AJMC® in the Press, October 23, 2026

The article, “Containing Chronic Disease Costs With the Ambulatory Specialty Model,” published in The American Journal of Managed Care^® (AJMC^®) in October 2026, examined CMS’ mandatory Ambulatory Specialty Model for specialists treating heart failure and low back pain. The authors warned that its 2-sided risk, with payment adjustments of –9% to 9%, could push smaller specialty practices to consolidate. They recommended starting with upside risk only, allowing group-level participation, and delaying interoperability penalties. Becker’s Spine Review built an October 2026 article around the piece, framing consolidation as the key threat for spine and orthopedic practices and summarizing the authors’ recommendations to CMS.

The commentary, “Navigating the Evolving Landscape of Private Cardiology Practice,” published in the March 2026 issue, examined the shift of cardiology from physician-owned practices toward hospital integration and private equity ownership. It found that hospital employment of cardiologists rose from about 26% in 2008 to nearly 63% by 2019. Becker’s ASC Review cited that statistic in an October 2026 article about CardioOne’s combination with CardioSphere. It used the figure to set up its argument that cardiology’s future lies in a third path between hospital employment and full independence.

“Oral Targeted Anticancer Medication Use Following High-Deductible Health Plan Enrollment,” published in the October 2026 issue, used commercial claims from 2007 to 2021 to compare patients whose employers moved them into high-deductible health plans (HDHPs) with patients who stayed in low-deductible plans. HDHP enrollment did not reduce use of oral targeted cancer drugs, although the authors cautioned that patients may still face financial toxicity through trade-offs that claims data don’t capture. BenefitsPRO quoted the authors’ findings directly, highlighting the warning about financial hardship and echoing their call for research in low-income patients.

The commentary, “Toward Equitable Access to Cell and Gene Therapies: Rethinking Co-Payments,” published in the May 2026 issue of AJMC, argued that patient cost sharing for 1-time, potentially curative cell and gene therapies blocks access rather than curbing unnecessary use. The authors called for value-based insurance design that eliminates copayments for these therapies and ties coverage to enrollment in outcomes registries.

Insurance Business summarized the authors’ argument and recommendations, noted their industry ties, and connected the piece to the CMS Cell and Gene Therapy Access Model and to employer gene therapy programs. In addition, Human Resources Director quoted the authors’ question about what purpose cost sharing serves in this category of care and summarized their recommendations. It also paired them with Employee Benefit Research Institute data on utilization and plan exposure and advised self-funded employers that they can change cost sharing themselves.

“Primary Care Appointment Availability and Nonphysician Providers One Year After Medicaid Expansion,” published in June 2016, used a secret-shopper design in Michigan primary care practices. A year after Medicaid expansion, appointment availability for new Medicaid patients was up 6 percentage points, and the share of those appointments booked with nurse practitioners or physician assistants rose from 8% to 21%. The Office of the Assistant Secretary for Planning and Evaluation cited the study in its October 2026 report, “Financing Medicaid Through Provider Taxes on Hospitals: Spillover Effects on Employment-Based Coverage Premiums,” which found that hospital provider taxes used to fund Medicaid raise employer-sponsored insurance premiums.

The study “Early Signs of Success for Missouri’s New Notification of Pregnancy,” published in September 2026, evaluated a standardized statewide notification-of-pregnancy process run by MO HealthNet (Missouri Medicaid) and its 3 managed care organizations. After the new process took effect, the plans successfully contacted 52.8% of members, up from 29.3%, and engaged 39.7% of those contacted in care management, up from 17.0%. The median gestational age at notification also dropped from 13 to 12 weeks. InsuranceNewsNet republished an October 2026 NewsRx summary of the study.

The study, “Ambient AI Tool Adoption in US Hospitals and Associated Factors,” published in the January 2026 issue of AJMC, examined US hospitals using Epic, and found that 62.6% had adopted ambient artificial intelligence (AI) documentation tools. Adoption was higher among nonprofit, metropolitan, and financially stronger hospitals and among those with heavier workloads. Teknovation.biz cited the study in an October 2026 profile of Nashville startup Lacuna Health, using the adoption figure to show how common AI scribes have become before explaining how Lacuna flags high-risk patients that scribed visits may miss.

“5 Questions Dermatology Patients May Have About Newly Approved Bemotrizinol,” published in the June 2026 issue, discusses the FDA’s approval of bemotrizinol, the first new sunscreen ingredient in the US in more than 20 years. It covers reef safety, skin absorption, use in children, why US approval lagged Europe’s, and how the ingredient compares with existing filters. It notes that bemotrizinol keeps more than 90% of its protective capacity after extended sun exposure, while avobenzone breaks down in sunlight. iHeartRadio cited the AJMC article in an October 2026 story on bemotrizinol products reaching US store shelves. It used AJMC as the source for the ingredient’s photostability advantage over avobenzone.

The article, “Lymphoma Outcomes Hinge on Oncology, Not Viral Load in People With HIV,” published on AJMC.com, the companion website to The American Journal of Managed Care, in October 2026, covered a retrospective study of Spain’s CoRIS cohort published in HIV Medicine. Among people living with HIV diagnosed with lymphoma, survival was predicted by tumor stage, CD4 count, and lymphoma type rather than by viral suppression. The authors concluded that standard oncologic criteria, alongside continued antiretroviral therapy, should guide treatment. The European AIDS Treatment Group (EATG) republished the opening of the AJMC story in its October 2026 HIV and co-infections news feed, and linked readers to ajmc.com for the full article.