Coverage of our peer-reviewed research and news reporting in the healthcare and mainstream press.
A study in the August issue of The American Journal of Managed Care® (AJMC®) interviewed stakeholders about the early effects of California’s policy addressing surprise medical billing and concluded that the state’s experience implementing the policy demonstrates that out-of-network payment standards can influence payer—provider bargaining leverage, affecting prices and network breadth. The study, “Influence of Out-of-Network Payment Standards on Insurer—Provider Bargaining: California’s Experience,” was featured in an article from RevCycle Intelligence.
Healthcare Finance News highlighted an article contributed to AJMC.com, the website of AJMC®, by America’s Health Insurance Plans that also examined the impact of the California policy to protect patients from surprise medical bills. The author of the article, “Can We Stop Surprise Medical Bills AND Strengthen Provider Networks? California Did,” wrote that in-network specialty doctors in the state have increased since the legislation passed.
A study published in the May issue of AJMC®, “Improving Provider Directory Accuracy: Can Machine-Readable Directories Help?,” was referred to in Benefits Pro’s article on provider directories. The study authors examined the accuracy of provider directories and found that machine-readable directories are not more accurate than conventional directories, despite their advantages.
OBR Oncology’s Monday newsfeed included an article from AJMC®’s sister site The Center for Biosimilars®. The article, “Given On-Body Injector Failure With Pegfilgrastim, Biosimilar Filgrastim Offers Greatest Cost Efficiency,” covered a recent cost simulation that found when taking into account that administering brand-name pegfilgrastim via an on-body injection device carries the risk of device failure, assured prophylaxis with biosimilar filgrastim offers the greatest cost-efficiency. Wednesday’s newsfeed included The Center for Biosimilars®’ article “Data From 11 Head-to-Head Trials Underscore Safety, Efficacy of Biosimilar Rituximab Products,” which reported findings from a new paper that may help allay some concerns that US providers may have about using FDA-approved biosimilar rituximab.
Wednesday’s daily newsfeed from the National Pharmaceutical Council featured AJMC®’s interview with Patty Taddei-Allen, PharmD, MBA, BCACP, BCGP, director of outcomes research, WelldyneRx, in which she discussed how feedback from patient-reported outcomes can help achieve better quality of life.
AI in Health Care: Balancing Governance, Innovation, and Trust
September 2nd 2025In this conversation with Reuben Daniel, associate vice president of artificial intelligence at UPMC Health Plan, we dive into how UPMC Health Plan builds trust with providers and members, discuss challenges of scaling AI effectively, and hear about concrete examples of AI's positive impact.
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Team Coordination, Data Sharing Help Prioritize Value in Cardio-Renal-Metabolic Care
September 12th 2025Cardiologists, nephrologists, and payers met in Scottsdale, Arizona, on August 26, 2025, to share insights on how team members can work together, empowered by data, to achieve value-based management of cardio-renal-metabolic syndrome.
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