June 2025

Accessing medical and social resources for patients, heavy administrative burden, and lack of data integration are barriers to Medicaid managed care organization care coordinators’ job performance.

Rural marketplace rating area change in Texas did not increase enrollment but increased share of enrollment in gold plans.

A large academic medical center implemented a charitable care formulary with clinical pharmacist oversight, which resulted in more efficient usage of funds and fewer readmissions.

Use of voluntary alignment attribution by Next Generation Accountable Care Organization (ACO) participants was limited. The authors highlight the reasons and describe organizational use cases via a mixed-methods approach.

Specialty televisits remain common in the Veterans Health Administration following the COVID-19 pandemic, suggesting they will remain an important ongoing care modality for many patients.

This observational evaluation compared an adult medical care coordination intervention with usual care and found that the intervention was associated with significant improvements in patient activation.

A score was developed to measure patient risk from payer utilization management policies and its relationship to real-world US commercial payer utilization management policies.

Older adults with cardiovascular disease (CVD) or CVD risk factors report that gaps in communication among their providers are common and hazardous.

Payers should consider providing higher reimbursement rates and/or preferred pharmacy networking status for pharmacies that provide chronic medications in blister packs for patients.

To mark the 30th anniversary of The American Journal of Managed Care (AJMC), 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 June issue features a conversation with Melinda B. Buntin, PhD, a health economist and a Bloomberg Distinguished Professor at the Johns Hopkins Bloomberg School of Public Health and Carey Business School.