Insurance

Constance Blunt, MD, medical oncologist, Mary Bird Perkins Cancer Center, discusses the potential consequences of losing free health care screening coverage.

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.

Adolescents face significant barriers to obesity medication access, despite a surge in prescriptions. Discover the disparities and potential solutions in obesity care.

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.

David Awad, PharmD, BCOP, says pharmacists play a growing role in managing access, safety, and toxicity for these therapies, ensuring treatments are appropriate and sustainable in real-world oncology practice.

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

Constance Blunt, MD, medical oncologist, Mary Bird Perkins Cancer Center, shares how one mobile health care initiative is addressing critical barriers to medical access for underserved populations.

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.

Mental health outpatient services decreased in adults aged 65 years and older who were eligible for Medicare.

Decisions made during the first few months of the Trump administration do not inspire confidence in Ali Khawar for further protections for parity in coverage of mental health.

A new State of Drug Access report shows that more than 40% of people living in the US could not afford their prescribed drugs.

It is unclear whether Congress would pass a law to codify or expand on the Mental Health Parity and Addiction Equity Act should the federal rule be appealed by the Trump administration, according to Ali Khawar.

The repeal of the federal rule could leave those with mental health and substance use disorders at risk of losing coverage for their treatment.

Veterans primarily receiving care through the Department of Veterans Affairs (VA) similarly used dental and vision services under Medicare Advantage (MA) and traditional Medicare, challenging the justification for full MA capitated payments based on supplemental benefits.

Emma Achola-Kothari, PhD, highlights the need to expand Medigap access for Medicare beneficiaries younger than 65 years and calls for future research connecting access barriers to health outcomes.

Emma Achola-Kothari, PhD, explains that younger Medicare beneficiaries without supplemental coverage face high costs, while dual-eligible beneficiaries in Medicare Advantage plans struggle with provider access.

Emma Achola-Kothari, PhD, explains that Medicare beneficiaries younger than 65 years without supplemental coverage face greater financial and access barriers to care, while dual-eligible individuals experience fewer of these challenges.

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

Proposed Medicaid cuts in the Republican budget proposal hold significant implications for health care access and coverage.

The Maryland All-Payer Model was associated with an increase in population-based rates of elective major joint replacements, with a more pronounced effect observed in Maryland-only hospitals.

Physician groups under 2-sided risk–based Medicare Advantage provide care associated with higher quality and efficiency compared with care by these same groups under fee-for-service Medicare.

Laundromats offer a promising outreach setting for Medicaid payers because Medicaid enrollees represent a majority of laundromat users and have disproportionately high levels of unmet needs.

Asembia’s AXS25 Summit covered a variety of relevant topics in the pharmaceutical industry, from the effects of the new administration to how artificial intelligence (AI) is reshaping the patience experience.

Timely outpatient telepsychiatry care for Medicaid enrollees was associated with lower hospitalization rates and comparable overall costs, supporting its potential role in value-based care models.

Self-paying patients can now obtain semaglutide at a lower cost through trusted telehealth providers.

Approximately 1 million Aetna members will need new coverage with the announcement that CVS will be leaving the Affordable Care Act (ACA) individual exchange business next year.

Experts urge for technology-driven, collaborative solutions as patients shoulder a growing burden of prescription costs.

New treatments for neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME) enhance patient care with gene therapies and new mechanisms of action on the horizon, explained Casey Koch, PharmD, from Select Health.

Early actions by the new administration signal major changes in health policy, taxes, and pharmaceutical pricing.