Reimbursement

A reimbursable, team-based remote blood pressure monitoring program significantly improved hypertension control in patients with multiple chronic conditions.

Readers of PHEO this year found value in research, conference coverage, and insights that touched on health outcomes and care quality.

Federal policy changes, the push for fair pricing, and growing competition in the drug pipeline were major topics at this year’s meeting.

Leaders describe how shared data, theranostics programs, and coordinated clinical trials support independent practices and advance value-based cancer care.

How strategic partnerships in oncology can enhance patient care by addressing diverse needs through collaboration.

Oncology leaders warn that declining reimbursements and policy gaps threaten patient access and drive inequities in cancer care.

Recent political shifts impacting health policy and access to care for millions dominated the news in 2025.

Both health care plans brought forward by Republican and Democratic senators, respectively, did not garner enough support from across the aisle.

A study finds that community oncology practices limit financial toxicity for patients with cancer, offering significant cost savings compared with hospital outpatient settings.

A new study shows fee-for-service care is linked to higher odds of low-value surgery, suggesting salaried models may reduce unnecessary procedures.

A vote on the House floor allowed for the government to reopen immediately, but the fight over the extension of ACA subsidies still goes on.

In this investigation, the authors evaluated the impact of a voluntary transition to risk-based contracts under Medicare Advantage on health care use.

The introduction of more stringent work requirements for those enrolling or renewing their Medicaid coverage can affect both children and adults.

CMS introduced the GENEROUS Model to reduce Medicaid drug costs, enhance access, and improve health outcomes for beneficiaries starting in 2026.

The White House announced significant drug pricing cuts for GLP-1s for diabetes and obesity for Medicare and Medicaid beneficiaries and on TrumpRx.

Experts analyze how Trump's drug pricing policies, including Most Favored Nation (MFN) and tariffs, reshape pharma markets and impact patient costs and access.

Confusion around how to verify work hours could leave millions unenrolled after the passing of the One Big Beautiful Bill Act.

Experts discuss the evolution of cancer care, emphasizing value-based approaches, precision oncology, and the importance of multidisciplinary collaboration for improved patient outcomes.

Individuals with both low incomes and health problems were more likely to gain employment when covered by Medicaid.

Payers cited high upfront costs, long-term uncertainty, and narrow coverage criteria as factors continuing to limit access and reimbursement innovation.

Physician burnout rates have decreased since the pandemic, but the likelihood of Medicare exits threatens access to underserved populations.

Telehealth medication abortion service requests double after the Supreme Court's Dobbs ruling, as patients seek accessible and cost-beneficial care.

ACOs serving patients with complex needs are on the rise, but policy changes are needed to support providers treating special populations.

Explore the implications of the Most Favored Nation Order on US drug pricing reform and its potential impact on patient access and innovation.

Laxmi Patel discusses proposed Medicaid reforms in HR 1, including work rules, coverage limits, and state-level risks for vulnerable populations.

New demands to follow the most favored nation executive order could lead to some compliance but it is unknown just how effective they will be across all health care.

Remote patient monitoring enhances cancer care by improving outcomes and reducing emergency visits, despite challenges in reimbursement and technology access.

Participating hospitals in the Prime Vendor Program and the 340B program spent nearly $37.3 billion more on drugs from 2010 to 2021.

Panelists at the Community Oncology Alliance Payer Exchange Summit discuss the urgent need for innovative reimbursement models in cancer care to match advancements in biomedical technology and drug discovery.

In the first part of this Q&A, Kathy Oubre, MS, discusses how likely it is that the most favored nation executive order will lead to price reductions in prescription drugs.