Insurance

AI revolutionizes pharmacy by automating workloads, enhancing patient care, and navigating drug pricing challenges amid evolving federal policies.

New treatments, care gaps, and cardiac monitoring were major focuses in cardiovascular news this year.

Our top 5 obesity articles of 2025 highlight GLP-1 prescribing trends, insurance coverage, co-pay caps, real-world use, and access challenges.

The most-viewed content focused on the “One Big Beautiful Bill,” the Most Favored Nation drug policy, and other changes under the Trump administration.

From oncology to cardiology, Institute for Value-Based Medicine® conversations highlighted the ways value-based care is reshaping access, equity, and outcomes.

A last-minute push to extend Affordable Care Act subsidies was stopped as GOP leadership prevented an expedited vote, leaving the future of the subsidies uncertain.

With ACA subsidies expiring, experts warn coverage losses could worsen access to behavioral health care and emergency department strains.

Recent political shifts impacting health policy and access to care for millions dominated the news in 2025.

Value-based care adoption in employer insurance requires replacing fragmented point solutions with unified, at-risk performance contracts that align vendors, providers, and members around total cost and quality goals.

Self-insured employers face regulatory challenges when adopting value-based contracts, requiring careful data governance, standardized metrics, and legal frameworks to align with federal value-based care models.

Employers struggle to define value from health care spending amid complexity and misaligned incentives. Achieving measurable outcomes requires transparency, incentive realignment, and gradual, employee-centered change.

Financial and social barriers hinder access to specialized care and impact treatment outcomes for adolescents and young adults with leukemia.

Most Medicare beneficiaries perceived low health care burdens, but 1 in 4 Medicare Advantage enrollees with at least 6 chronic conditions experienced high administrative and financial burdens.

As value-based care mandates expand, a new survey highlights documentation burdens and burnout risks.

Democrats move to extend ACA subsidies as enrollment closes, leaving consumers uncertain about premiums, coverage, and alternative health options.

In analyzing 2025 Transparency in Coverage (TIC) files from national insurers, the authors found vast payer-level differences; overall, physician/outpatient data were more complete, and hospital inpatient data were less complete.

Patients with stage I to IIIA NSCLC had lower 2- and 4-year mortality in states that expanded Medicaid coverage.

As open enrollment continues, 77% of surveyed Americans were happy with their options for 2026 health care coverage, although cost concerns surfaced.

Connecting primary care providers and commercially insured adults to outpatient behavioral health services via a digital platform improved health outcomes and reduced medical costs.

With ACA subsidies ending in 2025, Ben Light explains how rising premiums may push individuals toward ICHRAs and reshape employer health coverage strategy.

A new study shows fee-for-service care is linked to higher odds of low-value surgery, suggesting salaried models may reduce unnecessary procedures.

New research shows immigrant children face higher odds of unmet medical needs as federal and state coverage rules narrow.

Within the same physician groups, 2-sided risk in Medicare Advantage (MA) was associated with higher quality and lower utilization for dually eligible beneficiaries compared with fee-for-service MA and traditional Medicare.

Medicare Advantage beneficiaries with mental health diagnoses see more nurse practitioners and fewer internal medicine and emergency medicine specialists after switching to traditional Medicare.

Shared savings reflects continued growth of long-term-care ACOs in Medicare’s value-based models.

The expansion of direct-to-consumer (DTC) pharmaceutical manufacturer models and the upcoming TrumpRx launch offer lower costs but create new complexities for patients.

Requiring individuals on Medicaid to report their work hours has been attempted in other states previously, with mixed results.

Targeted financing, clinician recruitment, and telehealth expansion are needed to improve rural primary care.

Cuts to Medicaid could spell trouble for pediatric health, as millions of children rely on Medicaid to cover their hospital expenses.

Chronic Conditions Data Warehouse comorbidity data vary by insurance status. Analyses using these data that fail to account for insurance status are subject to information bias.