Health Equity & Access Weekly Roundup: July 17, 2026

Home-Based Heart Failure Care Shows Comparable Safety to Continued Inpatient Care

An advanced medical care at home (AMCAH) program for patients hospitalized with heart failure produced comparable safety outcomes to continued inpatient hospitalization, according to a retrospective cohort study of Kaiser Permanente Southern California (KPSC) patients published in JAMA Network Open.

Using propensity score matching across 11 service areas, researchers found no significant difference in a 30-day composite of care escalation, readmission, or mortality between AMCAH (24% of matched pairs) and brick-and-mortar care (26%; OR, 0.89; 95% CI, 0.61-1.28). Guideline-directed medical therapy scores also remained similar through 60 days despite patients receiving AMCAH entering with a higher comorbidity burden before matching. Program penetration remained modest, however, at just 6% to 7% of eligible hospitalizations. The authors cautioned that findings from KPSC's integrated, capitated care model may not generalize to systems with different reimbursement structures; still, the results suggest hospital-at-home programs can expand safely when eligibility is clinician-determined.

FTC Reaches Settlement With CVS Caremark to Curb Insulin Rebate Practices, Cut Patient Costs

The Federal Trade Commission (FTC) reached a settlement with CVS Health's Caremark over allegations that the pharmacy benefit manager (PBM) inflated insulin list prices and restricted patient access, projecting up to $8.5 billion in patient savings over 10 years. Under the deal, Caremark must avoid disadvantaging low-list-price insulin products on standard formularies, offer plan sponsors a rebate pass-through option at the point of sale, and allow sponsors to move away from rebate guarantees and spread pricing, with an additional $4.5 billion in projected pharmacy-counter rebate savings.

It is the second of the “Big Three” PBMs—alongside Express Scripts and Optum Rx, which together handle roughly 80% of US prescriptions—to resolve the FTC's September 2024 lawsuit, following a February 2026 settlement with Cigna's Express Scripts that projected up to $7 billion in savings. Optum Rx remains the only one of the 3 originally named PBMs still facing active litigation.

SNAP Participation Linked to Smaller Colorectal Screening Gap

Food-insecure US adults were significantly less likely to be up to date with colorectal cancer (CRC) screening than food-secure peers, but the disparity nearly disappeared among those enrolled in the Supplemental Nutrition Assistance Program (SNAP), according to a cross-sectional analysis of 251,107 adults using 2022 Behavioral Risk Factor Surveillance System data published in JAMA Network Open.

Among adults not enrolled in SNAP, food insecurity was associated with lower odds of guideline-concordant CRC screening (adjusted OR [aOR], 0.78; 95% CI, 0.74-0.83). Among SNAP participants, the association was no longer statistically significant (aOR, 0.94; 95% CI, 0.86-1.03; interaction P = .008). The absolute SNAP-associated difference was modest, however—just 1.9 percentage points among food-insecure adults—the smallest of the 3 cancer screening modalities studied. Authors cautioned the cross-sectional design precludes causal inference, suggesting benefits assistance alone will not close the gap without also pairing it with active SNAP referrals and lower-burden screening options.

Innovation Is Outpacing Reimbursement, Health System Execs Warn

Health care affordability has reached a crisis point that no single stakeholder can solve alone, and reimbursement models have failed to keep pace with the shift toward prevention or the pace of clinical innovation, 4 health system executives said during a Chief Healthcare Executive Peer Exchange roundtable. Panelists included Robert Garrett, FACHE, CEO of Hackensack Meridian Health; Benjamin P. Levy, MD, clinical director of medical oncology at Johns Hopkins Sidney Kimmel Cancer Center; Deepak L. Bhatt, MD, MPH, MBA, director of the Mount Sinai Fuster Heart Hospital at the Icahn School of Medicine; and Kevin Beiner, chief operating officer of Northwell Health.

They described payer contract disputes disrupting active cancer treatment, including a collapsed Johns Hopkins payer contract that left longtime oncology patients unable to see their physicians, and cited reimbursement models that penalize innovation, such as pulsed field ablation, a faster atrial fibrillation procedure that nonetheless reimburses hospitals at a lower rate than the procedures it replaces. None of the 4 systems reported large-scale movement toward value-based care, citing unresolved downside risk-sharing as the central barrier, with executives calling for shared accountability among providers, insurers, drug makers, and regulators.

Kerry Rogers, MD, Talks BTK Inhibitor Sequencing, Cost, Access in CLL

Kerry Rogers, MD, of The Ohio State University Comprehensive Cancer Center–The James, said financial toxicity from Bruton tyrosine kinase (BTK) inhibitor therapy for chronic lymphocytic leukemia (CLL) weighs on patients regardless of their actual out-of-pocket costs, describing patients who have questioned whether they are “worth” 6-figure annual drug costs even when cost-sharing is $10 a month or less.

She said her institution's medication assistance office has so far ensured cost has never blocked a recommended therapy, but addressing the broader problem will require action across government regulation, drug pricing negotiation, and health system reimbursement. On access, Rogers argued BTK inhibitors' oral, at-home convenience may actually improve equity for rural and underserved patients compared with infusion-based regimens like venetoclax-obinutuzumab. By contrast, she pointed to persistent clinical trial underrepresentation of non-White patients in CLL research—despite roughly 8% of the CLL population being non-White—as an unresolved equity gap.