Coverage of our peer-reviewed research and news reporting in the health care and mainstream press.
An article by Newsmax cited a study published in the August 2019 issue of The American Journal of Managed Care® (AJMC®). The study, “Influence of Out-of-Network Payment Standards on Insurer–Provider Bargaining: California’s Experience,” documented California’s experience implementing a policy to address surprise medical billing. Researchers found that out-of-network payment standards can influence payer-provider bargaining leverage, affecting prices and network breadth.
A PolitiFact article fact-checking a claim made by candidate Cal Cunningham in a debate against Senator Thom Tillis, R-North Carolina, cited a June 2018 article published on AJMC.com, “5 Things to Know About the CREATES Act.” The Creating and Restoring Equal Access to Equivalent Samples, or CREATES, Act aimed to foster a more competitive drug market by ending the “shenanigans” that delay competition from generic and biosimilar drugs. The PolitiFact piece explained that although Tillis initially opposed the CREATES Act, he supported it after amendments.
Urticaria Diagnosis Challenged by Overlapping Pruritic Skin Conditions
April 23rd 2025Urticaria is complicated to diagnose by its symptomatic overlap with other skin conditions and the frequent misclassification in literature of distinct pathologies like vasculitic urticaria and bullous pemphigus.
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New Research Challenges Assumptions About Hospital-Physician Integration, Medicare Patient Mix
April 22nd 2025On this episode of Managed Care Cast, Brady Post, PhD, lead author of a study published in the April 2025 issue of The American Journal of Managed Care®, challenges the claim that hospital-employed physicians serve a more complex patient mix.
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Personalized Care Key as Tirzepatide Use Expands Rapidly
April 15th 2025Using commercial insurance claims data and the US launch of tirzepatide as their dividing point, John Ostrominski, MD, Harvard Medical School, and his team studied trends in the use of both glucose-lowering and weight-lowering medications, comparing outcomes between adults with and without type 2 diabetes.
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ACOs’ Focus on Rooting Out Fraud Aligns With CMS Vision Under Oz
April 23rd 2025Accountable care organizations (ACOs) are increasingly playing the role of data sleuths as they identify and report trends of anomalous billing in hopes of salvaging their shared savings. This mission dovetails with that of CMS, which under the new administration plans to prioritize rooting out fraud, waste, and abuse.
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