Payers

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

Texas Oncology boosts precision medicine with near-universal biomarker testing, quality measurement, and genomic insights—advancing health equity through streamlined workflows and coverage. This commentary will appear in the June issue of Evidence-Based Oncology.

Women’s Health Month highlights major 2026 shifts in menopause care, brain health, abortion access, doula coverage, and wearable tech.

Prior authorization and payer hurdles delay prescription drugs; the Alliance for Patient Access urges health policy shaped by patient experience.

Food insecurity identification modeling for Medicare can establish a reliable method of prioritizing members at risk of food insecurity for identification and program enrollment.

Health-system specialty pharmacies leverage EHR insights to enhance real-world evidence, improve access, and streamline prior authorizations.

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

As CAR T-cell therapy reaches community oncology, practice leaders discuss the challenges of payer hurdles, single case agreements, apheresis costs and whether to pursue accreditation.

Advanced therapies are pressuring reimbursement and necessitating real-world durability data and new payment models, said Fran Gregory, PharmD.

Policy experts discuss how PBM reforms came together, what changes are on the horizon, and what threats are looming for community oncology.

Bringing these curative treatments to more patients means making them available at the community practice level. But that's a big lift, according to experts who spoke at a COA session.

As physician shortages and burnout threaten the patient experience in oncology, The US Oncology Network works to scale solutions, including the use AI ambient scribes and other workflow fixes, as well as fostering self-care strategies.

At NAACOS 2026, value-based care leaders make the case for treating payers as partners and explain what providers must see in return.

FDA grants lunsotogene parvec-cwha approval for OTOF-related hearing loss, delivering single-dose gene therapy gains and expanding access with free US supply.

A new AHIP report outlines evidence-based strategies to cut chronic disease prevalence by 10% by 2035.

LaShawn McIver, MD, MPH, discusses a new report from a task force aiming to cut chronic disease prevalence 10% by 2035 through prevention and coordinated care.

During an afternoon AMCP 2026 session, experts called for integrated clinical and payer care models to combat rising metabolic disease prevalence, costs, and complexity.

Todd Doyle, MD, of OneOncology, warns that commercial payers lag on updating bundled codes, which has slashed radiation oncology revenue and risks community cancer access in 2026.

Prior authorization and PBM utilization management delay oncology and hematology novel therapies, shifting reimbursement risk to patients in Medicare Advantage.

Tim Church, MD, PhD, MPH, explains that access to care—not willpower—is the central barrier to GLP-1 use, and says employer coverage decisions are finally catching up.

A phase 1 clinical trial specialist, Nancy L. Lewis, MD, MBS, FACP, most recently spent more than a decade at Novartis and was previously a faculty member at Fox Chase Cancer Center and Thomas Jefferson University Hospital.

ACIP changes threaten vaccine coverage and raise costs, according to a roundtable of experts warning of widening disparities and long-term public health risks.

The law stems from the case of a beneficiary of the state workers health plan, repeatedly denied an alternative cancer treatment, only to be approved after he was too ill to be a candidate.

The study covers the period of 2015-2019 in Germany, before approvals for CAR T-cell therapy, pirtobrutinib, and the arrival of less toxic BTK inhibitors.

Rapid genetic test for IVF identifies FSHR variant in 60 minutes, guiding IVF hormone selection and improving in vitro fertilization success.