Payers

This case study describes Tennessee’s process for convening key stakeholders to develop uniform payment guidelines to encourage increased preventive service delivery.

Given the track record of good outcomes and savings, policy leaders must do more to promote growth of for-profit PACE programs, the author asserts.

The FDA approved zopapogene imadenovec, the first therapy for recurrent respiratory papillomatosis, providing an option beyond repeated surgeries to manage the rare condition.

Children with spinal muscular atrophy (SMA) showed motor function improvements after switching to onasemnogene abeparvovec following prior treatment with nusinersen or risdiplam in a real-world study.

DYNE-251 received FDA breakthrough therapy designation, showcasing its potential for patients with Duchenne muscular dystrophy (DMD).

This retrospective analysis explored the impact of infertility health benefit design on the use of infertility medications and procedures and pregnancy outcomes.

Taletrectinib was added to the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology as a preferred option for the first-line and subsequent treatment of advanced ROS1-positive non–small cell lung cancer (NSCLC).

A new survey reveals widespread consumer frustration with prior authorization, highlighting the need for urgent reform in insurance coverage.

This article examines the prevalence of pay-for-performance incentives to promote human papillomavirus vaccination and other quality metrics as reported by frontline clinical staff.

Brentuximab vedotin combined with cyclophosphamide, doxorubicin, and prednisone (CHP) shows promising results as a first-line treatment in newly diagnosed peripheral T-cell lymphoma (PTCL).

There is a great need to streamline the process from the tissue sample to the diagnostic lab, whether it's genomic or immunohistochemistry, Robert Kratzke, MD, says.

Jayme Ambrose, DNP, RN, CCM, of Adobe Population Health, explores how addressing social determinants of health transforms maternal care delivery, reduces disparities, and improves outcomes for mothers and infants.

Artificial intelligence (AI) transforms oncology by enhancing clinical decision-making, improving patient outcomes, and shaping future health care training, as discussed by experts at Tennessee Oncology's “Tech Innovations in Community Oncology."

Families caring for individuals with Duchenne muscular dystrophy (DMD) face significant financial burdens from necessary home and vehicle modifications to enhance quality of life.

During the “Tech Innovations in Community Oncology” meeting from Tennessee Oncology, oncologists explore artificial intelligence (AI) tools like DeepScribe to enhance documentation efficiency, reduce burnout, and improve patient engagement in clinical settings.

Precision oncology has entered a new phase, as data sets mature and a new wave of tools emerges to help clinicians manage cancer care over time.

Several evidence-based health literacy resources may be beneficial in health plan settings to improve organizational health literacy, personal health literacy, and health equity.

Coverage from IVBM Princeton, held May 8, 2025.

The Choose Medicare Act would establish a Medicare Part E that would give employers and the general public the ability to opt into the program.

A private oncology shared savings plan reduced colon cancer treatment costs. Results varied by tumor, with none in breast cancer and mixed effects in lung cancer.

Patients who remained on treatment, especially at higher doses or on tirzepatide, were more likely to achieve clinically meaningful weight loss and improved glycemic control.

Results for IRAKLIA show noninferiority for Sanofi's on-body delivery system for isatuximab, compared with IV administration. Patients overwhelmingly preferred the hands-free delivery option.

Zanubrutinib showed long-term efficacy in patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) and deletion of the 17p chromosome, with progression-free survival similar to patients without high-risk disease characteristics.

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.

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

Delandistrogene moxeparvovec, a gene therapy for Duchenne muscular dystrophy (DMD), showed high dystrophin expression and a favorable safety profile in young patients.

Despite holding promise in a range of disease states, a variety of challenges prevent cell and gene therapies (CGTs) from more widespread use, according to a new report from Cardinal Health.

Delandistrogene moxeparvovec (Elevidys; Sarepta Therapeutics) appeared to protect muscle from progressive damage in patients with Duchenne muscular dystrophy (DMD) based on muscle quantitative magnetic resonance measures.

Covered California and Health Net’s novel data exchange initiative significantly improved quality measurement and potentially reduced costs by more than $640,000.