October 2025

Medicare expenditures for patients with amyotrophic lateral sclerosis are more than 3 times those of the average Medicare beneficiary, and drug therapies are an important cost driver.

Infliximab biosimilars created price competition causing insurance claims costs for infliximab originator and infliximab biosimilars to decrease, generating significant savings to the health care system.

The authors explore the limitations of the current system of revisit interval assignment and discuss the importance of standardization to optimize patient health care outcomes.

A retrospective multicenter study found that patients with heart failure discharged by noon had higher short- and long-term mortality and increased early readmission rates compared with afternoon discharges.

Patients with chronic kidney disease (CKD) stages 3b or 4 experienced slower decline in estimated glomerular filtration rate 20 months after enrollment in a value-based kidney care program.

As the hospital-at-home model grows, a consortium is needed to advance scalability, equity, caregiver well-being, and cost efficiency through research and collaboration.

This article examines how prices, insurer payments, and patient payments for outpatient surgeries differ by site of care and network status.

This study describes the current opportunities and obstacles associated with Medicare Diabetes Prevention Program implementation from the novel perspective of program suppliers across the US.

Among Medicare Advantage enrollees, the mortality of Hispanic enrollees in Puerto Rico was significantly higher than that of Hispanic enrollees in the US during 2010-2022.

This national study of neonatology services found no clear evidence that state surprise billing regulations influenced prices or provider network participation for the commercially insured.

To mark the 30th anniversary of The American Journal of Managed Care, each issue in 2025 includes a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The October issue features a conversation with Ge Bai, PhD, CPA, professor of accounting at Johns Hopkins Carey Business School and professor of health policy and management at Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland.

Physician groups under 2-sided risk–based Medicare Advantage provide care associated with higher quality and efficiency compared with care by these same groups under fee-for-service Medicare.

Primary care nurse practitioners were found to use low-value care at lower or relatively similar rates compared with the general clinician population.