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Skylar is an associate editor for The American Journal of Managed Care® (AJMC®) and The Center for Biosimilars®, and joined AJMC® in 2020. She is responsible for covering all aspects of the ever-changing global biosimilar industry and produces content that is accessible and informative for all health care stakeholders.

She has a BA in journalism and media studies from Rutgers University. You can connect with Skylar on 

Articles

Researchers unveil a spatial multi-omics atlas revealing immune cell interactions and lipid metabolism's role in metabolic liver diseases, offering new therapeutic insights.

Detailed Liver Atlas Links Macrophage Activity to MASH Progression

Sabrina McCrear is an assistant editor for 

 (AJMC®), which she joined in 2025. She produces written and video content across a range of disease areas and manages social media platforms for 

Sabrina holds a B.A. in Journalism with a minor in Biology from Howard University in Washington, D.C. You can connect with her on 

New York City nurses continue their strike over staffing, safety, and benefits through negotiations on day 5 of the city’s largest nursing strike.

NYC Nurses Strike Enters Day 5 Amid Staffing, Safety, and Benefit Disputes

France approved botensilimab plus balstilimab for select ovarian cancers and soft tissue sarcomas, expanding early access to this dual immunotherapy.

France Expands BOT–BAL Immunotherapy Access for Ovarian Cancer and Soft Tissue Sarcoma

. Her work focuses on disparities and systemic inequities in care and access to the health system, as well as the impacts of health policy on various racial, gendered, and socioeconomic communities. She seeks perspectives from experts in internal medicine, health equity, community outreach, clinical research, mental health, and legislative policy.

, she delved into rare disease coverage at HCPLive

, a sister publication, where she fostered connections that extended beyond the research community into that of health advocacy, paving the way to her current role. Her work has been featured in 

NewsBreak, CHEST Today, Contemporary Pediatrics, Contemporary OB/GYN, Dermatology Times, Drug Topics, Managed Healthcare Executive, RamaOnHealthcare, and CGTLive.

In this week’s health equity news, ICHRAs may offer flexible health coverage options amid ACA subsidy uncertainties, and advocates rally for mental health funding stability.

Health Equity & Access Weekly Roundup: January 16, 2026

The American Journal of Managed Care provides insights into the latest news and research in managed care across multimedia platforms.

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J&J Agreement Brings 15 of 17 Pharma Companies Into Trump's Drug-Pricing Effort

Johnson & Johnson has joined a voluntary drug-pricing agreement with the Trump administration aimed at lowering costs and improving access to medicines, becoming the 15th of 17 major pharmaceutical companies to sign on. Under the deal, the company will sell most of its drugs to Medicaid at prices comparable to those in Europe and participate in TrumpRx.gov, a direct-to-consumer platform allowing Americans to purchase certain medicines at discounted rates, in exchange for a 3-year exemption from potential pharmaceutical tariffs. The agreement is part of a broader administration strategy that pairs voluntary industry commitments with the possibility of future regulation. Alongside the pricing deal, Johnson & Johnson highlighted its ongoing $55 billion investment in US manufacturing, research, and development through 2029, including major biologics and cell therapy facilities in North Carolina and Pennsylvania, which the company says will support access, innovation, and domestic job growth.

House Votes to Extend ACA Subsidies, Eyes Turn to Senate

The House of Representatives has passed legislation to extend Affordable Care Act health insurance subsidies, which were set to expire in early 2026 and could otherwise raise premiums and increase uninsured rates for millions of Americans. The bill advanced after a Democratic discharge petition forced a vote, with limited Republican support driven in part by political concerns, and ultimately passed 230-196 with 17 Republicans joining all Democrats. However, the measure faces significant hurdles in the Senate, where it lacks the 60 votes needed to overcome a filibuster, prompting bipartisan negotiations on possible compromises such as a shorter 2-year extension, income caps, health savings account provisions, and abortion-related restrictions. As talks continue, the fate of the subsidies remains uncertain, underscoring their importance to affordability and coverage for ACA enrollees as lawmakers weigh competing priorities heading into 2026.

Nimbus Therapeutics, Eli Lilly Partner to Develop Novel Oral Metabolic Drug

Nimbus Therapeutics has entered a multiyear research collaboration with Eli Lilly and Company to develop a novel oral small-molecule therapy for obesity and other metabolic diseases, expanding on a prior partnership launched in 2022 focused on AMP-activated protein kinase (AMPK) activators. Announced January 6, 2026, the agreement leverages Nimbus’ computational chemistry and structure-based drug design capabilities to address longstanding challenges in targeting AMPK, a key regulator of energy metabolism, with the goal of improving treatment options in obesity care. Under the deal, Nimbus will receive $55 million in upfront and near-term milestone payments and is eligible for up to approximately $1.3 billion in additional development, commercial, and sales milestones, along with tiered royalties. Both companies emphasized that a novel oral therapy could help overcome current barriers related to cost, access, and low uptake of existing obesity treatments, potentially expanding equitable access for patients with metabolic diseases.

CDC Reduces US Childhood Immunization Schedule From 17 to 11 Diseases

Federal health officials have announced sweeping revisions to the US childhood immunization schedule, reducing routine coverage from 17 diseases to 11, a move that public health experts say departs sharply from the long-standing, evidence-based process that has guided vaccine policy. Issued by CDC Acting Director Jim O’Neill under HHS Secretary Robert F. Kennedy Jr, the changes maintain universal recommendations for measles, polio, and pertussis but limit or condition vaccines for other diseases, including respiratory syncytial virus, influenza, rotavirus, and hepatitis A, prompting concern amid an already severe respiratory season. Experts and former CDC officials criticized the lack of transparency, scientific review, and involvement of the Advisory Committee on Immunization Practices, whose members were removed in 2025, warning the overhaul could increase confusion, reduce vaccine uptake, and endanger child health. The revisions follow a directive from President Trump to align US policy with other high-income countries, though critics argue such comparisons ignore key epidemiologic differences, and legal scholars have questioned whether the administration has the authority to enact the changes without formal rulemaking, despite assurances that insurance coverage for vaccines will remain unchanged.

OpenAI for Healthcare Aims to Streamline Clinical Workflows, Reduce Administrative Burden

OpenAI has launched OpenAI for Healthcare, a suite of GPT-5.2–powered, HIPAA-supportive artificial intelligence (AI) tools—including ChatGPT for Healthcare and its API—aimed at reducing administrative burden, supporting clinicians, and enabling custom clinical workflows, as the platform rolls out to major health systems such as AdventHealth, Memorial Sloan Kettering, and Cedars-Sinai. The tools offer capabilities ranging from chart summarization and documentation support to evidence synthesis with citations and integration of institution-specific policies, while maintaining governance controls and data protections. OpenAI also introduced ChatGPT Health, a consumer-facing tool designed to help patients better understand health information and prepare for care without replacing clinical decision-making. As adoption expands, experts have emphasized the need for careful implementation, highlighting both AI’s potential to accelerate evidence generation and personalize care and the ethical risks, particularly bias and inequity, that require rigorous validation, oversight, and responsible governance.

This week's news roundup covers updates in health policy, technology, and access to pharmaceuticals. 

Managed Care Cast News Roundup: January 13, 2026

On today’s episode of Managed Care Cast, 

 spoke with Sachin H. Jain, MD, MBA, CEO of SCAN Group and Health Plan.

 for 2026, covering several topics and pinpointing what may change in the new year. Many of these issues included the succession of artificial intelligence (AI) in the health care space, expansion of the Make America Healthy Again (MAHA) movement, increased demand for glucagon-like peptide-1 (GLP-1) agonist receptors, Medicare Advantage, digital health IPOs, and modest incremental policy movement.

During the interview, Jain expanded on his predictions, explaining how the short-term and long-term implications should come to fruition. Many of his predictions may have downstream effects should the Affordable Care Act subsidies expire at the end of the year. For example, GLP-1 receptor agonists will continue to grow and have been associated with the significant increase Americans are expected to see in their health care premiums next year.

Jain also predicted an increase in patient and provider dissatisfaction with the US health care system. Providers are “inflamed by flattening wages,” and 

authorizations are proving to be significant hurdles to adequate patient care, especially with the addition of AI. Whereas patients “have never felt more justifiably abused by US health care,” Jain wrote in his predictions.

 Government misinformation, specifically from HHS, combined with oversaturated, inaccurate health influencers on social media, is also fueling patient mistrust and the growth of the MAHA movement in the new year.

Lastly, Jain predicts that diversity, equity, and inclusion (DEI) initiatives will make a drastic return as companies and government entities recoil from the public scrutiny of their dismissal. In 2024, Jain predicted the Department of Government Efficiency would slash DEI programs and major industries and companies would follow suit, which materialized with more fervor than anticipated. This year, he hopes that DEI initiatives make a comeback with the same intensity.

1. Jain SH. 10 healthcare industry predictions for 2026. Forbes. December 1, 2025. Accessed December 18, 2025. 

https://www.forbes.com/sites/sachinjain/2025/12/01/top-10-healthcare-industry-predictions-for-2026/

2. Grossi G. Prescription costs and inflation drive 2025 health insurance premium hikes. 

. August 14, 2024. Accessed December 18, 2025. 

https://www.ajmc.com/view/prescription-costs-and-inflation-drive-2025-health-insurance-premium-hikes

Listen above or on one of these podcast services:

Sachin H. Jain, MD, MBA, discusses 2026 health care predictions, including AI adoption, GLP-1 demand, MAHA growth, DEI’s return, and policy shifts.

2026 Health Care Predictions: AI, GLP-1s, MAHA, DEI: Sachin H. Jain, MD, MBA

On this episode of Managed Care Cast, we dive into 

, or RTM, a topic of great interest in the physical rehabilitation industry. We are joined by Donovan Campbell, CEO of Medbridge, a leading provider of physical therapy education, currently serving approximately 360,000 clinicians and supporting 15 million patients annually.

 as part of the Calendar Year 2026 Physician Fee Schedule (CMS-1832-P), recognizing that RTM is critical for supporting physical therapy, patient health, and patient engagement. At its core, RTM is the fusion of in-person care with convenient, digitally provided care—a core component of what is known as hybrid care.

With CMS proposing new codes that materially 

—including the potential shift to allowing billing after just 2 days of data transmission—RTM has the opportunity to move from a niche category to a mainstream model of care delivery.

We will explore how this shift provides a crucial financial incentive for organizations, but more importantly, how the successful adoption of RTM enhances the clinical value proposition by improving population health, lowering overall costs, and tackling the problem of access barriers to conservative care.

Medbridge is working to refine remote therapeutic monitoring, or RTM, to transform physical therapy and enhance patient care.

From Niche to Mainstream: Transforming Physical Therapy by Refining Remote Therapeutic Monitoring

 talks with Barbara Kelley, executive director of the Hearing Loss 

Association of America. In the conversation, we discuss her organization's role in advocating for hearing loss awareness, breaking down 

, and empowering individuals through legislation and public 

. Kelley also highlights the importance of early intervention, advancements in hearing technology, and the social and 

 faced by individuals with hearing loss, advocating for better hearing health integration into overall wellness.

To learn more about integrating audiological care, psychological support, and mental health resources alongside hearing loss awareness, please click to read 

Discover how the Hearing Loss Association of America advocates for hearing loss awareness and hearing health integration through a dialogue with Barbara Kelley, executive director.

Advocacy, Access, and Awareness: Addressing Barriers in Hearing Health

) speaks with Laxmi Patel, chief strategy officer at Savista, about how the proposed federal Budget Reconciliation Act could 

, rural hospital dependence, or provider tax funding could face the most immediate disruptions and what payers can do to prepare.

, this conversation explores how coverage loss, 

, and administrative burdens may evolve if these reforms move forward—and what proactive, 

Laxmi Patel of Savista discusses how the Budget Reconciliation Act could widen Medicaid coverage gaps and strain hospitals across states.

How Medicaid Reforms Could Deepen State Coverage Gaps

This podcast originally premiered on The Center for Biosimilars

. This version is the audio-only version.

In this insightful podcast episode, host Giuseppe Randazzo, senior vice president of sciences and regulatory affairs at the Association for Accessible Medicines (AAM), welcomes former Sandoz executive and biosimilar expert Hillel Cohen, PhD, to discuss the evolving world of biosimilars. The conversation covers the scientific and regulatory landscape, touching on the progress in streamlining biosimilar development, the importance of following scientific advancements, and the potential for harmonization in global health regulations.

This special vodcast series provided by The Center for Biosimilars was developed in partnership with the AAM and Biosimilars Council. Check out 

 of the series featuring a discussion between Giuseppe Randazzo and Craig Burton, former executive director of the Biosimilars Council and current senior vice president of government affairs and policy at Fresenius Kabi.



Jeremias S. The Biosimilar Void: 90% of Biologics Coming Off Patent Will Lack Biosimilars. February 5, 2025. Accessed May 3, 2025. 

https://www.centerforbiosimilars.com/view/the-biosimilar-void-90-of-biologics-coming-off-patent-will-lack-biosimilars

Follow the Science: Bridging the Biosimilar Gap With Dr Hillel Cohen

Precision medicine has long shaped cancer care by tailoring treatment to the molecular profile of a patient’s tumor. But Sadie Dobrozsi, MD, medical director for genetic testing and oncology imaging at Evolent, says predictive genomics goes deeper, integrating a patient’s genetic makeup, family history, environment, and overall health to guide both risk reduction and treatment decisions.

Dobrozsi explains how predictive genomics 

 individuals with inherited mutations, such as 

, that increase cancer risk. This enables personalized risk-reduction strategies, ranging from enhanced screening, like breast MRI, to preventive surgery. While payer coverage for germline testing and screening has improved, coverage for more invasive interventions still varies.

Predictive genomics also shapes treatment planning, not only identifying which therapies may work but also who might avoid unnecessary toxicity. Genomic signatures in tumors can determine the need for chemotherapy in early-stage breast cancer or guide the use of targeted agents like PARP inhibitors in 

An emerging area, pharmacogenomics, may further refine treatment by revealing how individuals metabolize drugs, helping avoid ineffective dosing or severe adverse effects. However, Dobrozsi explains the field faces barriers, including data overload, ancestry bias in genetic databases, and inconsistent insurance reimbursement, especially for newer tools like circulating tumor DNA tests.

Evolent plays a key role by aligning clinical evidence with payer policy. Dobrozsi says her team evaluates test quality and relevance, helping health plans streamline access to the most clinically meaningful diagnostics.

As predictive genomics evolves, the goal is clear: “right-sizing” cancer therapy for each individual, using evidence to improve outcomes while minimizing harm.

Sadie Dobrozsi, MD, of Evolent, discusses how predictive genomics is pushing cancer care into a new era of personalization

Navigating Risk, Treatment, and Reimbursement in Precision Oncology: Sadie Dobrozsi, MD 

RFK Jr Sued by Medical Societies Over Unlawful COVID-19 Vaccine Rollbacks

Six major medical organizations and a pregnant physician have filed a lawsuit against HHS Secretary Robert F. Kennedy Jr, alleging that his removal of COVID-19 vaccine recommendations for pregnant individuals and children was unlawful, unscientific, and dangerous. Filed on July 7, 2025, in the U.S. District Court for Massachusetts, the suit argues Kennedy bypassed standard federal procedures and undermined expert guidance by dissolving the CDC’s vaccine advisory committee and replacing members with vaccine skeptics. The plaintiffs, including the American Academy of Pediatrics, American College of Physicians, and Society for Maternal-Fetal Medicine, warn that Kennedy’s actions are eroding public trust, spreading misinformation, and jeopardizing maternal and child health. They are seeking injunctions to halt the changes and restore science-based policy, emphasizing that Kennedy’s unilateral moves threaten decades of established vaccine infrastructure and the physician-patient relationship.

How AI Can Address the Troubled Business Model in Oncology

Over the past 15 years, oncology has experienced a technological revolution, from the adoption of electronic health records under the Affordable Care Act to today's emerging use of artificial intelligence (AI) to address mounting clinical and operational challenges. While groundbreaking therapies like CAR T-cell treatment and supportive services like navigation and palliative care have advanced care, community oncology practices now face a crisis: growing staff shortages, declining Medicare reimbursement, and increasing burnout. At a June 2025 meeting hosted by Tennessee Oncology, leaders highlighted how AI is no longer a future concept but a practical solution, helping streamline operations, support clinical decisions, and ease documentation burdens. Tools like Flatiron Assist, OncoSmart, and DeepScribe are enabling practices to deliver high-quality care more efficiently despite fewer resources. As costs rise and workforce gaps widen, AI may be the key to sustaining and expanding the gains of the past decade.

Insurance Gaps Threaten Cancer Treatment Success

A new cross-sectional study reveals that while immune checkpoint inhibitors (ICIs) have improved survival for patients with stage IV melanoma, non–small cell lung cancer (NSCLC), and renal cell carcinoma (RCC), the benefits are not evenly distributed across insurance types. Patients with private insurance experienced greater survival gains compared with those on Medicaid or uninsured, highlighting widening disparities despite widespread ICI adoption. The study analyzed data from over 183,000 patients between 2002 and 2019 and found that while survival rates improved across all groups after ICI approval, gaps persisted—and in some cases widened—especially for the uninsured. The findings suggest that expanding Medicaid coverage and offering financial assistance and patient navigation programs may help close these gaps. However, limitations such as a lack of data on cancer-specific mortality and insurance changes during treatment highlight the need for further research to understand and address the inequities in access and outcomes.

Without IRA Fix, COA Warns Community Oncology Practices Will Shut Down

The Community Oncology Alliance (COA) has issued a warning that provisions of the Inflation Reduction Act (IRA) could severely undermine community oncology practices unless Congress or CMS intervenes. In a detailed letter to CMS, COA criticized the upcoming shift in Medicare Part B drug reimbursement—from the current average sales price (ASP) plus 6% model to a lower "Maximum Fair Price" (MFP) plus 6%—as financially devastating, particularly for practices administering high-cost cancer therapies. COA also raised concerns about the operational burden of managing separate drug inventories and the increased costs tied to manufacturer rebate options. Combined with recent cuts to physician payments, fallout from the Change Healthcare cyberattack, and longstanding challenges like prior authorization and competition from 340B hospitals, COA argues the system is nearing a breaking point. The group is advocating for a legislative “carve out” to protect providers or, failing that, for CMS to use its authority to mitigate harm. COA leaders stressed the urgency of action ahead of 2028, when the IRA’s Part B price negotiation rules take effect, warning that smaller oncology practices may not survive without meaningful reform.

Practical Considerations for AI in Community Oncology

At a recent “Tech Innovations in Community Oncology” event, experts debated whether artificial intelligence (AI) can meaningfully improve daily oncology practice, amid skepticism rooted in past disappointments with electronic health records. Panelists highlighted how modern AI can now proactively analyze vast data sets, identify care gaps, and personalize treatment decisions, potentially easing physician workloads and improving patient outcomes. However, challenges remain, including data standardization, equitable access, funding, and ensuring clinical accuracy. Speakers emphasized that AI must remain a supportive tool, not a decision-maker, with validation and oversight shared across the health care ecosystem. While AI holds promise for transforming oncology care and reducing inefficiencies, success will depend on responsible adoption, robust infrastructure, and collaboration among providers, payers, and technology developers.

Medical societies challenge HHS Secretary Robert F. Kennedy Jr's COVID-19 vaccine rollbacks, and more news updates from the week. 

Managed Care Cast News Roundup: July 8, 2025

A recent national analysis commissioned by the Path Forward coalition reveals promising but disparate progress in expanding access to the Collaborative Care Model (CoCM). Anna Bobb, MPH, executive director of the Path Forward coalition, which unites health care stakeholders around actionable solutions to expand equitable access to 

 care, discusses how the proven, team-based approach that integrates mental health screening, treatment, and psychiatric consultation directly into primary care can help address the current mental health crisis.

, conducted by an independent global data firm for the Meadows Mental Health Policy Institute, examined 5 years of claims data for 219 million Americans, representing nearly two-thirds of the US population. It found a 10-fold increase in the use of the CoCM among commercially insured individuals from 2018 to 2023. Despite this growth, access remains limited: only an estimated 100,000 people with commercial insurance received care through the CoCM last year, representing less than 1% of the nearly 60 million adults and children with mild to moderate mental health conditions who could benefit.

The CoCM is available in all 50 states and has been shown to reduce depression recovery times 7-fold and improve patient outcomes through a collaborative team led by primary care providers and supported by behavioral health care managers and psychiatric consultants. More than 90 randomized controlled trials have demonstrated its effectiveness, yet start-up costs and uneven reimbursement remain major barriers to widespread adoption.

Path Forward, in partnership with the Meadows Institute and the American Psychiatric Association, released supporting materials, including 

 of coverage, and urged lawmakers to pass the bipartisan COMPLETE Care Act. This 

Explore how the Collaborative Care Model enhances mental health access in this episode featuring Anna Bobb, MPH, executive director of the Path Forward coalition. 

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