OneOncology Leaders Say Structure Allows Growth While Keeping Independence
December 18th 2025Leaders of OneOncology share how the managed services organization empowers independent oncology practices through advanced technology, clinical trials, and value-based care, enhancing patient-focused cancer treatment.
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Impact of Medicaid Institution for Mental Diseases Exclusion on Serious Mental Illness Outcomes
Medicaid’s Institution for Mental Diseases (IMD) rule bars federal funding for psychiatric facilities with more than 16 beds, but findings indicate that state waivers allowing treatment of serious mental illness in IMDs do not increase overall psychiatric hospitalizations.
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Price Transparency With Gaps: Assessing the Completeness of Payer Transparency in Coverage Data
December 9th 2025In 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.
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Trends in Hospital Pricing for Vulnerable Emergency Department Users, 2021-2023
December 4th 2025Self-pay emergency department prices rose significantly from 2021 to 2023, especially at for-profit and system-affiliated hospitals, highlighting growing affordability challenges for uninsured and underinsured patients.
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Managed Care Reflections: A Q&A With A. Mark Fendrick, MD, and Michael E. Chernew, PhD
December 2nd 2025To mark the 30th anniversary of The American Journal of Managed Care (AJMC), each issue in 2025 includes a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The December issue features a conversation with AJMC Co–Editors in Chief A. Mark Fendrick, MD, director of the Center for Value-Based Insurance Design and a professor at the University of Michigan in Ann Arbor; and Michael E. Chernew, PhD, the Leonard D. Schaeffer Professor of Health Care Policy and the director of the Healthcare Markets and Regulation Lab at Harvard Medical School in Boston, Massachusetts.
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Health Outcomes of Dually Eligible Beneficiaries Under Different Medicare Payment Arrangements
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.
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