Policy

Although the gap between low and high value has been established in many areas, insurance design has yet to adapt, according to a panel at the 20th annual Value-Based Insurance Design (VBID) Summit.

Medication costs are only a piece of the puzzle when clinicians think about health care access, explains Leigh Maria Ramos-Platt, MD.

Recent cuts to federal grants are set to have a widespread impact across numerous scientific and medical studies.

Robert Califf, MD, former commissioner of the FDA, delivered a keynote address at the 2025 Muscular Dystrophy Association Clinical & Scientific Conference that highlighted the enormous opportunities for progress in neuromuscular disease care amid a changing policy environment.

Data on care satisfaction, ease managing care, and out-of-pocket spending were the outcomes of interest for this new analysis that investigated the relationship between healthcare utilization and beneficiary experience within traditional Medicare.

Michael Chernew, PhD, professor of health care policy and director of the Healthcare Markets and Regulation Lab, Harvard Medical School, shares how cost-sharing policies shape access to critical health care services and influence value-based insurance design.

Mehmet Oz, MD, the nominee to lead CMS under the Trump administration, testified in a confirmation hearing before the Senate Finance Committee, where he found common ground on improving outcomes through healthier lifestyle choices but encountered repeated questions on potential Medicaid cuts.

As health care costs continue to rise and the burden of chronic disease grows, data-driven insights will be essential in shaping the future of patient care, according to experts from Komodo Health and SmarterDx.

The study found that just 20% of trials submitted to both the FDA and European Medicines Agency had matching evidence.

Molly Dean, MSW, policy advisor at Siftwell, discusses how states have encouraged managed care entities to invest in local communities, build partnerships with nonprofits, and support social determinants of health initiatives.

A new report shows most Americans believe the government is too involved in health care regulation and want to see a ban on pharmaceutical company advertisements in the US.

States must analyze the data on Medicaid and social determinant programs to understand the consequences of how potential policy changes will impact residents, Molly Dean, MSW, Siftwell, explains.

A discussion with the presidents of the Association of Cancer Care Centers (ACCC) and the American Society of Clinical Oncology took place at the ACCC 51st Annual Meeting & Cancer Center Business Summit.

Thy N. Huynh, MD, FAAD, Bruce A. Brod, MHCI, MD, FAAD, and Melissa Piliang, MD, FAAD, discussed expanding access to pediatric dermatology, dermatology data aggregation, and advocacy for Medicare physician payment reform, respectively.

Jorge García, PharmD, MS, MBA, MHA, discusses key takeaways from ACCC Capitol Hill Day and innovative strategies in pharmacy optimization.

Enhanced premium tax credits (PTCs) have made marketplace health insurance more affordable, and eliminating them could have sweeping impacts on consumers and the health care industry, according to a new report.

Jay Bhattacharya, MD, PhD, defended his vision for the National Institutes of Health in a Senate committee confirmation hearing, tackling concerns on research funding, public trust, and scientific integrity.

Expanding coverage and access to glucagon-like peptide-1 (GLP-1) medication can be beneficial for all with the cooperation of multiple parties in health care.

This investigation analyzes public data on adult patients from the 2017 National Health Interview Survey, including how often they were treated with respect and could see health care providers who shared their cultural views.

Andrew S. Oseran, MD, MBA, MSc, hypothesizes that higher Medicare Advantage (MA) risk scores may result from either a more accurate capture of beneficiaries' comorbidities or inappropriate "upcoding" of conditions.

The Braidwood Management v Becerra decision could require payers to step up to continue covering preventive services, depending on the decision, according to Richard Hughes IV, JD, MPH.

The excess payments Medicare Advantage plans receive for higher risk scores may be more influenced by differences in coding practices rather than actual differences in disease burden between MA and fee-for-service Medicare beneficiaries, according to Andrew, S. Oseran, MD, MBA, MSc, of Beth Israel Deaconess Medical Center.

Medicare beneficiaries treated by physicians with high levels of Medicare Advantage risk exposure had higher care quality and efficiency outcomes compared with those treated by other physicians.

The Republican bill for the congressional budget narrowly passes the House of Representatives, advancing to the Senate floor.

Medicare Advantage (MA) plans, with fixed payments based on medical complexity, incentivize aggressive coding of comorbidities, potentially inflating costs for the federal government, according to Andrew S. Oseran, MD, MBA, MSc, of Beth Israel Deaconess Medical Center.

Delays in receiving coverage for essential medications like insulin and albuterol can worsen symptoms, increase costs, and add stress for patients.

Of the surveyed physicians, 93% reported that prior authorization delays patient care, and 89% said it contributes to burnout.

These findings support the claim that Medicare Advantage (MA) payments may be driven more by diagnosis and coding practices rather than differences in disease burden between MA and fee-for-service (FFS) Medicare beneficiaries.

Health care institutions with large numbers of Medicare and Medicaid patients may be constrained from offering cancer therapies made available under the accelerated approval pathway.

The rising frequency of natural disasters due to climate change could make health plans more susceptible to significant negative effects, according to Maria DeYoreo, PhD, of RAND Corporation.