July 18th 2025National Minority Mental Health Month emphasizes the persistent mental health disparities among US racial and ethnic minorities, stemming from lower access to services, lack of culturally competent providers, discrimination, and medical mistrust, underscoring the need for dedicated resources and community action.
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Lung Transplant Referrals Lag for High-Risk Patients With PAH
July 18th 2025Despite recommendations on early referral for lung transplantation in cases of pulmonary arterial hypertension (PAH), there is a lack of in-depth understanding of this current landscape; in this analysis, clinical parameter data were used to compare outcomes between patients who were and were not referred for lung transplantation.
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