Policy

To conclude his conversation with AJMC, Jordan Karlitz, MD, outlines clinical, behavioral, and policy strategies to reverse rising CRC deaths in adults aged under 50.

New bipartisan legislation extends key health care programs and tightens oversight of PBMs in Medicare Part D and commercial markets, but impacts on drug costs will not be immediate.

Penetration of Medicare Shared Savings Program accountable care organizations and Medicare Advantage was not associated with substantive changes in health care use among commercial enrollees.

These new data show that 64.8% of US adults take at least 1 prescription medication each year.

New reports reveal rising insurance costs, senior drug savings, and cancer care inequities, showing how policy and partnerships shape health outcomes.

Sarah M. Lima, PhD, MPH, on how historical redlining continues to shape breast cancer survival disparities through treatment access and innovation.

Study finds breast cancer survival gaps tied to historical redlining narrowed over time, though newer therapies may be widening disparities again.

New bipartisan legislation would ban parent companies from owning insurers or PBMs and providers or management services organizations simultaneously.

As pharmaceutical R&D policies evolve, the authors argue it is crucial to embed American patient values in reimbursement deliberations and frameworks.

The Orphan Drug Act has boosted treatments, but Kristi Martin, MPA, MA, urges modernizing incentives and pricing to sustain future innovation.

The Consolidated Appropriations Act of 2026 gives CMS more leverage to intercept when pharmacy benefit managers are driving up prices in Medicare Part D, explains Jesse Dresser, Esq.

This article highlights challenges in prior authorization and offers practical, experience-based strategies to streamline workflows, reduce delays, and improve patient access to necessary treatments.

A Commonwealth Fund analysis finds employer health premiums and deductibles exceed 10% of income in 19 states, worsening affordability gaps.

PBM reforms, Medicare Advantage trends, TrumpRx launch, and Express Scripts settlement highlight key shifts in drug pricing, coverage, and patient access.

Osama Abdelghany, PharmD, explains how medically integrated dispensing improves oncology workflows, patient access, and outcomes through EMR-driven care.

Medicare Advantage enrollment has increased in the US and Puerto Rico, with a dramatic growth among Puerto Rico beneficiaries with end-stage renal disease.

The Consolidated Appropriations Act of 2026 acts as a first step in addressing prescription drug pricing challenges related to the role of pharmacy benefit managers (PBMs).

The postpandemic reinstatement of Medicare’s 3-day rule lengthened hospital stays without affecting SNF use, spending, or short-term outcomes, raising questions about its value.

Medically integrated dispensing improves oncology treatment coordination through EMR-based care, but payer restrictions remain a key barrier.

The authors call for policy reforms that could strengthen patient-provider relationships, support care innovation, and improve quality for Medicare beneficiaries.

First announced in September 2025, the online platform is set to offer access to prescription medications at steep discounts, with potential savings in the millions.

The FTC first sued Express Scripts, CVS Caremark, and Optum in 2024, claiming anticompetitive and unfair rebating practices surrounding insulin.

Clearer definitions, tailored programs and policies, and telestroke care could help close rural stroke care disparities.

Finance Committee leaders propose expanding Medicare negotiation, curbing middlemen, and reinvesting in biomedical innovation as part of a 2026 health care affordability strategy.

The Consolidated Appropriations Act of 2026 features new language that could change the way that pharmacy benefit managers (PBMs) operate in the US.