Insurance

National HIV Testing Day highlights how state policies, pharmacists, and long-acting therapies are reshaping access to HIV testing, PrEP, and PEP.

New research reveals complex treatment costs from MM strain patients and caregivers during active therapy, while pain goes undertreated at end of life.

Texas abortion ban worsens maternal mental health; SCD trials exclude 90% of adults; nutrition, hepatitis B, and cost-control gaps persist.

Broader cancer care networks were not consistently associated with lower Medicare Advantage disenrollment after cancer diagnosis.

Commercial health care costs are projected to grow 9% in 2027, driven by AI billing tools, pharmacy spend, and provider consolidation, per a PwC report.

Cancer trauma, drug pricing claims, abortion cost gaps, insurance denials affecting 1 in 5, and food insecurity's economic toll top this week's roundup.

During a White House briefing, Mehmet Oz, MD, discussed the expansion of Trump Rx and crackdowns on duplicate ACA enrollment and fraudulent hospice programs.

Coverage denials delay care, drive patients into debt, and erode trust in insurers—yet nearly half of affected patients never appeal.

Even spending just 5% of income on medical costs raises food insecurity risk by 80% for families with children, study finds.

Accountable care offers one of the most promising frameworks for stabilizing and expanding access, but only if policy is intentionally designed to support rural participation.

Research indicates that prior authorizations for drugs take physician practices and pharmacies 15 to 64 minutes to complete and cost $15 to $63 each.

This article provides a commentary on a news feature published on AJMC.com in 2025 titled “AI Seen as Key to Reducing Health Care Claim Denials, Survey Finds.”

Medicare FFS beneficiaries with metastatic cancer received broad genomic profiling more often than MA patients.

Insured patients paying over $15 in generic drug co-pays may save more buying direct through a direct-to-consumer pharmacy like Cost Plus Drugs

US health care faces massive shifts: rising ACA deductibles, federal health leadership shakeups, and major care gaps in women's health and dermatology.

ACA enrollment drops 21.5% in 2026 after enhanced subsidies end. Deductibles hit record $3786 as enrollees shift to high-deductible bronze plans.

Investigators found major variation in prior authorization rules across commercial insurers, highlighting limited standardization and transparency.

This study evaluated differences in racial and ethnic disparities in surgical outcomes between Medicare Advantage and traditional Medicare beneficiaries, finding consistent but nonuniform smaller disparities within Medicare Advantage.

Fears that the telemedicine boom would send health care costs soaring haven’t been borne out, a major new study finds, and the timing couldn’t be more critical for federal policy makers.

Here is a policy briefing for chief medical officers and managed care leaders on key pressure points about the Medicaid funding cuts.

Their study found cost nudges had minimal effect on clinic selection, as 85% already chose lower-cost tiers, suggesting tiered benefit design works.

Hospital at home is linked to lower mortality and ED use vs inpatient care in Medicare patients.

This week, a Capitol hearing spotlights Medicare fraud gaps, reports warn of equity setbacks, community oncology boosts survival, and Medicaid work rules loom.

Experts at AXS26 laid out why advanced therapies are underutilized and what payers, providers, and manufacturers must do together to change that.

The new work requirements for Medicaid eligibility, included in the One Big Beautiful Bill Act, will officially be required in January 2027.