October 31st 2025
As open enrollment begins November 1, 2025, millions are signing up under enhanced subsidies that are set to expire at the end of this year.
Revumenib’s Safety Profile and Path to Formulary: Ivo Abraham, PhD, RN
July 20th 2025Revumenib is now the sole targeted therapy recommended by the National Comprehensive Cancer Network for KMT2A-rearranged acute leukemia, which opens a path for payers, said Ivo Abraham, PhD, RN, of The University of Arizona.
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Insurance Gaps Threaten Cancer Treatment Success
July 7th 2025Access to and affordability of immune checkpoint inhibitors, which can be lifesaving if patients receive them on time and under optimal circumstances, continue to top the list of reasons behind outcomes disparities for patients who have private insurance vs those who remain uninsured.
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Potential Health Literacy Resources for Health Plans: A Narrative Review
Several evidence-based health literacy resources may be beneficial in health plan settings to improve organizational health literacy, personal health literacy, and health equity.
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From Red Tape to Relief: Rewriting the Rules of Prior Authorization
June 23rd 2025Up to 257 million Americans could benefit from these prior authorization reforms that could have cross-market implications on health care plans administered through commercial insurers, Medicare Advantage, and Medicaid.
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Cost and Coverage Issues Drive GLP-1 Discontinuation: Hamlet Gasoyan, PhD
June 17th 2025Real-world cost barriers and insurance denials contribute to early discontinuation of injectable glucagon-like peptide-1 (GLP-1) receptor agonists, reducing their effectiveness for weight loss, explains Hamlet Gasoyan, PhD, Cleveland Clinic.
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How Value-Based Care With Provider Enablement Improves Maternal and Infant Outcomes in Medicaid
Supported value-based care improves prenatal care while reducing neonatal intensive care unit stays, preterm birth rates, low birth weight rates, and costs for mothers and infants.
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Utilization and Costs Among Oncologists Participating in a Private Insurance Shared Savings Model
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.
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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.
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Pharmacists Essential to Expanding CAR T, Bispecific Access: David Awad, PharmD, BCOP
June 6th 2025David 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.
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Mobile Services Improve Access to Preventive Care, Cancer Screening: Constance Blunt, MD
June 4th 2025Constance 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.
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Should Payers Incentivize Pharmacies to Blister-Package Chronic Medications?
Payers should consider providing higher reimbursement rates and/or preferred pharmacy networking status for pharmacies that provide chronic medications in blister packs for patients.
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Codifying the Mental Health Parity Federal Rule May Not Be on the Table: Ali Khawar
May 28th 2025It 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.
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