Policy

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.

ACIP delayed the vote on the hepatitis B vaccine schedule amid ongoing controversy and misinformation surrounding vaccine safety and infant immunization.

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.

A national survey shows high overall trust in scientists, but confidence declines steadily with political conservatism.

Self-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.

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.

This commentary proposes a hybrid drug pricing reform model balancing most favored nation (MFN) benchmarking with domestic negotiation strategies that drive equity-focused valuation frameworks.

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

To 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.

McKesson's report highlights key trends in community oncology, emphasizing patient-centered care, precision medicine, and the need for innovative clinical trials.

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.

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

With ACA subsidies and key CMS payment models ending in 2025, premiums are set to rise, shifting costs to consumers and employers.

Svetlana Barbarash, MD, outlines the lack of cardiologists and transplant services in Las Vegas and the policy changes needed to close gender gaps in care.

A large cohort study found adolescents and young adults starting TMP-SMX faced a higher 30-day risk of acute respiratory failure than those on other antibiotics.

The quick turnaround between the introduction of Medicaid work requirements and implementation could leave many states spread thin, explains William Schpero, PhD, MPhil, MPH

Immune-boosting herbs were linked to lower autoantibody rates in patients before dermatomyositis onset, suggesting activation of alternative immune pathways.

Lower-income countries rarely gain timely access to FDA-approved drugs tested in their populations, highlighting major global and ethical disparities.

Clark Alsfeld, MD, discusses how telemedicine, pharmacists, and evolving policies help overcome financial and geographic barriers in oncology care.

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

Infectious disease was hit hardest by funding cuts to NIH grant for clinical trials that did not align with the Trump administration's priorities.

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

One in 5 of the highest-revenue drugs of 2022 was exclusively approved for rare conditions, accounting for more than 7% of US pharmaceutical spending.

Experts say proposed pharmaceutical tariffs could raise drug prices, impacting patient access and health care budgets.

One-third of F32 grant recipients secure follow-up NIH K awards, fueling new biomedical discoveries and career growth.

To mark the 30th anniversary of The American Journal of Managed Care, 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 November issue features a conversation with Laurie C. Zephyrin, MD, MPH, MBA, senior vice president for achieving equitable outcomes at the Commonwealth Fund. This interview has been edited for length and clarity.