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Alopecia profoundly disrupts identity, emotional wellbeing, and social life, with many people struggling due to stigma, concealment pressures, and unmet psychological support needs.

Exploring Identity, Appearance Experiences Among Patients With Alopecia

Oral semaglutide (Wegovy; Novo Nordisk) expands GLP-1 weight-loss options, but pharmacy budgets and health care cost pressures persist.

5 Things to Know About the Oral GLP-1 Era

Mary Caffrey is the Executive Editor for The American Journal of Managed Care® (

®). She joined AJMC® in 2013 and is the primary staff editor for 

the multistakeholder publication that reaches 22,000+ oncology providers, policy makers and formulary decision makers. She is also part of the team that oversees speaker recruitment and panel preparations for 

®'s premier annual oncology meeting, Patient-Centered Oncology Care®. For more than a decade, Mary has covered ASCO, ASH, ACC and other leading scientific meetings for 

Mary has a BA in communications and philosophy from Loyola University New Orleans. You can connect with Mary on 

A study from Sweden, the largest of its kind, challenges the standard 24-month milestone as the key point when early relapse is a concern.

Even After 6 Years, Disease Progression Impacts Survival in Mantle Cell Lymphoma

Study links elevated serum haptoglobin to chronic spontaneous urticaria activity, suggesting it predicts treatment response and complete disease control.

Potential Predictor of Treatment Response in Chronic Spontaneous Urticaria Identified

The American Journal of Managed Care provides insights into the latest news and research in managed care across multimedia platforms.

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On today’s episode of Managed Care Cast, 

 spoke with Sachin H. Jain, MD, MBA, CEO of SCAN Group and Health Plan.

 for 2026, covering several topics and pinpointing what may change in the new year. Many of these issues included the succession of artificial intelligence (AI) in the health care space, expansion of the Make America Healthy Again (MAHA) movement, increased demand for glucagon-like peptide-1 (GLP-1) agonist receptors, Medicare Advantage, digital health IPOs, and modest incremental policy movement.

During the interview, Jain expanded on his predictions, explaining how the short-term and long-term implications should come to fruition. Many of his predictions may have downstream effects should the Affordable Care Act subsidies expire at the end of the year. For example, GLP-1 receptor agonists will continue to grow and have been associated with the significant increase Americans are expected to see in their health care premiums next year.

Jain also predicted an increase in patient and provider dissatisfaction with the US health care system. Providers are “inflamed by flattening wages,” and 

authorizations are proving to be significant hurdles to adequate patient care, especially with the addition of AI. Whereas patients “have never felt more justifiably abused by US health care,” Jain wrote in his predictions.

 Government misinformation, specifically from HHS, combined with oversaturated, inaccurate health influencers on social media, is also fueling patient mistrust and the growth of the MAHA movement in the new year.

Lastly, Jain predicts that diversity, equity, and inclusion (DEI) initiatives will make a drastic return as companies and government entities recoil from the public scrutiny of their dismissal. In 2024, Jain predicted the Department of Government Efficiency would slash DEI programs and major industries and companies would follow suit, which materialized with more fervor than anticipated. This year, he hopes that DEI initiatives make a comeback with the same intensity.

1. Jain SH. 10 healthcare industry predictions for 2026. Forbes. December 1, 2025. Accessed December 18, 2025. 

https://www.forbes.com/sites/sachinjain/2025/12/01/top-10-healthcare-industry-predictions-for-2026/

2. Grossi G. Prescription costs and inflation drive 2025 health insurance premium hikes. 

. August 14, 2024. Accessed December 18, 2025. 

https://www.ajmc.com/view/prescription-costs-and-inflation-drive-2025-health-insurance-premium-hikes

Listen above or on one of these podcast services:

Sachin H. Jain, MD, MBA, discusses 2026 health care predictions, including AI adoption, GLP-1 demand, MAHA growth, DEI’s return, and policy shifts.

2026 Health Care Predictions: AI, GLP-1s, MAHA, DEI: Sachin H. Jain, MD, MBA

) speaks with 2 public health dental hygiene practitioners whose work is helping reshape access to oral health services across Pennsylvania. Doree L. Rossey, BS, PHDHP, RDH, a public health dental hygiene practitioner and dental care manager supervisor with 

, and Crystal Siebka, RDH, PHDHP, COA, also a dental care manager at UPMC Health Plan, discuss the goals and evolving strategies behind the organization’s Dental Care Management Program—an initiative designed to increase access to preventive oral health care, strengthen oral health literacy, and ultimately reduce the need for restorative treatment through proactive education and community outreach.

Rossey describes the program’s guiding philosophy: meeting members where they are, understanding their needs, and building strong dental homes that support long-term oral health. She highlights the importance of outreach tailored to individual members and communities and the value of collaborating with dental providers throughout the state. These efforts are particularly critical in rural areas, where provider shortages and limited transportation options often leave families without reliable access to routine dental care.

Siebka expands on these efforts by describing several innovative initiatives that have emerged in recent years. During the COVID-19 pandemic, for example, she and her team developed interactive oral health education tools to keep children and families engaged despite school closures. She also details collaborations with Child and Youth Services designed to support vulnerable children and discusses the expansion of school-based dental programs under Act 55—an opportunity to bring preventive services directly into classrooms and reach students who might otherwise go without care.

Explore innovative strategies in dental care that are enhancing access, promoting health equity, and improving community health in Pennsylvania.

Frameworks for Advancing Health Equity: Dental Health Care Access

, Rachel A. Prusynski, DPT, PhD, an assistant professor at the University of Washington's School of Medicine, speaks with 

about her research published in the November 2025 issue.

, "Medicare Advantage Reimbursement Structures Impact Home Health Delivery and Outcomes," explores how 

 and patient outcomes differ between 3 plan types: traditional 

, episodic Medicare Advantage, and per-visit Medicare Advantage.

Throughout the conversation, Prusynski discusses what motivated the research, the study's key findings, and the broader implications for improving the quality and 

Rachel A. Prusynski, DPT, PhD, discusses her study on how payment models affect home health care delivery and patient outcomes.

Home Health Care Delivery, Outcomes Vary by Payment Model: Rachel A. Prusynski, DPT, PhD

When imatinib (Gleevec; Novartis), the first-ever tyrosine kinase inhibitor, made its debut in chronic myelogenous leukemia (CML), it revolutionized the treatment of a disease with a once-dismal prognosis.

Prior to its 2001 approval, CML therapies were often harsh, invasive, and ineffective.

Now, 25 years later, current studies continue to align with previous research associating imatinib with major cytogenic responses,

 and targeted therapies have become cornerstones of treatment in a range of tumor types.

Imatinib was first used to treat patients during a clinical trial in 1998. Lead researchers in the earliest studies were Brian J. Druker, MD; Stephen G. O’Brien, MD; Jorge Cortes, MD; and Jerald Radich, MD. 

had the pleasure of speaking with Cortes, discussing the history and evolution of imatinib in the CML treatment paradigm.

Patients with CML, unlike patients with acute lymphoblastic leukemia, are likely to have a longer life expectancy with and without treatment. Those with CML can still have a life expectancy of 3 to 5 years after diagnosis without treatment, but with treatment, their life expectancy is closer to the national average.

“I still remember Dr. Talpaz coming out of rooms and saying, ‘Wow, this thing works.’ He had this expression of wonder at the big change that it was representing... When the new study started...patients came to the study, but they wanted to get imatinib,” Cortes said.

Development of imatinib began in the early 1990s under Druker at Oregon Health and Science University.

 Druker aimed to find a treatment for CML, and with the help of Nicholas Lyndon, MD, they identified a drug that was able to kill CML cells efficiently.

The phase 1 clinical trial of imatinib in 1998 was partially funded by the National Cancer Institute. The drug was then FDA-approved in 2001 to treat patients with CML. Of the patients in the original trial, 5 years later, 98% of them were still in remission.

“[But] we're not done [yet]. Patients are still looking for a better quality of life, for being able to stop therapy and all of that. We've made tremendous progress, and… we want to be optimistic, but we want to still always be careful and cautious and respect what cancer can do,” Cortes said.

1. How Gleevec transformed leukemia treatment. National Cancer Institute. April 11, 2018. Accessed November 10, 2025. 

https://www.cancer.gov/research/progress/discovery/gleevec#:~:text=NCI-supported%20research%20led%20to,evidence%20to%20support%20this%20hypothesis

2. Druker BJ, O’Brien SG, Cortes J, Radich J; Chronic myelogenous leukemia. 

 2002 (1):111–135. doi:10.1182/asheducation-2002.1.111

3. Chronic myeloid leukemia (CML) research. Blood Cancer United. Accessed November 10, 2025. 

https://bloodcancerunited.org/research/blood-cancer-research-development-progress/leukemia/chronic-myeloid-leukemia-cml

4. Targeted therapy for cancer. National Cancer Institute. Updated May 31, 2022. Accessed November 11, 2025. 

https://www.cancer.gov/about-cancer/treatment/types/targeted-therapies

5. Faiman B. The impact of federal funding cuts on research, practice, and patient care. 

. 2025;16(4):124-125. doi:10.6004/jadpro.2025.16.4.1

Lead CML researcher discusses the evolution of a groundbreaking treatment and its effect on patient survival.

Inside the Discovery That Changed CML Treatment Forever: Jorge Cortes, MD

On this episode of Managed Care Cast, we dive into 

, or RTM, a topic of great interest in the physical rehabilitation industry. We are joined by Donovan Campbell, CEO of Medbridge, a leading provider of physical therapy education, currently serving approximately 360,000 clinicians and supporting 15 million patients annually.

 as part of the Calendar Year 2026 Physician Fee Schedule (CMS-1832-P), recognizing that RTM is critical for supporting physical therapy, patient health, and patient engagement. At its core, RTM is the fusion of in-person care with convenient, digitally provided care—a core component of what is known as hybrid care.

With CMS proposing new codes that materially 

—including the potential shift to allowing billing after just 2 days of data transmission—RTM has the opportunity to move from a niche category to a mainstream model of care delivery.

We will explore how this shift provides a crucial financial incentive for organizations, but more importantly, how the successful adoption of RTM enhances the clinical value proposition by improving population health, lowering overall costs, and tackling the problem of access barriers to conservative care.

Medbridge is working to refine remote therapeutic monitoring, or RTM, to transform physical therapy and enhance patient care.

From Niche to Mainstream: Transforming Physical Therapy by Refining Remote Therapeutic Monitoring

Age and insurance status were associated with disproportionate access to antibody-drug conjugate (ADC) treatment among patients with metastatic 

 from Komodo Health, a health care intelligence company, and the Tigerlily Foundation, a national breast cancer advocacy organization.

The incidence of metastatic breast cancer cases reported in the US increased from 5.8 per 100,000 women in 2001 to 7.9 per 100,000 women in 2021.

 Furthermore, from 2021 to 2023, ADC treatment rates increased 3.7-fold. During this same period, the median time to treatment also decreased from 331 to 109 days. However, demographic data showed that older women had disproportionately lower rates of treatment (2557 per 100,000) and the longest delays (median, 242 days).

Contrary to historical cancer care patterns, Black women saw higher rates of treatment when compared with those of White and Asian women, which researchers likely attribute to the higher prevalence of triple-negative breast cancer.

The analysis, powered by Komodo’s Health Care Map, included a refined subset of 17,005 patients from an initial cohort of 431,276 patients. Treatment rates adjusted by insurance coverage saw a significant difference in commercially insured patients, second to that of Medicaid beneficiaries. Medicare beneficiaries had the lowest rate of treatment.

“While we've overcome some racial barriers, which I think is extremely positive, I think that this is an example of where we can target older patients a little bit better,” said Tabby Khan, MD, senior director of analytics at Komodo Health, in an interview with 

“We have to continue to counsel these patients and also providers on why this may be a really good option for women in that age group.”

Komodo Health layered its platform Marmot on top of its health care map, which has data of over 330 million patients, to quantify disparities on a vast scale.

“I think this was a great example of using this AI platform to really blend all of those things, and in recognition of Breast Cancer Awareness Month,” Khan said.

1. Freckelton E. Komodo health analysis uncovers dual reality in metastatic breast cancer care: rapid targeted cancer therapy adoption amid glaring age-related disparities. Komodo Health. October 20, 2025. Accessed October 29, 2025. 

https://www.komodohealth.com/press/dual-reality-metastatic-breast-cancer-care-rapid-targeted-cancer-therapy-adoption-amid-glaring-age-related-disparities/

2. Metastatic female breast cancer incidence. Centers for Disease Control and Prevention. November 12, 2024. Accessed October 29, 2025. 

https://www.cdc.gov/united-states-cancer-statistics/publications/metastatic-breast-cancer.html.

3. Komodo Health; Tigerlily Foundation. ADC treatment patterns in metastatic breast cancer: research brief. New York, NY: Komodo Health; 2025. Accessed October 25, 2025. 

https://knowledge.komodohealth.com/hubfs/2025/PDFs/Komodo_And_Tigerlily_ADC_Treatment_Patterns_In_Metastatic_Breast_Cancer.pdf

A new analysis from Komodo Health pinpointed significant disparities by age and insurance in antibody-drug conjugate (ADC) treatment rates for metastatic breast cancer. 

Age-Related Disparities in ADC Treatment Rates in Breast Cancer: Tabby Khan, MD

Studies focused on applying deep-learning artificial intelligence (AI) models to mammography screenings have shown promising results in improving radiologist reading times and reducing false negatives 

 spoke with Robert Nishikawa, PhD, a professor in the Department of Radiology at the University of Pittsburgh, in light of Breast Cancer Awareness Month. Nishikawa’s career and research focus on breast imaging technology, development, implementation, and assessment.

Nishikawa discussed the practical implications and evolution of AI models used in mammography screenings to aid radiologists’ readings and advance 

 screenings for patients.

Recent developments in deep-learning AI models applied to mammography screening improved double-radiologist readings in the Netherlands while detecting a significant number of malignancies. However, when forced to match the high specificity of double-radiologist readings, its sensitivity was far less.



Contrary to European practices of double-radiologist readings, the US only requires a single reader with the assistance of computer-aided detection.

Whereas European studies supplement the second radiologist’s readings with deep-learning AI models, practical application is not as feasible for studies in the US, Nishikawa said. However, when used, it allowed radiologists to read screenings faster at a higher sensitivity and specificity, he said.

To further develop the accuracy of deep-learning AI models, Nishikawa suggested using them in clinical settings to gauge their effectiveness in the US. As the AI models cannot replace single-radiologist readings, Nishikawa emphasized it’s up to the radiologist to decide whether they want to use it or not. Within that, he explained that radiologists must maintain a certain level of trust when interacting with AI, as current algorithms are “very accurate.”

Clinical applications of AI models may also optimize survivorship care, as screenings are one of the primary points in follow-up care. In cases where there is a low likelihood of malignancy, AI can be used to expedite such cases, thus relieving radiologists’ workload so they can focus on more complex cases.

1. McCrear S. AI-assisted mammogram readings reduce radiologist workload and maintain performance. 

. August 20, 2025. Accessed October 22, 2025. 

https://www.ajmc.com/view/ai-assisted-mammogram-readings-reduce-radiologist-workload-maintain-performance

2. Taylor-Phillips S, Stinton C. Double reading in breast cancer screening: considerations for policy-making. 

. 2020;93(1106):20190610. doi:10.1259/bjr.20190610

AI-powered mammography is enhancing breast cancer screening and early detection through cutting-edge radiology insights.

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