Insurance

New GLP-1 pills challenge injections as competition, and discussions of possible Medicare coverage could push prices down.

Reform priorities aim to reshape PBM oversight, delink compensation from drug prices, boost transparency, and protect pharmacy access.

Oral Wegovy reshapes GLP-1 costs: cash pay can be cheaper, insurance pricing often matches shots, and coverage hinges on employer benefits and coding.

Medicare Advantage beneficiaries face forced disenrollment in 2026 as plan exits drive coverage termination, pushing millions toward traditional Medicare and Part D’s $2100 cap.

Penetration of Medicare Shared Savings Program accountable care organizations and Medicare Advantage was not associated with substantive changes in health care use among commercial enrollees.

Oral GLP-1 costs, insurance gaps, and formulary switches reshape drug pricing and access—learn how to navigate coverage.

These new data show that 64.8% of US adults take at least 1 prescription medication each year.

New reports reveal rising insurance costs, senior drug savings, and cancer care inequities, showing how policy and partnerships shape health outcomes.

A large commercial insurer is increasingly covering acupuncture, which is a safe and effective alternative to opioids, for multiple pain conditions.

This article highlights challenges in prior authorization and offers practical, experience-based strategies to streamline workflows, reduce delays, and improve patient access to necessary treatments.

A Commonwealth Fund analysis finds employer health premiums and deductibles exceed 10% of income in 19 states, worsening affordability gaps.

Medicare Advantage enrollment has increased in the US and Puerto Rico, with a dramatic growth among Puerto Rico beneficiaries with end-stage renal disease.

The Consolidated Appropriations Act of 2026 acts as a first step in addressing prescription drug pricing challenges related to the role of pharmacy benefit managers (PBMs).

The postpandemic reinstatement of Medicare’s 3-day rule lengthened hospital stays without affecting SNF use, spending, or short-term outcomes, raising questions about its value.

The authors call for policy reforms that could strengthen patient-provider relationships, support care innovation, and improve quality for Medicare beneficiaries.

Increasing Medicare Advantage payments for full Medicaid enrollees was not associated with meaningful changes in inpatient or nursing home use.

A spending bill advancing PBM reforms aims to delink Medicare Part D compensation from drug rebates and improve pricing transparency.

Patients on commercial insurance were more likely to have at least 1 chronic condition, which can affect health care spending overall.

Philip Mease, MD, discusses the different treatment options now available for patients with psoriasis and psoriatic arthritis.

CMS’s 2027 proposed MA payment rate increase of .09% falls short of expectations, potentially increasing premiums and reducing benefits for seniors.

With the CDC’s decision to roll back recommendations to vaccinate for several conditions, questions have arisen as to what that may mean in the US.

Socioeconomic and demographic factors influenced amputation and recurrence rates in upper extremity soft tissue sarcoma.

David Muhlestein, PhD, breaks down ghost rates, data gaps, and why stronger oversight is needed to make Transparency in Coverage files usable for patients.

In this week’s health equity news, ICHRAs may offer flexible health coverage options amid ACA subsidy uncertainties, and advocates rally for mental health funding stability.

With ACA subsidies in limbo, ICHRAs may reshape how Americans access coverage. Here are 5 FAQs explaining what they are, who benefits, and key trade-offs.