Health Care Cost

New guidelines and advocacy enhance myasthenia gravis treatment access, promoting proactive management and improved insurance coverage for diverse patient populations.

More frequent routine primary care visits for certain higher-risk commercially insured adults are associated with lower net population-level health care costs.

Many states are enacting restrictions on insurers’ prior authorization policies, but these laws may increase costs and lead to other undesirable consequences.

A study finds that $100 rideshare rides for follow-up colonoscopy after fecal immunochemical test (FIT) doubled completion rates, reduced colorectal cancer (CRC) deaths, and lowered health care costs.

Patients with ovarian cancer who undergo BRCA testing face higher health care resource utilization (HCRU) and costs but are more likely to receive genomically targeted therapies and progress to later lines of treatment (LOT).

Psoriasis received the second-most funding of any pediatric dermatology condition, even though it ranked fifth in terms of disease burden.

Why is health care so staggeringly difficult to use? How do we fix it? To move forward, we first must look back, because the system we have today was not really designed, it evolved, notes Ariela Simerman, Turquoise Health.

Housing assistance significantly reduces medical financial hardship for renters with a history of cancer, enhancing their financial security and access to care amid rising health costs.

New research highlights which US counties lead in patient experience, health outcomes, and cost efficiency—and the policies that drive success.

Ravi Vij, MD, MBA, discusses how measurable residual disease (MRD) testing is shaping treatment decisions in hematology and its potential to reduce costs and toxicity.

Ravi Vij, MD, MBA, explains how insurance-related delays in CAR T approval slow treatment initiation, increase interim therapy costs, and contribute to patient burden.

Treatment challenges that Anasuya Gunturi, MD, PhD, encounters in her work at Lowell General Hospital include language differences and confusion about scheduled appointments.

A new study finds that drugmakers’ use of overlapping patents delayed generic entry for 4 top-selling drugs, driving billions in excess spending.

A new report found that 9 of 10 small- to midsize businesses are not sure they will be able to provide health benefits to their employees in the near future.

Employers explore glucagon-like peptide-1 (GLP-1) therapies' impact on health benefits, showcasing accountability and data-driven strategies in Philadelphia, Pennsylvania, and Wilmington, Delaware, for sustainable health programs.

Hospital accountable care organization (ACO) participation did not impact emergency department admission rates, length of stay, or costs, suggesting limited effectiveness in reducing spending for unplanned admissions and challenging hospital-led ACO cost-saving strategies.

Laxmi Patel, chief strategy officer at Savista, outlines major impacts of the “One Big Beautiful Bill” Act on Medicaid and what hospitals can do to prepare for these changes.

Clayton Irvine, PharmD, MBA, MS, discusses strategies to address payer-driven biosimilar and prior authorization challenges through integrated digital solutions, while advocating for flexible, regularly reviewed treatment pathways supported by molecular tumor boards and artificial intelligence to balance standardization with personalized, biomarker-driven oncology care.

Elise S. Tremblay, MD, MPH, explores potential policy solutions and research directions to address ongoing challenges in insulin affordability and access.

Proposed Affordable Care Act (ACA) premium hikes threaten health care access, with potential increases of over 75% for enrollees.

In this clip, Elise S. Tremblay, MD, MPH, explores factors behind fluctuations in insulin out-of-pocket costs and highlights the serious health consequences of persistently lower insulin use.

A real-world study found that semaglutide prescriptions were associated with improvements in weight, blood pressure, and cholesterol, but also a $80 monthly rise in health care spending outside of drug costs.

Elise S. Tremblay, MD, MPH, discusses her study on trends in insulin out-of-pocket costs and use disparities from 2008 to 2021, highlighting how health plan structure and income level influenced access and adherence.

A new report from Bluesight reveals how automation and analytics are helping hospital pharmacy teams cut spending, manage shortages, and streamline procurement.

In this second part of his interview with The American Journal of Managed Care®, Sanjay Doddamani, MD, MBA, a former senior advisor to CMMI and founder and CEO of Guidehealth, continues a dialogue on the future of value-based care and the promise—and limits—of AI-enabled innovation, reflecting on challenges like rising Medicare costs and patients’ growing financial burdens.

Adults with type 2 diabetes, especially those in vulnerable groups, face higher risks of medical debt, low credit scores, and bankruptcy.

Large language models (LLMs) such as GPT-3.5 and GPT-4 may offer a solution to the costly and inefficient process of manual clinical trial screening, which is often hindered by the inability of structured electronic health record data to capture all necessary criteria.

President Donald Trump has sent letters to pharmaceutical companies, aiming to compel them to lower drug prices in the US to match the lowest prices offered in other developed nations, a move that could significantly reduce costs and disrupt the current system of pharmacy benefit managers.

Given trends in cost and use, insulin out-of-pocket cost reduction policies would be more efficient if they targeted members in high-deductible health plans with savings options and low-income patients.

This study examined the impact of price transparency and prosocial messaging on patient engagement of price-protected consumers in seeking value-based care.