Insurance

Recent political shifts impacting health policy and access to care for millions dominated the news in 2025.

Value-based care adoption in employer insurance requires replacing fragmented point solutions with unified, at-risk performance contracts that align vendors, providers, and members around total cost and quality goals.

Self-insured employers face regulatory challenges when adopting value-based contracts, requiring careful data governance, standardized metrics, and legal frameworks to align with federal value-based care models.

Employers struggle to define value from health care spending amid complexity and misaligned incentives. Achieving measurable outcomes requires transparency, incentive realignment, and gradual, employee-centered change.

Financial and social barriers hinder access to specialized care and impact treatment outcomes for adolescents and young adults with leukemia.

Most Medicare beneficiaries perceived low health care burdens, but 1 in 4 Medicare Advantage enrollees with at least 6 chronic conditions experienced high administrative and financial burdens.

As value-based care mandates expand, a new survey highlights documentation burdens and burnout risks.

Democrats move to extend ACA subsidies as enrollment closes, leaving consumers uncertain about premiums, coverage, and alternative health options.

In analyzing 2025 Transparency in Coverage (TIC) files from national insurers, the authors found vast payer-level differences; overall, physician/outpatient data were more complete, and hospital inpatient data were less complete.

ICHRAs may help employers and employees manage rising premiums and the loss of extended tax credits, according to expert insights from Ben Light.

Patients with stage I to IIIA NSCLC had lower 2- and 4-year mortality in states that expanded Medicaid coverage.

As open enrollment continues, 77% of surveyed Americans were happy with their options for 2026 health care coverage, although cost concerns surfaced.

Connecting primary care providers and commercially insured adults to outpatient behavioral health services via a digital platform improved health outcomes and reduced medical costs.

With ACA subsidies ending in 2025, Ben Light explains how rising premiums may push individuals toward ICHRAs and reshape employer health coverage strategy.

A new study shows fee-for-service care is linked to higher odds of low-value surgery, suggesting salaried models may reduce unnecessary procedures.

Avoiding losses of coverage due to administrative barriers can be done with a focus on making some of the processes automatic.

New research shows immigrant children face higher odds of unmet medical needs as federal and state coverage rules narrow.

Within the same physician groups, 2-sided risk in Medicare Advantage (MA) was associated with higher quality and lower utilization for dually eligible beneficiaries compared with fee-for-service MA and traditional Medicare.

Medicare Advantage beneficiaries with mental health diagnoses see more nurse practitioners and fewer internal medicine and emergency medicine specialists after switching to traditional Medicare.

The uninsured rates may skyrocket when Medicaid work requirements go into effect and if the Affordable Care Act (ACA) subsidies are not extended.

Shared savings reflects continued growth of long-term-care ACOs in Medicare’s value-based models.

The expansion of direct-to-consumer (DTC) pharmaceutical manufacturer models and the upcoming TrumpRx launch offer lower costs but create new complexities for patients.

Experts discuss the clinical and economic burden of idiopathic pulmonary fibrosis (IPF), emerging clinical data, and strategies to improve patient outcomes.

The quick turnaround between the introduction of Medicaid work requirements and implementation could leave many states spread thin, explains William Schpero, PhD, MPhil, MPH

Jonathan Strober, MD, discusses the challenges of diagnosing pediatric myasthenia gravis, especially in seronegative cases, and the importance of antibody testing.