Insurance

New studies link extreme heat, obesity coaching gaps, cancer delays, ACA cost spikes, and income inequality to widening global health disparities.

A survey of marketplace enrollees revealed that they expect to cut back on basic household expenses to keep insurance coverage.

One in 4 Medicaid managed care organization sanctions are not remediated, revealing inconsistent state and federal oversight and the need to standardize CMS reporting and enforcement guidelines.

Legislation that passed the Senate will introduce reform in how pharmacy benefit managers are addressed by CMS starting in 2028.

The website officially launched on February 5, introducing a key part of the Trump administration’s health care plan.

Cost barriers push Latino adults to delay care, raising emergency department visits.

Susan Cantrell, CEO of AMCP, discusses the impact of the CDC's recent changes to the childhood immunization schedule and the role of managed care pharmacy in addressing them.

As Medicare Advantage grows, first-time enrollees demonstrate increasing demographic and clinical diversity, indicating that benefits should be designed to reflect the population’s changing composition.

Experts unpacked MFN drug pricing, expired ACA subsidies, and IRA fallout for community oncology in a recent webinar.

Medicaid managed care organizations should prioritize children in low-opportunity neighborhoods to optimize health care utilization, improve minority health, and address health-related social needs.

Employers and members can cut GLP-1 weight-loss costs with carve-outs, split payments, and transparent, updated price guides.

Scripta allows consumers to compare prescription prices, coupons, and insurance options in one place, helping patients and employers find affordable meds and smarter choices.

340B covered entities are expanding contracts with retail pharmacies that are increasingly located in counties with high rates of Medicare and Medicaid insurance coverage.

Employers use carve-outs and cash-pay channels to reduce GLP-1 costs, while Scripta’s Navigator helps members compare prices and find support.

Mark Meiselbach, PhD, at Johns Hopkins, explains Medicare Advantage market corrections, Star Rating System pressures, and rural plan exits.

MA grocery card use was associated with modest increases in wellness, primary care, and specialist visits among dual-eligible beneficiaries, says Jennifer L. Kowalski, MS.

The authors discuss ways to ensure that accountable care organizations do not bear the cost of inaccurate spending growth predictions.

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.