Policy

Accountable care organizations (ACOs) are increasingly playing the role of data sleuths as they identify and report trends of anomalous billing in hopes of salvaging their shared savings. This mission dovetails with that of CMS, which under the new administration plans to prioritize rooting out fraud, waste, and abuse.

Jaime Almandoz, MD, MBA, of UT Southwestern Medical Center, speaks on results of a study that investigated tirzepatide uptake trends in commercial claims data.

The case, which has implications across preventive care, is now an argument between Robert F. Kennedy Jr, the Secretary of HHS, and Braidwood Management.

Despite widespread concern following the Dobbs v Jackson Women’s Health Organization decision, researchers found no significant changes nationwide in obstetrician and gynecologist (OBGYN) practice locations.

Richard Hughes IV, JD, MPH, spoke about the upcoming oral arguments to be presented to the Supreme Court regarding the Braidwood case, which would determine how preventive services are guaranteed insurance coverage.

Health care disparities are often driven by where patients live, explained Antoine Keller, MD, as he discussed the complex, systematic hurdles that influence the health of rural communities.

The draft would call for a major budget cut of $40 billion to HHS, among other proposals.

The proposal aims to align global leaders on pandemic prevention, preparedness, and response to future pandemics.

The executive order targets lower drug prices through Medicare reforms, anticompetitive crackdowns, and transparency mandates.

JC Scott, CEO and president of The Pharmaceutical Care Management Association, discusses current efforts in increasing biosimilar adoption and pharmacy benefit manager (PBM) reform.

From the potential impact of tariffs to the World Health Organization's year-long campaign launch focused on improving maternal and newborn health and addressing preventable deaths, here's the latest from the Center on Health Equity & Access.

Several court cases have been filed against the Trump administration over disruptions touching health care, including funding cuts and employee layoffs.

This study found no evidence that hospital employment of physicians resulted in physicians treating sicker patients, undercutting claims that hospital-employed physicians serve a higher-acuity patient mix.

Neha Kashalikar, PharmD, director of strategic pharmacy consulting at MassHealth, breaks down the outcome measures often used in pharmacy and medical claims to evaluate the performance of value-based contracts.

Laura Bobolts, PharmD, BCOP, senior vice president of clinical strategy and growth at OncoHealth, shares how health care leaders are advancing value-based care through improved data strategies, real-world evidence, and AI-driven efficiencies, without losing the human touch.

Adam Colborn, JD, associate vice president for congressional affairs, Academy of Managed Care Pharmacy, highlights key policy updates that are impacting managed care pharmacy.

Taxing imports to the US could spell major consequences for health care prices, innovation, and access, as a great amount of medical supplies and ingredients are manufactured overseas.

The Center on Health Equity & Access delves into the latest policy shifts, research, and expert perspectives on advancing equity and improving access to care.

As new Federal Communications Commission rules take effect April 11, 2025, mPulse CEO Bob Farrell explains how health organizations can stay compliant while building patient trust through transparency and personalized engagement.

The former television personality and heart surgeon was confirmed in a 53-45 vote on party lines.

The findings appear as multiple lawsuits pit pharmaceutical companies against hospitals as well as HHS.

A bipartisan letter from lawmakers questions the legality of Robert F. Kennedy Jr's HHS changes and the lack of clear communication regarding their potential impact on American health.

Prior authorizations create substantial administrative and financial burdens on physicians and patients and can disrupt the continuity of care.

Federal legislative and regulatory changes are reshaping pharmacy practice, with key challenges in government funding, pharmacy benefit manager reform, and health care policy shifts—topics explored by experts at the Academy of Managed Care Pharmacy's annual meeting.

A new Commonwealth Fund report estimates that states' collective gross domestic products would shrink by $95 billion, with total economic output declining by $157 billion.

As 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.

The Trump administration has expressed interest in eliminating or changing the Division of HIV Prevention in the CDC, which could introduce gaps in addressing the HIV epidemic.

These results suggest that the rise in avoidable mortality is driven by widespread factors across the entire US.

The researchers emphasized the need for ongoing research and advocacy to further address drug affordability.