April 2025

Claims data reveal larger hemoglobin A1c decreases in people with type 2 diabetes who use continuous glucose monitoring and semaglutide compared with semaglutide alone.

Care coordination engagement increases over time in long-term high-cost, high-need patients, with no identifiable data-driven times for when to initiate patient care de-escalation.

Prior authorizations create substantial administrative and financial burdens on physicians and patients and can disrupt the continuity of care.

This commentary explores the current state, challenges, and potential of artificial intelligence (AI) in health care revenue cycle management, emphasizing collaboration, data standardization, and targeted implementation to enhance adoption.

To mark the 30th anniversary of The American Journal of Managed Care® (AJMC®), each issue in 2025 will include 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 April issue features a conversation with Hoangmai H. Pham, MD, MPH, a member of AJMC’s editorial board and the president and CEO of the Institute for Exceptional Care (IEC).

Among hospitalized patients with traumatic brain injury, Medicaid fee-for-service was associated with longer hospital stays than private insurance and Medicaid managed care organizations.