May 7th 2025
The National Comprehensive Cancer Network (NCCN) policy summit, “Primary Care and Oncology Collaboration to Improve Patient Outcomes,” took place May 6, 2025, at the National Press Club in Washington, DC.
High Drug Costs, PBM Reform, and Access Challenges Take Center Stage at AMCP 2025
March 25th 2025As managed care pharmacy navigates rapid transformations in policies, high-cost drug strategies, and innovative therapies, the upcoming AMCP annual meeting will provide critical insights into legislative impacts, drug affordability, formulary design, and emerging treatment trends.
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MDA Reflects on 75 Years of Research and the Precarious Times Ahead
March 24th 2025Speakers from the Muscular Dystrophy Association (MDA) highlighted 75 years of progress in understanding and treating neuromuscular diseases but also raised concerns about how potential funding cuts could impact this community.
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For Neuromuscular Disease Community, an Era of Opportunities and Threats
March 17th 2025Robert 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.
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More Care Doesn't Equal Happier Patients in Traditional Medicare
March 17th 2025Data 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.
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The Impact of Cost Sharing on High-Value Care
March 14th 2025Michael 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.
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Oz Confirmation Hearing Probes Vision for Medicaid but Coalesces Around Well-Being
March 14th 2025Mehmet 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.
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As Claims Denials Surge, AI and Data-Driven Insights Equip Clinicians, Hospitals to Fight Back
March 13th 2025As 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.
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States Call for Managed Care to Prioritize Rural Health
March 12th 2025Molly 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.
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Shaping Dermatology's Future by Increasing Access, Data, and Advocacy
March 7th 2025Thy 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.
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Eliminating Enhanced PTCs Would Have Cascading Economic Impacts, Report Estimates
March 6th 2025Enhanced 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.
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Senate Questions NIH Nominee on Funding, Transparency, and COVID-19 Impact
March 5th 2025Jay 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.
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Patients With Disabilities Report Low Access to Culturally Sensitive Care
March 3rd 2025This 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.
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Further Research Into Medicare Advantage Upcoding, Documentation Accuracy Needed
February 27th 2025Andrew 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.
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Chronic Condition Prevalence Similar in Medicare Advantage, Traditional Medicare Beneficiaries
February 26th 2025The 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.
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Potential Spillover Effects on Traditional Medicare When Physicians Bear Medicare Advantage Risk
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.
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