Insurance

Laundromats offer a promising outreach setting for Medicaid payers because Medicaid enrollees represent a majority of laundromat users and have disproportionately high levels of unmet needs.

Asembia’s AXS25 Summit covered a variety of relevant topics in the pharmaceutical industry, from the effects of the new administration to how artificial intelligence (AI) is reshaping the patience experience.

Timely outpatient telepsychiatry care for Medicaid enrollees was associated with lower hospitalization rates and comparable overall costs, supporting its potential role in value-based care models.

Self-paying patients can now obtain semaglutide at a lower cost through trusted telehealth providers.

Approximately 1 million Aetna members will need new coverage with the announcement that CVS will be leaving the Affordable Care Act (ACA) individual exchange business next year.

Experts urge for technology-driven, collaborative solutions as patients shoulder a growing burden of prescription costs.

Early actions by the new administration signal major changes in health policy, taxes, and pharmaceutical pricing.

Medicaid beneficiaries face higher rates of pulmonary hypertension, with significant economic burdens and racial disparities in prevalence and costs.

Expanding Medicare coverage for glucagon-like peptide 1 (GLP-1) receptor agonists could significantly reduce obesity-related health issues, but it also risks adding tens of billions in new costs, highlighting the need for smart policy strategies to ensure access, affordability, and long-term sustainability.

Asembia's AXS25 Summit will unite more than 8000 key decision-makers to explore pharmacy innovation, artificial intelligence, policy, and patient care from April 27 to May 1 at Wynn & Encore in Las Vegas, Nevada.

Richard Hughes IV, JD, MPH, spoke about the upcoming oral arguments to be presented to the Supreme Court regarding the Braidwood case, which would determine how preventive services are guaranteed insurance coverage.

The executive order targets lower drug prices through Medicare reforms, anticompetitive crackdowns, and transparency mandates.

The California-based entities plan to offer new Medicare Advantage (MA) products in select counties by this fall.

As Medicare Advantage (MA) enrollment grows, Johnie Rose, MD, PhD, Case Western Reserve University School of Medicine, underscores the importance of ongoing research into outcomes for MA beneficiaries vs fee-for-service (FFS) Medicare beneficiaries.

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

In 2021, UnitedHealth Group received 42% of the $33 billion in additional Medicare Advantage payments from differential coding.

This study examined postdiagnosis breast cancer treatment outcomes for Medicare Advantage vs fee-for-service (FFS) Medicare in Ohio and found no significant differences overall but disparities for Black patients with FFS Medicare.

Prior authorizations create substantial administrative and financial burdens on physicians and patients and can disrupt the continuity of care.

Best practices can help MA plans improve their Star Ratings performance while allow for strategies for medication adherence to grow.

The researchers emphasized the need for ongoing research and advocacy to further address drug affordability.

Tenacious efforts at every level, from the individual clinician to the hospital to the state to Congress, will be needed to make sure patients can access life-saving gene therapies for neuromuscular diseases.

Posters presented at the 2025 Muscular Dystrophy Association (MDA) Clinical & Scientific Conference show that therapeutic advances in treating spinal muscular atrophy (SMA) are not uniformly making it into the hands of patients who could benefit.

Michael Chernew, PhD, professor of health care policy and director of the Healthcare Markets and Regulation Lab, Harvard Medical School, shares how cost-sharing policies shape access to critical health care services and influence value-based insurance design.

The second Trump administration is expected to bring changes to Medicaid, Medicare Advantage, and the health insurance exchanges, as well as highlight the Make America Healthy Again (MAHA) movement, speakers at the Value-Based Insurance Design Summit said.

Flood exposure was more strongly associated with increased health care use and cost during the summer months and among Medicare beneficiaries aged 85 or older.

A new report shows most Americans believe the government is too involved in health care regulation and want to see a ban on pharmaceutical company advertisements in the US.

Older, generic medications, including ones for cyclosporine, nicotinamide, and dapsone, can effectively treat patients with various dermatological conditions while helping to reduce insurance and cost barriers.

Thy N. Huynh, MD, FAAD, Bruce A. Brod, MHCI, MD, FAAD, and Melissa Piliang, MD, FAAD, discussed expanding access to pediatric dermatology, dermatology data aggregation, and advocacy for Medicare physician payment reform, respectively.

Information on health equity was removed by the federal government for both the Children’s Health Insurance Program and Medicaid.

Enhanced premium tax credits (PTCs) have made marketplace health insurance more affordable, and eliminating them could have sweeping impacts on consumers and the health care industry, according to a new report.